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The Epidemiology of Falls

The Epidemiology of Falls. Nursing 702 Maria Lens, RN, MSN, PHN, FNP-BC. EPIDIMIOLOGY OF FALLS. Most common in older population and high rank in clinical problem. 40% of adults 65 and older fall at least once a year at home.

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The Epidemiology of Falls

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  1. The Epidemiology of Falls Nursing 702 Maria Lens, RN, MSN, PHN, FNP-BC

  2. EPIDIMIOLOGY OF FALLS • Most common in older population and high rank in clinical problem. • 40% of adults 65 and older fall at least once a year at home. • In hospital setting after a fall only half live after a year from a fall. • 2/3 of deaths from falls could have been prevented.

  3. In 2000, $0.2 billion was spent on fatal falls, and $19 billion on non-fatal falls. • Estimated to costs in 2020, $ 32.4 billion. • JCAHO implemented national safety goals to reduce falls. • CMS not reimbursing for health care needed after a fall if occurred in hospital. • Incidence of falls in hospital, 1.4 falls per bed per year

  4. Causes of falls

  5. Assessment Tools • Morse Fall Scale • Schmid Fall Scale • Hendrick Fall Scale

  6. Background • Acute care facility in suburb area • Schmid Fall Scale used • Pt assessed every 4 hours for falls on medical/telemetry, ICU, TCU, and peds, every 8 hours med/surg • Many falls occurring still despite interventions • Bed alarms, restraints, room near nurses station • One death this year from from after hip replacement due to fracture from fall.

  7. audits • Bed alarms not on • Score not same from observer. • Least restrictive restraint not used (lap belt)

  8. Data on Facility Falls

  9. Surveillance • Figure out PPV and NPV from Schmid Fall Assessment tool • Determine sensitivity and specificity • Look at retrospectively, for a years worth • Do case-control study. • Look for relationships, associations and causation

  10. Example: diseases (DM, Cardiac, Alzheimer's, CVA) • Diagnosis: (ETOH, ALOC, UTI) • Environment: Specific room, low-staffed day, skill mix • Determine odds/ratios to diagnosis

  11. Figure Odds/Ratio

  12. Health Promotion • Do pilot study based on outcomes from retrospective study. • Target most common reasons for falls at our specific facility. • Implement new interventions (low-beds, chair alarms, hip protectors) • After pilot study, determine outcomes

  13. If benefits are seen, implement change in policy and procedure for falls • Contact CNO, Director of adult care services. • Let it be known, it is evidenced-based practice. • Promote health and wellness.

  14. Conclusion • Change policy and procedure based on new data not on outdated policy. • Disseminate results • Decrease falls, injury from falls, and most important deaths

  15. References • Boyer, C. (2010). Falls by Quarter. (Email) • Gordis, L. (2009). Epidiomiology. (Fourth edition ed.). Baltimore, Maryland: Saunders Elsevier. • Jensen J. Nyberg, L., Gustafson, Y., & Lundin-Olsson, L. (2003). Fall and injury prevention in • residential care-effects in residents with higher & lower levels of cognition. Journal of   • American Geriatrics, 51, 627-635. • Rubenstein, L. (2006). Falls in older people: epidemiology, risk factors and strategies for   • prevention. Age and Aging, 35-S2, ii37-ii47. • Sizewise. (2010). Sizewise fall risk toolkit: Understanding fall risk, prevention, & protection., 1- • 37.

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