The Role of the US Trauma Centers in Older Adult Fall Prevention: A National Survey

2021 ◽  
pp. 000313482110475
Author(s):  
Lisa Allee ◽  
Mark Faul ◽  
Prathima Guntipalli ◽  
Peter A. Burke ◽  
Sowmya R. Rao ◽  
...  
Keyword(s):  
Injury Prevention ◽  
Older Adult ◽  
Fall Prevention ◽  
Prevention Program ◽  
Fall Risk ◽  
Screening Tools ◽  
Trauma Centers ◽  
Fall Prevention Program ◽  
American College Of Surgeons

Introduction Approximately 27.5% of adults 65 and older fall each year, over 3 million are treated in an emergency department, and 32 000 die. The American College of Surgeons and its Committee on Trauma (ACSCOT) have urged trauma centers (TCs) to screen for fall risk, but information on the role of TC in this opportunity for prevention is largely unknown. Methods A 29-item survey was developed by an ACSCOT Injury Prevention and Control Committee, Older Adult Falls workgroup, and emailed to 1000 trauma directors of the National Trauma Data Bank using Qualtrics. US TCs were surveyed regarding fall prevention, screening, intervention, and hospital discharge practices. Data collected and analyzed included respondent’s role, location, population density, state designation or American College of Surgeons (ACS) level, if teaching facility, and patient population. Results Of the 266 (27%) respondents, 71% of TCs include fall prevention as part of their mission, but only 16% of TCs use fall risk screening tools. There was no significant difference between geographic location or ACS level. The number of prevention resources (F = 31.58, P < .0001) followed by the presence of a formal screening tool (F = 21.47, P < .0001) best predicted the presence of a fall prevention program. Conclusion Older adult falls remain a major injury risk and injury prevention opportunity. The majority of TCs surveyed include prevention of older adult falls as part of their mission, but few incorporate the components of a fall prevention program. Development of best practices and requiring TCs to screen and offer interventions may prevent falls.

scholarly journals HOW TO STEADI YOUR PATIENTS WITH THE COORDINATED CARE PLAN TO PREVENT OLDER ADULT FALLS AND EVALUATION GUIDE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S857-S858
Author(s):  
Janice A Mark
Keyword(s):  
At Risk ◽  
Older Adult ◽  
Fall Prevention ◽  
Prevention Program ◽  
Fall Risk ◽  
Healthcare Providers ◽  
Care Plan ◽  
Coordinated Care ◽  
Fall Prevention Program ◽  
Risk Patients

Abstract Falls are common, costly, and the leading cause of fatal and nonfatal injuries for older Americans. Reports show that fall death rates are increasing. Healthcare providers play an important role in fall prevention but few talk to their patients about falls. This lack of communication demonstrates the need for more physician-initiated fall prevention. The Centers for Disease Control and Prevention (CDC) created the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative to help providers talk to their patients about falls. Specifically, CDC’s new STEADI-based fall prevention program, the Coordinated Care Plan to Prevent Older Adult Falls (CCP) and Evaluation Guide for Older Adult Clinical Fall Prevention Programs can assist healthcare providers in integrating and evaluating new fall prevention programs that screen older adults for fall risk, assess patients’ modifiable fall risk factors, and implement evidenced-based fall prevention interventions (e.g., medication management, physical therapy). The CCP offers guidance for incorporating a STEADI-based fall prevention program including how to engage leadership, integrate with existing clinic workflow and electronic health records, and strategies on how to obtain reimbursement for fall prevention. The Evaluation Plan offers details on how to engage stakeholders, collect data, interpret findings and how to share results for maximum impact. Both documents were based on lessons learned from successful implementation of STEADI-based programs in primary care. A STEADI-based program in New York found fewer fall-related hospitalizations among at-risk patients who received a fall prevention care plan compared to at-risk patients who did not receive a care plan.

scholarly journals Implementation of a Multicomponent Fall Prevention Program: Contracting With Patients for Fall Safety

2020 ◽  
Vol 185 (Supplement_2) ◽  
pp. 28-34
Author(s):  
Arrah L Bargmann ◽  
Stacey M Brundrett
Keyword(s):  
Patient Education ◽  
Literature Review ◽  
Fall Prevention ◽  
Prevention Program ◽  
Fall Risk ◽  
Assessment Tool ◽  
Evidence Based ◽  
Fall Rate ◽  
Prevention Measures ◽  
Fall Prevention Program

Abstract INTRODUCTION Falls during hospitalizations can increase the length and cost of a hospital stay. Review of patient safety reports on a 26-bed medical-surgical telemetry unit revealed that the number of falls went from 6 in 2015 to 12 in 2016. The reports identified a knowledge gap in the patient population and nursing staff related to high fall risk interventions. A literature review suggests that patient-staff safety agreements, in combination with proper implementation of Clinical Practice Guidelines, can successfully increase education and adherence to fall prevention measures and reduce the number of inpatient falls. MATERIALS AND METHODS The objective of this evidence-based practice project was to determine if the implementation of a patient fall safety agreement in combination with an existing evidence-based fall prevention bundle reduces the number of falls. Based on the literature review, the unit developed a multicomponent fall prevention program that emphasizes staff and patient education. The program consists of (1) assessment of the patient’s fall risk using the Johns Hopkins Fall Assessment Tool, (2) daily patient education on factors contributing to the patient’s fall risk during the shift assessment, (3) an educational handout on fall risk factors maintained at the bedside, (4) ensuring compliance with implementation of previously existing fall prevention measures, and (5) a patient fall safety agreement. RESULTS During the first 4 months, the fall rate decreased by 55% and staff compliance with interventions for high fall risk patients increased to 89%. To achieve added compliance, the unit implemented an incentive program, which resulted in the increased adherence to the fall risk interventions. The unit experienced 87 and 88 consecutive fall-free days, which was the longest consecutive days since May 2015. This project has reached sustainment and the unit continues to see a low fall rate, well below the national average for medical-surgical units. CONCLUSION One of the largest obstacles to this project was staff and leadership turnover. However, the project found that patient fall safety agreements facilitate a dialogue among staff and patients as well as encourage patients to take ownership of their own care. They improve the safety of patients and create a collaborative environment for nurses to conduct safe, quality patient care.

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