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Fall Prevention Specialty Team
A fall is defined as “an unintentional change in position resulting in coming to rest on the ground or at a lower level” (Missouri Alliance for Home Care).
Fall prevention is a major component of patient safety. The Institute of Medicine (IOM), 2003, stated that patient safety is defined as the prevention of harm to patients, where harm can occur through errors of commission and omission.
No longer can health care providers just respond to patient incidents by investigating the reason for the fall and responding to prevent injuries. Decisive and progressive health care providers must search for a proactive approach to patient safety, including patient fall prevention interventions.
The Norwell VNA and Hospice Fall Prevention Specialty Team is committed to this approach and uses the following as their guideline.
Fall Prevention Definition:
Fall prevention in the home health setting is defined as a strategy that uses specific interventions to help specific patient or all patients avoid the risks of falling in an effort to reduce hospitalizations. Norwell VNA and Hospice utilizes the Four C’s approach ---Consistent, Cross Discipline, Coordinated, Culture.
Care Team
- An interdisciplinary Fall Prevention Team utilizing evidence based approach to assess and protect patients in the community that are at risk for falling.
- Team consists of experienced nurses, physical therapists, occupational therapists, and HHA representatives.
Services Provided
- Individual Fall Risk Assessments
- Client/caregiver participation in the development of a personal fall prevention plan.
- Evidence based fall prevention care pathways
- Intensive patient/caregiver education both verbally and in writing
- Outcome measures are defined and monitored
- Ongoing processes and systems to ensure there is equity for all individuals related to fall prevention assessment, harm reduction and interventions.
- Ongoing Benchmarking regarding Adverse Event related to Falls.
Elder Falling in Home Facts:
Consider the following:
- More than one third of adults 65 and older fall each year in the United States. [CDC]
- More than 30 percent of community-dwelling older adults fall at least once each year; of the 30%, half do so repeatedly. [AGS]
- In 2003 there were more than 309,500 hospital admissions for hip fractures [NCHS 2006]
- Of those who fall, one in forty will be hospitalized. Of those hospitalized only half will be alive at the end of the year [Kane et.al.1994)
- Almost 16,000 older adults died from falls in ‘05
Significance:
- Fall-related injuries recently accounted for 6 percent of all medical expenditures for people age 65 and older in the US
- In 2000 alone, direct medical costs totaled $179 million for fatal and $19 billion for nonfatal fall injuries [CDC]
- Falls, even without injury, often cause a person to develop a fear of falling, which in turn, limits their activity [CDC] and predisposes them to repetitive falls.
Falls are usually associated with health and aging conditions:
- Mobility problems due to muscle weakness or poor balance
- Loss of sensation in feet
- Chronic health conditions
- Vision changes or loss
- Medication side effects
- Drug interactions
- Home and environmental hazards such as clutter or poor lighting.
Community Outreach
The “Watch Your Step” Program is a community-based program, which combines a 1-hour educational program and an individual fall risk screen done by licensed professionals. This program is evidence based on the latest research about fall risk and prevention and offers seniors in the community recommendations to enhance living safely and independently at home or in their community dwelling. The “Watch your Step” screening includes a questionnaire of risk factors and a risk assessment including the “Timed Up and Go”, the Functional Reach, and the Romberg Test to assess balance with eyes closed. If you are interested in finding out more about this program please contact Laurie Galvin, Rehab. Manager, Norwell VNA and Hospice, at lgalvin@nvna.org or 781-659-2342.
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