Development and Implementation of a Pharmacy Fall Prevention Program

Abstract

Purpose Describe the development, implementation, and outcomes of a pharmacy fall prevention program (PFPP) that incorporates medication profile review and a medication fall risk score to identify high-risk patients. Summary Falls are a common cause of morbidity and mortality among elderly patients in the United States. Injury-related falls may contribute to frequent visits to emergency departments (EDs) and hospitals, as well as functional and emotional decline. Falls account for more than 10% of ED visits and more than 5% of hospital visits. Numerous reports describe common risk factors associated with falls of hospitalized patients and which safety measures should be taken to prevent or eliminate falls. The fall prevention program has a positive financial impact by reducing injury falls in hospitalized patients. During the first 2 years of implementation, the injury fall rate decreased from 2.06 to 1.07 per 1,000 patient-days (48%). The total falls rate decreased from 5.13 to 3.59 per 1,000 patient-days (30%). This program showed a savings of $217,000 per year in prevented falls. Conclusion Incorporating medications and their related adverse effects into a fall prevention program is an integral part of a multidisciplinary approach to reduce total falls and related injuries. The decrease in falls has improved patient safety and quality of care.

Medication-related inpatient falls: a critical review

“…A famous tool recommended by the Agency of Health Research and Quality (AHRQ, 2016) which is based on the study conducted by Beasley and Patatanian (2009) classified drugs according to the risk of falling for patients in hospital settings. This tool evaluates medication-related fall risk on admission based on a score.…”

Hospital falls prevention with patient education: a scoping review

“…Others used videotapes [62], handouts [32,54,57,65] or fall prevention posters [67] as single modalities. Some combined face to face discussions with handouts [28,29,56,68,71,74,75], videotapes [61,63], posters [69,72], or a combination of videotapes and handouts [30,31,38]. Yet others combined handouts with videotaped education [55,70], posters [76], or with posters and videotapes [33].…”

“…Others either reported the raw number of falls in intervention and control groups [35, 52, 53, 56, 69-71, 75, 76], falls risk ratio (ratio of cumulative fall incidence in intervention group to control group) [30,34,38,52], falls rate ratio (ratio of fall incidence rate in intervention group to control group) [38,53,57], or odds ratio (ratio of the odds of falling in the presence or absence of the intervention) [38,65]. The injury rates associated with falls were sometimes given [28,32,38,54,68,70,71,73]. Most of the trials showed an improvement in falls outcomes, with seven reporting otherwise [28,30,52,53,56,66,71].…”

“…Most of the trials showed an improvement in falls outcomes, with seven reporting otherwise [28,30,52,53,56,66,71]. Other outcomes included the impact of falls prevention interventions on staff knowledge and practice [31,58,71], patient adherence to the falls prevention interventions [32,61,69], changes in gait and balance [66], and economic outcomes [64,68,69]. Overall, the literature showed positive benefits of hospital falls education.…”

Development of a Risk Assessment Tool for Falls Prevention in Hospital Inpatients Based on the Medication Appropriateness Index (MAI) and Modified Beer's Criteria

“…Sources of information would be systematic reviews, rating the available evidence using a standardized taxonomy, rather than expert opinions and integrating meta-analyses, such as the ones on drugs in older people conducted for psychotropic [21] and cardiac and analgesic drugs [43]. [44]. These authors suggest that a score greater than 6 may warrant further in depth-medication review.…”