New Tools Help
Health Providers Reduce Patients’ Risk of Falls
By Carolyn M.
Clancy, M.D.
February 5, 2013
For older adults,
falls are serious, whether they take place in
the home or in a health care setting.
More than
one-third of adults over age 65 fall each year.
Falls can cause bone fractures, disability, and
even death. Among people 75 and older, falls are
far more likely to cause admissions into a
long-term care facility than for adults 10 years
younger,
Federal data show.
An
estimated 500,000 falls
happen each year in U.S. hospitals, causing
150,000 injuries. Patients have a higher risk of
falls if they--
- Have weak
muscles or problems walking.
- Take drugs
or a combination of drugs that make them
sleepy.
- Use a cane
or walker.
- Have chronic
conditions.
- Need to use
the bathroom frequently.
Health care
providers have known for a long time that falls
among patients are a serious problem. But they
haven’t always agreed on the best way to prevent
them.
This is changing,
which means you or your loved ones may be safer
from falls in the future.
Today, many
hospitals and long-term care settings use new
programs based on scientific evidence of what
works best. The goal is to make sure clinicians
understand the risk of falls, identify which
patients have the higher risk, and take steps to
reduce patients’ risk.
One program is an
AHRQ-funded project (PDF File,
Plugin Software Help) from a Wisconsin
health system, a health technology company, and
a university-based school of nursing. They
developed a computerized program with four
individual care plans, based on patients’ risk
for a fall and their ability to follow
instructions on how to prevent one.
The program helps
nurses develop fall-prevention plans that match
patients’ needs and that can go in patients’
electronic health records.
For example, the
program identifies patients who are usually at
low risk for falls but who may have an injury or
condition that increases their risk.
For these
patients, steps to reduce falls include--
- Making sure
they are carefully watched the first time
they get out of bed after surgery or a
procedure.
- Making sure
they or a family member understand the need
to call and wait for help before doing
something that could cause a fall.
- Helping them
identify hazards or behaviors that make a
fall more likely.
- Learning
safer approaches before they leave the
hospital.
Some patients are
at a high risk of falling but can follow steps
on how to prevent a fall.
For these
patients, steps to reduce falls include--
- Making sure
they understand why they should use a walker
or other device to help them move safely.
- Consulting
with the pharmacist or physician to be
careful about drugs that can increase the
risk of falls.
- Using an
alert system, such as wristbands, signs, or
other communication to warn of the risk of
falls.
We know that
communication and teamwork among health care
providers are important to reduce errors and
improve patient safety. In fact, up to 70
percent of medical errors, including falls, are
due to breakdowns in communication among health
care teams.
To address this
need, AHRQ and the Department of Defense have
developed a
teamwork system specifically for long-term care
settings. Known as TeamSTEPPS®, the system
is based on more than 20 years of research into
how teamwork improves safety. It is used in
hundreds of hospitals across the United States.
Early results
show that TeamSTEPPS improves safety and quality
in long-term care settings. For example, staff
using teamwork skills reduced the rate of
serious pressure ulcers among nursing home
residents by 48 percent.
Reducing the risk
of falls in hospitals and long-term care
settings is an important goal. New tools can
help health providers--and their
patients--attain it.
I’m Dr. Carolyn
Clancy, and that’s my advice on how to navigate
the health care system.
Resources
Agency
for Healthcare Research and Quality
Using a Computerized Fall Risk Assessment
Process to Tailor Interventions in Acute Care
http://www.ahrq.gov/downloads/pub/advances2/vol1/Advances-Hook_25.pdf
[Plugin
Software Help]
TeamSTEPPS
Long-Term Care Version
http://www.ahrq.gov/teamsteppstools/longtermcare/
Centers
for Disease Control and Prevention
Falls Among Older Adults: An Overview
http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html
National
Patient Safety Foundation
Key Facts about Patient Safety
http://www.npsf.org/for-patients-consumers/patients-and-consumers-key-facts-about-patient-safety/#Fal
Current as of February 2013
Internet Citation:
New Tools Help Health Providers Reduce
Patients’ Risk of Falls. Navigating the
Health Care System: Advice Columns from Dr.
Carolyn Clancy, February 5, 2013. Agency for
Healthcare Research and Quality, Rockville, MD.
http://www.ahrq.gov/consumer/cc/cc020513.htm
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