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Best Practices for Falls Reduction a Practical Guide

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Best Practices for Falls Reduction a Practical Guide C on C ti E Supplement to nu in 1. g S 9 Ed ee cr u PECIAL EPORT p ed ca S R a it ti ge s on 20 ww w.AmericanNurseToda y.com March 2011 Best Practices for Falls Reduction A Practical Guide This continuing education program is supported by an unrestricted educational grant from Hill-Rom. Because even the best nurses in the world can use some support. The Sabina™ II Lift. Part of Hill-Rom’s No Falls™ Program. For patients requiring extra help to get up and down, Hill-Rom’s Sabina II sit-to-stand li gives the safest, smoothest, most comfortable li possible while helping to minimize falls and injuries. Be more condent knowing the Sabina II Li is giving you all the support you need. Find out more about the Sabina II Li and the Hill-Rom® No Falls Program at hill-rom.com. © 2011 Hill-Rom Services, Inc. ALL RIGHTS RESERVED Meeting the challenge of falls reduction By Melissa A. Fitzpatrick, MSN, RN, FAAN, Vice President and Chief Clinical Officer, Hill-Rom ing concern. How many times have you and caregiver. By using a safety status hurt your back or shoulder while trying to board to provide visibility to critical proto - move a patient or pick her up from the cols and alarms, nurses can monitor pa - floor after she has fallen? tients from afar and keep them safe from Patient falls are ubiquitous. We must falls. You’ll find other examples and ap - think of new ways to solve this age-old con - proaches in this special report—practical cern. The stakes have never been higher guidelines you can apply where you work. and the need for holistic falls-prevention If patient falls were easy to eliminate, programs has never been greater. we would have eliminated them by now. As This special report describes what we with many clinical challenges, there’s no know about patient falls and how to over - single easy answer to the challenges posed come challenges and barriers to creating by patient falls. Analyzing the data, learn - environments in which patients are safe ing from colleagues’ successes, disseminat - from falling. Articles were written by ing enhanced outcomes, and stomping out thought leaders and experts on patient falls myths and ineffective practices will help you who discuss pertinent evidence and share as you work to reduce patient falls on your reventing patient falls is at the programs, care processes, assessment unit and across your organization. the top of mind for every methods, and outcomes associated with I wish to thank each of the authors for caregiver in every clinical their falls-prevention strategies. We share their contributions to this body of knowl - setting. Multidisciplinary their best practices so that you can use edge. I hope you will draw from their rich teams across the continuum them as a guide as you work to decrease experience as you try to replicate their of care convene each day as falls “champi - patient falls in your organization. strategies and results. All of us at Hill-Rom, ons” to determine the best ways to identify All articles in this special report reflect including the hundreds of nurses, therapists, patientsPat highest risk for falls and to de - the reality that clinical outcomes can im - and ergonomists on our team, are proud to velop falls-prevention strategies. prove—and those improvements can be support this special report on patient falls. Despite heightened national attention to sustained—when the best people, process - We hope you will apply what you learn to this issue, threats to reimbursement, and the es, and technology are employed. Not only your practice so you can continue to make best possible intentions, patient fall rates do the authors share their positive clinical your optimal contribution to patient care. across the United States continue to esca - outcomes; they explain how your efforts At Hill-Rom, we are dedicated to en - late, putting patients and caregivers at in - can contribute to your organization’s bot - hancing outcomes for patients and their creasing risk. The facts are undeniable: tom line by enhancing throughput and ac - caregivers. We know that as we work to - Up to 50% of hospitalized patients are at cess when patient fall rates decline. gether using people, process, and technol - risk for falls, and almost half of those who The ability to build a strong business ogy, we can achieve better clinical out - fall suffer an injury. case for quality is an important tool for all comes with fewer patient complications. While falls have a tremendous impact nurses today. This special report provides Thank you for all you do every day and on the patient, they also directly affect a the language and process to help you artic - thank you for allowing Hill-Rom to be your healthcare organization’s cost per case ulate the difference that quality outcomes partner in patient care. G and length of stay. The average hospital mean for patients, caregivers, and the fi - stay for patients who fall is 12.3 days nancial health of your organization. Also Selected references longer, and injuries from falls lead to a crucial to your success is the ability to un - Bates DW, Pruess K, Souney P, Platt R. Serious falls 61% increase in patient-care costs. derstand the technology available to help in hospitalized patients: correlates and resource uti - Nearly every nurse can recall an inci - keep patients safe from falling, along with lization. Am J Med . 1995;99(2):137-143. dent in which a patient fell, or nearly fell. the ability to use the science behind the Joint Commission. It’s a long way down: reduc - As patients continue to age and present technology to make sound technology deci - ing the risk of patient falls. www.jointcommis - sioninternational.org/Web-Based-Education/Its- with increasing vulnerability and comor - sions. Knowing, for example, when a low A-Long-Way-Down-Reducing-The-Risk-of-Patient- bidities, their potential for harm increases. bed is too low to keep the patient safe Falls/1435/. Accessed January 30, 2011. Likewise, as the American nurse ages, the helps you optimize patient safety. Using Schwendimann R, De Geest S, Millisen K. Evalu - risk of caregiver injury escalates, creating patient-lift technology also optimizes patient ation of the Morse Fall Scale in hospitalised pa - scenarios in which harm could be a grow - handling and safety for both the patient tients. Age Aging . 2006;35(3):311-313. www.AmericanNurseToday.com March 2011 Best Practices for Falls Reduction: A Practical Guide 1 Reducing patient falls: A call to action By John Jorgensen, MPA, RN fear of falling or of a fall-related injury may be as disabling as a fall itself. Impact of falls on facilities In today’s evolving pay-for-performance envi - ronment, healthcare facilities have a huge financial stake in reducing the number of patient falls. As of 2008, hospitals no longer receive payments for treating injuries caused by in-hospital falls, based on a 2007 final rule by the Centers for Medicare & Medicaid Services (CMS). The rule is a strong incentive for healthcare providers to implement practices that reduce the number of preventable patient falls. alls and fall-induced injuries lion for fatal falls and $19 billion for nonfa - are among the most common tal fall-related injuries. By 2020, the annual CMS and Joint Commission and serious health problems direct and indirect cost of fall injuries is ex - requirements facing adults age 65 and pected to reach $54.9 billion. CMS requires that a healthcare facility be a older in developed countries. Given the enormous human and finan - safe environment and setting for care. Facili - More than one-third of older adults experi - cial consequences of falls, the need for ro - ties that don’t meet this requirement can be ence falls. In this population, falls are the bust falls-reduction programs across the cited for immediate jeopardy and lose their leadingFcause of injury-related deaths and country has never been greater. eligibility to provide services. CMS also re - the most common cause of injuries and hos - quires that the safety of patients at risk be pital admissions. Impact of falls on patients assessed regularly and corrected if found to Nearly half of those who fall suffer mod - Falls are a major contributor to a patient’s be deficient. A facility that fails to correct erate to severe injuries that limit their mobili - functional decline and increased healthcare deficiencies is violating conditions of partici - ty and increase the risk of premature death. use. Even if a fall doesn’t cause a serious in - pation and could lose its Medicare or Medi - Up to 20% of falls cause serious injury, in - jury, it may triple the patient’s likelihood of caid funding. Patients and their families are cluding fractures and subdural hematomas. requiring placement in a skilled nursing fa - encouraged to contact the CMS or Joint Even when a fall doesn’t lead to death, cility. A serious fall increases the likelihood Commission with a complaint concerning it can necessitate prolonged hospitaliza - of skilled-nursing placement nearly tenfold. patient care, which may trigger a survey or tion. Many victims spend up to a year in A fall can cause lasting pain and suffering at least a site visit from the Department of recovery. Some suffer disability and loss of and may limit function, imposing additional Health. Also, patients and their families may function and are unable to return to their family and societal care burdens. initiate litigation related to a fall.
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