Fall Prevention II. Impact, Assessment and Hidden Risks. Webinar Education Series May 2016
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1 Fall Prevention II Impact, Assessment and Hidden Risks Webinar Education Series May 2016 Presented by Barbara E. West, RN, MSN, CWOCN and Capital Nursing Education
2 Fall Prevention II This webinar will address the following topics: 1. How falls impact the health care system 2. Making an accurate Fall Risk Assessment 3. Identifying dangers in the community 4. Fall prevention programs in your community 5. Community and educational resources All rights reserved. 2
3 Facts about Falls The Centers for Disease Control and Prevention reports: 1 of out every 3 people age 65 and older fall each year. Every 29 minutes an older adult dies from a fall. 1 out of 5 falls causes a serious injury such as a head trauma or fracture All rights reserved. 3
4 Impact on the healthcare system Medical costs Fall injuries total over $28 billion annually. Hospital costs account for 2/3 of the total. Hospitals Falls and Trauma is one of 10 hospital-acquired conditions (HACs) for which Medicare will not cover All rights reserved. 4
5 Making an Accurate Fall Risk Assessment Patient risk factors include: History of falls Confusion Age (over 65) Impaired judgment Sensory deficit Medications Unable to ambulate independently Decreased level of cooperation Increased anxiety/emotional lability Incontinence/urgency Cardiovascular/respiratory disease affecting perfusion and oxygenation Postural hypotension with dizziness Attached equipment (IV pole, tubes, etc.) Community safety hazards All rights reserved. 5
6 Fall Risk Assessment Tools Risk factors: Walking aid used Hx of dizziness, Parkinson s Fear of falling Hx of stoke, RA, Pain Antihypertensives, Sedatives, Antiepileptics History of falls Blood glucose >126 Lives alone Activity, Age, Vision, ADLs Number of drugs used All rights reserved. 6
7 Fall Risk Assessment Tools Current Risk Result: Predicts the risk as a probability 1.0 = 100% chance of a fall Fall prevention protocols and interventions can decrease the number of falls. To be effective, a prevention strategy requires a prior step to evaluate the fall risk of the subjects. Despite extensive research, existing assessment tools for fall risk have been insufficient for predicting falls All rights reserved. 7
8 Quick Assessment of Patient s Risk Timed Up and Go (TUG) Test Use this test to assess mobility. 30-Second Chair Stand Test This test will assess leg strength and endurance. 4-Stage Balance Test Assess balance using this test All rights reserved. 8
9 Hidden Dangers in the Community Sidewalk Cutouts Cutouts are now at all transitions. Change in level and angle are difficult to distinguish. New detectable warnings The bright color can warn of the transition, but they also bring additional risk All rights reserved. 9
10 Hidden Dangers in the Community Detectable Warnings Brightly colored with truncated domes. Present an uneven surface for walking and can be slippery when wet. Can be placed on flat or sloping transitions. Do not distinguish the surface, primarily to warn the visually impaired of entering traffic All rights reserved. 10
11 Hidden Dangers in the Community Doors and Entrances Variety in types of doors Manual Automated Fully automated Actuated Automation Difficulty Navigating Doors Double entrances Entryway grates Heavy doors Managing walking aids All rights reserved. 11
12 Hidden Dangers in the Community Automated? All rights reserved. 12
13 Hidden Dangers in the Community Escalators Difficult transitions Change of speeds, top & bottom Visual distinction Step height Other challenges Walking aids Balance Differing speeds, steps-vs-handrails Best solution, take the elevator! All rights reserved. 13
14 Hidden Dangers in the Community Wet Weather & Spills Be aware when coming in from wet or snowy weather Greatest risk with non-carpeted floors Beware if no entrance mats We think of this in the home/ bathroom, but must remember this as well All rights reserved. 14
15 Hidden Dangers in the Community Shopping: Parking Parking lots offer little space for exiting vehicles. Average parking space: 9 feet=108 inches Car width can be 76+ inches Subtract 6 for the doors and it can leave only 10 to exit All rights reserved. 15
16 Hidden Dangers in the Community Shopping: Grocery In-Aisle Promotions Multiple in aisle promotions Easy to back into, trip Appear in unexpected location All rights reserved. 16
17 Hidden Dangers in the Community Shopping: Retail Stores Race Track Layout Aisle confusing and difficult to navigate. Also with in-aisle promotions All rights reserved. 17
18 Fall Prevention: Physical aspects Regular exercise It is important that the exercises focus on increasing leg strength and improving balance, and that they get more challenging over time. Medication review by a doctor or pharmacist Identify prescription and over-the counter medicines that may cause side effects or interactions such as dizziness or drowsiness. Eye examination by an eye doctor at least once a year and update their eyeglasses to maximize their vision. Consider glasses with single vision distance lenses for some activities such as walking outside All rights reserved. 18
19 Regular Exercise Regular exercise Not hours at the gym! Make it fun Make it interesting Include each type of exercise Endurance Strength Balance Flexibility All rights reserved. 19
20 Endurance Endurance, or aerobic, activities increase breathing and heart rate. These activities help keep you healthy, improve fitness, and help do the every day tasks All rights reserved. 20
21 Endurance Endurance exercises improve the health of your heart, lungs, and circulatory system. They also delay or prevent many diseases that are common in older adults such as diabetes, colon and breast cancers, heart disease, and others All rights reserved. 21
22 Endurance Endurance activities will make it easier for you to: Push your grandchildren on the swings Vacuum Rake leaves All rights reserved. 22
23 Strength Even small increases in muscle strength can make a big difference in your ability to stay independent and carry out everyday activities such as climbing stairs and carrying groceries All rights reserved. 23
24 Strength Some people call using weight to improve your muscle strength strength training or resistance training. Strength exercises include: Lifting weights Using a resistance band All rights reserved. 24
25 Strength Strength training can maintain your ability to: -Carry a full laundry basket from the basement to the second floor -Carry your smaller grandchildren -Lift bags of mulch in the garden All rights reserved. 25
26 Balance Balance exercises help prevent falls Many lower-body strength exercises also will improve balance All rights reserved. 26
27 Balance Exercises to improve your balance include: Standing on one foot Heel-to-toe walk Tai Chi All rights reserved. 27
28 Balance Balance exercises can help you: Stand on tiptoe to reach something on the top shelf Walk up and down the stairs Walk on an uneven sidewalk without falling All rights reserved. 28
29 Flexibility Stretching can help your body stay flexible and limber. It will give more freedom of movement for your regular physical activity as well as for your everyday activities All rights reserved. 29
30 Flexibility To increase your flexibility, try: Shoulder and upper arm stretch Calf stretch Yoga All rights reserved. 30
31 Flexibility Flexibility or stretching exercises make it possible for you to: Look over your shoulder to see what s behind you as you back the car out of the driveway Make the bed Bend over to tie your shoes All rights reserved. 31
32 Exercise & Physical Activity From the National Institute for Aging All rights reserved. 32
33 STEADI Stopping Elderly Accidents, Death and Injuries Make fall prevention part of your clinical practice Learn to screen patients 65+ for falls, identify risk factors, and offer interventions. Continuing Education available for this free interactive course All rights reserved. 33
34 Fall Prevention Community and Educational Resources Centers for Disease Control and Prevention cdc.gov National Council on Aging ncoa.org Caregiver Action Network caregiveraction.org Shield HealthCare Community shieldhealthcare.com/community All rights reserved. 34
35 Fall Prevention Community and Educational Resources 6 Steps to Prevent Falls An infographic by National Council on Aging: Fall Prevention Awareness Week Sept , 2016: National Falls Prevention Resource Center Community Programs: pdf TIP Search keyword Fall Prevention at shieldhealthcare.com/community All rights reserved. 35
36 Fall Prevention II References: Aha-solutions.org CDC.Gov CMS.gov Payment/AcuteInpatientPPS/HAC-Reduction-Program.html Instruments/HomeHealthQualityInits/HHQIQualityMeasures.html Sage Journals All rights reserved. 36
37 Q & A Questions not answered during the live webinar will be answered via All rights reserved. 37
38 Fall Prevention II Impact, Assessment and Hidden Risks This concludes our presentation. Thank you for joining us. Special thanks to Barbara E. West, RN, MSN, CWOCN, and Capital Nursing Education All rights reserved. 38
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