Falls Prevention Program

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1 Falls Prevention Program Sun Country Health Region Presented by Larisa Murray Falls & Injury Prevention Coordinator SunCountry Health Region Therapy Services

2 Quote It takes a child one year to acquire independent movement and ten years to acquire independent mobility. An old person can lose both in a day. - Bernard Isaacs The Challenge of the Geriatric Medicine

3

4 Defining A Fall WHAT IS A FALL? o A fall is unintentionally coming to rest on the ground, floor or other lower surface with or without injury WHAT IS A NEAR FALL? o Catch yourself before you fall to the ground. o Near falls can be warning signs of future falls.

5 Results Of Falls Decrease Mobility Loss of Independence Increased cost to the Health Care System Death

6 Results Of Falls 73% of those falls are females BUT, men are more likely to be injured

7 Results Of Falls 900 Saskatchewan seniors will fall and fracture a hip

8 Results of Hip Fractures 40% 50% 60% 25% 20% RECOVER FULLY LTC WALKING AID DIE LOSS OF MOBILITY

9 Sun Country Health Region Stats In the fiscal year, there were 2,850 patient safety incident reports submitted and the #1 reported incident was falls at 1,597 (56%). In , we had 119 people fall out of 744 residents. That s a 16% resident fall rate compared to the provincial resident fall rate of 21% The two highest contributing factors for falls in LTC were poor balance and generalized weakness.

10 Saskatchewan STATS Falls are the #1 cause of injuries in older adults. 69% of Saskatchewan seniors experience a serious fall. Of the seniors who have fallen 25% decide to limit their daily activities because they fear falling again - reducing their quality of life. The risk of falling is higher among seniors who have had a previous fall, resulting in multiple hospitalizations

11 Saskatchewan STATS 7% of seniors admitted with hip fractures die in hospital within 30 days of admission 36% will die within 12 months % of all admissions to long term care are due to falls

12 Saskatchewan STATS Injury from falls account for 36% of the Saskatchewan s annual economic burden. Of the $125 million in direct costs spent on falls, 82% (or million dollars) is devoted annually to falls among the Saskatchewan seniors population.

13 Risk Factor Of Falling Behavior Lifestyle & Health Environment Social

14 Behavioral Risks Not paying attention Rushing Taking Risks Climbing on unsteady furniture Fear of falling Not using mobility aid

15 Lifestyle & Health Risks Poor Balance Previous Falls No Physical Activity Lower extremity weakness or injury Have frequent slips, trips or near falls Blackouts/Dizziness Foot problems Unsafe footwear Multiple Medications Poor Vision Poor nutrition or hydration Chronic Diseases

16 Environmental Risks Slippery floors Poor lighting Clutter on stairs Scatter rugs Ice and snow on sidewalks Poor building design, no curb ramps, no rest areas etc. Lack of hand rails or grab bars

17 Social/Economic Risks Low Income Lack of Education Illiteracy/language barriers Poor living conditions/unsafe housing Poor social environment Living alone Lack of support networks and social interactions

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19 Home Care & Fall Prevention

20 Falls Prevention Program The aim is to reduce falls and injury from falls in Home Care clients with completed MDS by 20% by March 2012 (Sk. Collaborative). The SCHR program is to protect and promote client safety and well being. The client is to be reassured that this program is to keep them active and independent so that can be safe and remain longer in their own homes. This is a Client Driven program.

21 Admitting You had A Fall

22 Fall Risk Interventions There are 3 interventions: 1. Home Assessment 2. Timed Up & Go (TUGS) 3. Fall Risk Questionnaire (FRQ)

23 Your Next Step Your Next Step Falls Prevention Program

24 Long Term Care & Fall Prevention

25 Goal of Falls Program To reduce the number of falls in LTC by 5% and the number of surgeries from residents falling by 5% by March 31 st, 2013.

26 LTC Falls Program LTC & HC were involved with the Sask. Falls Collaborative from May 2011 March Health Ministry set up a LTC Falls Group in July 2012 to help reach the goal. To obtain these goals, we gathered data, educated staff, residents and families, using the Falls Bundle and shared ideas from every region in the province.

27 ASSESSMENT TOOLS TLR Assessment Form Scott Tool Falls Interventions Falls Prevention Strategies From Referral to other health professionals Incident reports Falls Tracking Tool Patient Safety Checklist Falls Reviews

28 Re-assessing A Resident o After a fall with injury o After a serious fall with or without injury o After more than 3 falls in 2 weeks o A change in condition o Annually

29 FALLING STAR If you see this falling star it means that this resident has had a past history of falls and we want to keep a special eye on them. If you notice this resident having any difficulties, notify nursing staff immediately The logo will be located by their room door and in their care plans.

30

31 Acute Care & Falls Prevention

32 Assessment Tools Morse Scale Falling Stars Falls Interventions Falls Calendar Falls Reviews

33 Fall Prevention: Universal Fall Precautions (SAFE) for all Safe Environment Assist with Mobility Fall Risk Reduction Engage Patient and Family

34 Mental Health Inpatient Unit

35 Falls Program Started April 2012 Assessment Tools: Falling Star Edmonson Form Falls Interventions Recreation Therapist Incident Reports Falls Calendar

36 Vitamin D & Falls The major biologic function of vitamin D is to maintain normal blood levels of calcium and phosphorus. Vitamin D aids in the absorption of calcium, helping to form and maintain strong bones (Mayo Clinic, 2010). In Canada, our risk of vitamin D deficiency increases in the winter because we are not exposed to the sun and the absorption of vitamin D in the skin doesn t occur. In LTC facilities, the risk of vitamin D increases dramatically due to age, immobilization and seldom exposure to the sun.

37 Other effects of Vitamin D Vitamin D has also been shown to help reduce the risk of other diseases: Osteoporosis Cancer Prevention Chronic Pain Prevention Protection Against Autoimmune Diseases Reduced Risk of Cardiovascular Disease Multiple Sclerosis (MS) Diabetes (types 1 and 2) Reduces inflammation

38 How does Vitamin D help? Studies have shown that older adults who take vitamin D show improvements in the following: o Improved postural stability by 13% o Improved reaction time by 15% o Decrease in body sway o Linked to walking speed o 49% decrease in falls when vitamin D is taken with Calcium in comparison to just taking Calcium. o 30% reduction in hip fractures and 14% reduction in other vertebral fractures

39 Recommended amount of Vitamin D The recommended amount of Vitamin D each day for seniors is 1,000 IU to 2,000 IU. The upper limit is 4,000 IU.

40

41 YOUR Role in Fall Prevention Keep high traffic areas clean and clutter free. Make sure there are no wet spots on the ground. Assist any older adults who may need help. Watch for tripping hazards, such as rugs, cracks on sidewalks, cracks in flooring and report it to the appropriate person If you witness a fall, report it to the appropriate person and/or call 911. Learn who High Risk Fallers are and watch them more closely.

42 Maintenance & Housekeeping Staff Put up signs when you are washing floors so that people don t slip and fall Watch what time your washing the floor ie. Don t do it right before lunch in the dining room area If you have to clean a toilet with a raised toilet seat, make sure it is on correctly before leaving the bathroom. Make sure to not have anything laying out that would cause someone to trip and fall (reduce clutter)

43 3 Questions Ask theses 3 questions before leaving any residents/patients room: Do you need to use the bathroom? Are you comfortable? Do you need anything before I leave? Other questions to think about: Is the call bell within reach? Is there adequate lighting? Is there a clear path to the bathroom?

44

45 Importance of being Active Being active has been proven over and over to help reduce falls and improve your everyday life. Encourage seniors to be active, make sure they are walking throughout the day or even suggesting they take part in an exercise program. Balance and coordination exercises have been shown to be the most effective way to prevent falls.

46 Exercise Pilot Project A pilot project was done at Tatagwa view to see if doing balance and coordination exercises would reduce falls. Results: Decreased number of falls by 40% Decreased the # of injuries from 45% of all falls to 10% of all falls

47 Questions???

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