How to Prevent Falls and Fall-Related Injury in Your Institution

Transcription

1 How to Prevent Falls and Fall-Related Injury in Your Institution A Video Guide for Employing Breakthroughs in Clinical Care Facilitator s Guide A World of Resources in Geriatric Care 1

2 How to Prevent Falls and Fall-Related Injury in Your Institution Residents in long-term care and hospital patients fall three times more often than independently living older adults. In fact the numbers are staggering: 10% to 25% of falls in long-term care facilities result in hip fractures or hospital admissions. More than 1800 long-term care residents die every year from fall-related injuries. Falls result in significant negative complications and can greatly impact the effectiveness of an individual s care plan. Whether you work in a nursing facility or hospital, after viewing this program you will be able to: Describe the risk factors associated with falling, Design an effective fall prevention program to reduce the number and severity of falls, Use the tools you need to design care plans that prevent falls in the least restrictive way possible Discuss specific interventions that front-line caregivers and the interdisciplinary team can use to prevent falls and injuries. Lower your institutions liability Caring for your residents is your top priority. Residents and their families trust you to help protect them and their health. Understanding the risk factors and complications associated with falls and the tools used for preventing falls will help you to be proactive in planning and providing for the unique needs of residents at high risk. Above all, being educated and informed can help you make sure your residents receive the best possible care. This facilitator s guide will help you plan for and conduct sessions to help ensure that you maximize the material in this video. Consider your facility s protocol for preventing falls and caring for residents who do fall, and consider topics to engage in meaningful discussion regarding falls and fall prevention. This program will focus on defining common types of risk factors associated with falls, utilizing a fall prevention program, and discussing care planning for residents who do fall or pose the highest risk for falling. VIEWING GUIDELINES How to Prevent Falls and Fall-Related Injury in Your Institution is a video-based learning program. It supports the needs and motivations of health care professionals and staff that provide direct resident care. Conduct learning sessions for: All CNAs All RNs All newly hired CNAs and RNs PROGRAM CONTENT How to Prevent Falls and Fall-Related Injury in Your Institution is a practical educational tool. It demonstrates important methods and skills necessary to help care givers address the unique needs of residents who do fall or those at a high risk for falls. Filled with practical information and useful instruction, this video describes the incidence and relevance of falls, how falls can affect your residents and influence care decisions, and so much more. This video training provides a unique and interactive learning experience. In addition to the valuable learning information contained in the video and accompanying workbook, the video in-service provides opportunities for facilitated discussion to help involve participants in the acquisition of knowledge that helps 2

3 everyone to understand falls and how to utilize the tools at their disposal to prevent falls and reduce the severity of falls that do occur. SAMPLE GROUP SESSION AGENDA Use the following sample agenda to structure a session featuring How to Prevent Falls and Fall-Related Injury in Your Institution Length of videotaped program: approximately 25 minutes Suggested length of session: 1 hour and 45 minutes (including a 15 to 20 minute break) Materials needed: This facilitator s guide The How to Prevent Falls and Fall-Related Injury in Your Institution video program Optional paper and pencils for participant note-taking Optional flipchart and markers for writing key ideas SUGGESTED SESSION AGENDA Time Content 1 min Welcome the group to your session. 2 min Show first module of video program: Introduction 10 min INTRODUCE the How to Prevent Falls and Fall-Related Injury in Your Institution topic by leading this discussion: ASK: In your facility, how common are falls? How many residents do you care for on a regular basis that are at risk for falls or who have fallen? ASK: What steps do you take in your facility to attempt to prevent falls, reduce fall-related injuries, or address risk factors associated with falling? Review the learning objectives -- after viewing this program you will be able to: Recognize risk factors associated with falling Understand interventions that caregivers can use to prevent falls and reduce the severity of falls that do occur Utilize tools that help prevent falls in the least restrictive way possible Design a fall prevention program ASK: How are these learning objectives relevant in your facility? DISCUSS prior knowledge of falls, fall-related injuries, and risk factors associated with falling in the facility. Try to understand the group s prior knowledge so you can help reinforce good practices and change those that are incorrect. (Encourage discussion to help uncover staff knowledge). With this baseline, you can better understand how to focus later discussion and follow-up exercises. You can also realize how the learning sessions have helped to improve training. 5 min Show second module of video program Risk Factors 3

4 10 min Engage viewers in a brief discussion about MODULE 2. If group members are slow to respond, consider briefly recapping the main ideas emphasized in the first module (or the key situations and behaviors with which you feel your group can most easily relate). ASK: What percentage of your residents exhibits some of these risk factors? ASK: What are some of the most common intrinsic risk factors associated with falling that you see in your institution? ASK: What are some of the typical extrinsic risk factors associated with falling that you see in your institution? ASK: Are there any strategies and protocols in place at your institution that address these risk factors? If so, what are they? If not, do you find yourself addressing these risk factors in any other way? ASK: How do you think a thorough understanding of the most common risk factors associated with falling can affect care planning and the direct care you provide? ASK: What type of nursing interventions do you currently utilize as part of a fall prevention strategy? DISCUSS the general interventions currently in use at the participants facility. Allow them to talk about how they see their role in any fall prevention strategy and how that role can either be expanded or altered to better suit the needs or the residents under their care. 7 min Show third module of video program Intrinsic Risk Factor Assessment and Intervention 10 min Engage viewers in a brief discussion about MODULE 3. If group members are slow to respond, consider briefly recapping the main ideas emphasized in the second module (or the key situations and behaviors with which you feel your group can most easily relate). ASK: What types of intrinsic risk factors do you think you can change as part of any fall prevention strategy? ASK: What do you think is your role in the assessment of intrinsic risk factors that lead to falls and fall-related injuries? DISCUSS the participants views on the effectiveness of their facility s interventions and assessment methods that address intrinsic risk factors. Have they worked in the past? What would they change? What is their role? ASK: How is information regarding intrinsic risk factors associated with falling presented to members of the staff? Are caregivers made aware of the risks and any adjustments to resident care plans? ASK: How many residents with multiple intrinsic risk factors for falling do you care for on a daily basis? DISCUSS some of the differences in care planning for residents with different types of intrinsic risk factors for falling. How do the participants roles change as part of the care strategy when multiple risk factors exist? 4

5 15-20 min BREAK 1 min Welcome the group back from the break. 5 min Show fourth module of video program Extrinsic Risk Factor Assessment and Intervention 10 min Engage viewers in a brief discussion about MODULE 4. If group members are slow to respond, consider briefly recapping the main ideas emphasized in the third module (or the key situations and behaviors with which you feel your group can most easily relate). ASK: What types of extrinsic risk factors do you think you can change as part of any fall prevention strategy? DISCUSS the participants views on the effectiveness of their facility s interventions and assessment methods that address extrinsic risk factors. Have they worked in the past? What would they change? What is their role? ASK: How is information regarding extrinsic risk factors associated with falling presented to members of the staff? Are caregivers made aware of the risks and any adjustments to resident care plans? ASK: Are you made aware of your residents medication regimen, especially when they are on multiple medications that could lead to falls or fall-related injuries? ASK: What environmental risk factors do you see in your facility that can lead to falling? ASK: What are the protocols at your facility for addressing environmental risk factors for falling? What is your role in implementing those protocols? ASK: How do the protocols at your facility differ from the methods presented in this video? ASK: How are caregivers instructed to handle environmental risk factors for falling at your facility? How is your facility s method different from the method presented in this video? DISCUSS the use of side rails on beds. Is the practice currently in use as the participants facility? If so, why do they feel it is necessary? Have there been any complicating injuries as a result of the use of side rails? What other types of interventions or strategies can be used to minimize the use of side rails on resident beds? 5 min Show fifth module of video After a Fall 10 min Engage viewers in a brief discussion about MODULE 5. If group members are slow to respond, consider briefly recapping the main ideas emphasized in the fourth module (or the key situations and behaviors with which you feel your group can most easily relate). ASK: What steps do you take immediately after a resident falls? ASK: Does your facility have a specific protocol for tracking, reporting, and dealing with residents who do fall? If so, how is it different from the protocols highlighted in the video? ASK: According to your facility protocol, what role do you play following a resident fall? 5

6 DISCUSS the use of standard incidence reports at the participants facility. Is there any information that they feel is left off of their standard incidence reports that could help prevent future falls? If so, why? If not, why not? Go over a standard incident report provided by the facility. Try to point out grey areas where relevant information may be lost regarding a fall or important risk factors that exist. ASK: How are resident care plans commonly adjusted after a resident suffers from a fall? ASK: What steps are taken to prevent further falls or to protect the resident from fall-related injury? ASK: What role do you play in monitoring fall related interventions? Are a majority of interventions successful? What do you think can be done better to decrease the incidence and severity of future falls at your facility? DISCUSS the importance of interventions that consider resident needs by attempting to prevent falls in the least restrictive way. How do you properly balance resident safety with independence? 1 min Show Conclusion of video 5 min In closing: ASK for questions or additional comments from the group. DISCUSS as appropriate. Thank group members for their participation and conclude the session. 6

7 EXERCISES AFTER VIDEO How do you rate our current success in providing information regarding long-term care residents who fall or at high risk for falling? How do residents rate our success? What are some examples you ve seen in just the last week or two of: Risk factors associated with falling Instituting a fall prevention program to reduce the number of falls and severity of falls that do occur Behavioral issues that have affected care or led to a change in an individualized care plan Successes using interventions that prevent falls in the least restrictive way possible What can you do to help yourself and other members of the staff better understand falls, fall-related injuries, risk factors associated with falling, and how to provide the best care to safeguard resident health and quality of life? Suggest that participants accept a follow-up assignment as a proactive step in improving their understanding of how to provide for the unique needs of residents who fall or at a high risk for falling. For example, each participant might be asked to identify intrinsic and extrinsic risk factors throughout the facility that could lead to falls. Ask them to note how these risk factors are addressed and track the incidence of falls throughout the facility after the institution of these fall prevention programs. Participants could also track the success of interventions addressing those residents who have recently fallen. Then, hold a second meeting and ask each staff member to share what they have learned or any successes they have witnessed. Finally, as a group, establish a series of recommendations outlining how to best improve the care provided to residents who do fall or at high risk for falling. 7

8 For a complete listing of all our other programs available from Eldercare Communications go to: Eldercare Communications 680 Northland Blvd., Bldg C Cincinnati, OH elderinfo@eldercarecomm.com Phone: A World of Resources in Geriatric Care Geriatric Video Productions. All video and print materials contained in this program are protected by federal copyright. It is against the law to reproduce by any means any portion of this program. When you abide by the law, your cooperation and honesty allows us to serve you better and enables us to continue to offer high quality, affordable programs. 8