TIP OF THE WEEK
Falls Management
DEFINE A FALL
The Minimum Data Set (MDS) defines falls in several different ways, and the distance to the next lower surface is not a factor in determining if a fall has occurred or not. The following are examples of incidents that should be considered falls: An intercepted fall, a fall without an injury, and rolling off a low bed onto a mattress. When a resident is found on the floor, unless there is evidence to suggest something else, the most logical conclusion is that the resident has fallen. The reason to report these various incidents as falls is to communicate and identify resident problems or potential problems so the staff will consider and implement interventions. (TAP 2007)
WHY STUDY FALLS
- About 51 percent of residents in long-term care fall annually.
- About 10 to 20 percent of nursing home falls cause serious injury.
- About 1,800 fatal falls occur among nursing home residents in the US each year.
- Two-thirds of lawsuits filed against nursing homes are associated with falls and related fractures.
(TAP 2007)
CONSEQUENCES OF FALLS
- Mild to severe injury
- Increased morbidity and mortality
- Loss of independence
- Fear
- Decreased activity
- Decreased quality of life
(TAP 2007)
CHANGING OUR THINKING
Falls are no longer assumed to be “accidents” that either cannot be prevented or are the fault of the people who fell. Research indicates falls are a “non-specific sign or symptom” that represents an underlying condition. Most falls are due to a combination of physical, life-style, environmental and social factors that can be assessed and may be modified to decrease fall risks. (AQAF 2001)
Dial in to the Ohio Person-Centered Care Coalition teleconference on Thursday to learn more:
GUIDELINES AND CODING FOR RESTRAINTS TELECONFERENCE
Featuring Carla Brumby and Patsy Strouse, Ohio Department of Health
November 8, 2007 1:00 p.m. to 3:00 p.m. Dial-in: 1.866.256.9239
COMMUNICATION AND CREATIVITY
Don’t forget, an intervention may work for one resident but not another. Be creative by having the staff help develop protocols and interventions. A falls team can provide valuable input to increase the safety of your residents. Make sure there is a good line of communication to all staff on all shifts in regard to interventions and protocols. Together, you can decrease falls!
RESOURCE SPOTLIGHT
The Ohio Department of Health, Division of Quality Assurance, Technical Assistance Program (TAP) provides educational training opportunities in the following topic areas: self care for seniors, functional improvement project, early detection, urinary incontinence performance improvement project, prevention and investigation of abuse, effective leadership, nurse aide series, and falls management.
These programs are free, voluntary and non-regulatory. The TAP Nurse Educator will assist with implementation of the programs and provide education for your staff. Implementation of these programs can be customized for your facility. For more information and/or to schedule an inservice, contact the Nurse Educator in your area at the phone number listed below.
Shannon Richey, RN – TAP Program Manager – 614.728.3329
Bridget Orqvist, RN, CPHQ – Nurse Educator – North – 440.213.8044
Dottie Swingley, RN – Nurse Educator – South – 513.582.6303
Kathryn Costa, RN, BSN, MSA – Nurse Educator – East – 330.204.3797
Shirley Wamsley, RNC – Nurse Educator – West – 937.657.7377
IN THE NEWS
DOCTORS MAKE HOUSE CALLS TO THE ELDERLY
October 28, 2007 -- Cleveland Plain Dealer -- Seniors who can't leave their homes benefit from individual attention. Changes in Medicare reimbursement rates in 2005 have challenged the idea of physician house calls, but some systems are finding ways to make it work. Read more >>
VISUAL FIELD LOSS PRIMARY COMPONENT IN RISK OF FALLS FOR OLDER ADULTS
October 30, 2007 -- Association for Research in Vision and Ophthalmology (ARVO) -- Visual field loss (specifically peripheral visual fields) is the primary vision component that increases the risk of falls, according to a study published this month in Investigative Ophthalmology and Vision Science, a peer-reviewed monthly publication of ARVO.
For each 10 percent loss in the visual field, people in the study experienced an eight percent higher chance of falling after adjustment for other risk factors for falls. For example, persons with bilateral glaucoma, who on average would miss 48 points in the total visual field, would have 46 percent higher odds of falling. Read more >>
HHS ANNOUNCES PROJECT TO HELP 3.6 MILLION CONSUMERS REAP BENEFITS OF ELECTRONIC HEALTH RECORDS
October 31, 2007 -- eGov Monitor -- In a move that will improve health care for millions of Americans, HHS Secretary Mike Leavitt today announced a five-year demonstration project that will encourage small to medium-sized physician practices to adopt electronic health records (EHRs). Read more >>
AT ELIZA JENNINGS NURSING HOME, CARE IS GEARED TO INDIVIDUAL RESIDENTS
October 31, 2007 -- Cleveland Plain Dealer -- "It was a cultural change -- at 7:00 a.m. we used to go to their rooms, wake them up and get them to breakfast," said nursing assistant Edna Torres, who has worked at the home for 24 years. Eliza Jennings has made vast improvements in providing person-centered care, such as grouping residents into neighborhoods or households and providing the freedom of choice to residents. Read more >>
CMS TO END NPI CONTINGENCY PLAN FOR MEDICARE BILLING: NPI MUST POPULATE PRIMARY FIELDS ON JAN. 1, 2008
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) contains a provision requiring the assignment of single national provider identifiers (NPI) to healthcare providers that meet the definition of covered entities. Covered entities include health plans, healthcare clearinghouses, and healthcare providers that transmit any health information in electronic form, with the exception of small providers. The purpose of this requirement is to improve the efficiency of electronic transmissions. The NPI final rule was published in the Federal Register on Jan. 23, 2007. According to the final rule, covered entities were to be in compliance no later than May 23, 2007.
OHIO KEPRO EVENTS
Guidelines and Coding for Restraints Teleconference
Featuring Carla Brumby and Patsy Strouse, Ohio Department of Health
November 8, 2007 1:00 p.m. to 3:00 p.m.
Dial-in: 1-866-256-9239
INDUSTRY EVENTS
Reducing the Use of Alarms in the Nursing Home
Ohio Person-Centered Care Coalition Teleconference
November 6, 2007 1:00 p.m. to 3:00 p.m.
Questions? Call Amanda Trzcinski at 1-614-568-0512 or Leasa Novak at 1-800-385-5080, x2208
The Many Facets of Pain Management: An Integrated Approach
November 7, 2007, 8:00 a.m. to 4:30 p.m., MetroHealth Medical Center, Cleveland. Call (216) 778-7707 for more information.
Cuyahoga Community College Fall 2007 Calendar:
Continuing Education for Gerontology Professionals
Medicare Learning Network:
Learning resources and products for the healthcare professional.
Alzheimer’s Association Training Events
Case Western Reserve University School of Medicine Courses
Ohio Department of Health, Technical Assistance Program – New Programs
Ohio Health Care Association Events
An archive of The Nursing Home Weekly Update is available on our Web site. Click here >>
