Reducing falls in a care home

Abstract

Care home residents are 3 times more likely to fall than their community dwelling peers and 10 times more likely to sustain a significant injury as a result. 2 A project commenced at a care home in Aberdeen with the aim of reducing the number of falls by 20% by 30st April 2016 using the model for improvement. Qualitative data was gathered to establish staff belief about falls and their level of knowledge& understanding about falls risks and how to manage these. This informed the training which was delivered and iterative testing commenced with the introduction of the Lanarkshire Falls Risk/Intervention tool – where the multifactorial nature of a resident's falls risks are explored and specific actions to manage these are identified and implemented. Failure to meet PDSA predictions about sharing risk reducing actions with staff and length of time to complete the tool prompted a focus on communication and the processes whereby the tool is completed. “Teach back” was employed to highlight communication difficulties and ultimately the introduction of Huddles out improved the flow of information about residents and informed the Falls Risk/Intervention tool. 5 PDSAs were completed and within them multiple tests of change. The improvement shift came following a root cause analysis of the nature & cause of one resident's falls and applying the tool & communication processes. The average falls rate fell from 49 per 1000 occupied bed days to 23.6 and was sustained because of the attention to the importance of communication. The aim was achieved with a 36.6% reduction in Falls rate.Care home residents are 3 times more likely to fall than their community dwelling peers and 10 times more likely to sustain a significant injury as a result. 2 A project commenced at a care home in Aberdeen with the aim of reducing the number of falls by 20% by 30th April 2016 using the model for improvement. Qualitative data was gathered to establish staff belief about falls and their level of knowledge& understanding about falls risks and how to manage these. This informed the training which was delivered and iterative testing commenced with the introduction of the Lanarkshire Falls Risk/Intervention tool - where the multifactorial nature of a resident's falls risks are explored and specific actions to manage these are identified and implemented. Failure to meet PDSA predictions about sharing risk reducing actions with staff and length of time to complete the tool prompted a focus on communication and the processes whereby the tool is completed. “Teach back” was employed to highlight communication difficulties and the introduction of Huddles improved the flow of information. 5 PDSAs were completed and within them multiple tests of change. The improvement shift came following a root cause analysis of the nature & cause of one resident's falls and applying the tool & communication processes. The average falls rate fell from 49 per 1000 occupied bed days to 23.6 and was sustained because of the attention to the importance of communication. The aim...

Como Avaliar O Risco De Queda Em Idosos Institucionalizados?

“…; a St. Thomas Risk Assessment Tool (15,19) , a Escala de Downton (15,(17)(18)(19) , a Falls Risk Assessment in the Elderly (FRASE) (20) , a Morse Falls Scale (MFS) (27)(28) ; a Fall Risk Assessment (FRA) (27) , o Timed Up and Go Test (TUGT) (16,(23)(24)28) , o Berg Balance Test (BBS) (23)(24) , a Escala de Barthel (19,24) , o One-Legged Stance Test (OLST)…”

“…Tal como as escalas utilizadas em meio hospitalar, observa-se que os principais indicadores estão relacionados com a mobilidade, o estado mental, a incontinência, a polimedicação e a história prévia de quedas (9,15,17,(19)(20)(27)(28)(36)(37) .…”

“…Figura 1 -Fluxograma de seleção dos artigos para a revisão integrativa Fonte: Elaboração própria. , dois suecos (17)(18) , um belga (8) , um português (11) , um alemão (19) , um escocês (20) , um italiano (21) , um holandês (22) , um sérvio (23) , e um polaco (24) . Os outros estudos foram realizados na China (25) , no Irã (9) , na Turquia (26)(27) , nas Filipinas (28) e Canada (29) .…”

Managing patients in care homes

“…This is the point at which a Comprehensive Geriatric Assessment (CGA) should be performed; a CGA is a multifactorial complete assessment of the resident (British Geriatric Society, 2019). There is evidence that fall-prevention-specific tools may also help, and allow development with the nursing home of a personal prevention plan for each resident (Care Inspectorate, 2019;Cooper, 2017).…”

End-Users and Caregivers’ Involvement in Health Interventional Research Carried Out in Geriatric Facilities: A Systematic Review

“…This increased aging is associated with increased health issues, such as chronic diseases and falls, as well as undernutrition or drugs management, particularly in geriatric institutions where elderly people are commonly institutionalized [3]. Residents of nursing homes are three times more likely to fall than a similar group in the general population [4], while malnutrition is frequent in nursing homes [5]. In addition, low back pain is frequent in nursing homes where patient handling is common [6].…”