DOCSLIB.ORG

Study of the Cut-Off Point of the Morse Fall Scale (MFS)

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Study of the Cut-Off Point of the Morse Fall Scale (MFS) Disponível em: http://dx.doi.org/10.12707/RIII13101 RESEARCH PAPERS Study of the cut-off point of the Morse Fall Scale (MFS) Estudo do ponto de corte da Escala de Quedas de Morse (MFS) Estudio del punto de corte de la Escala de Caídas de Morse (MFS) Maria José Martins da Costa-Dias*; Teresa Martins**; Fátima Araújo*** Abstract Theoretical framework: The Morse Fall Scale (MFS) is a scale for assessing fall risk. It is designed for adults and widely used in Portugal. The scale should be calibrated for each particular setting so that fall prevention strategies are targeted to patients most at risk. Objective: To analyse the cut-off point of the scale that best distinguishes between people with and without fall risk in a hospital inpatient setting. Methodology: The receiver operator curve (ROC) was used to determine the optimal cut-off point. The predictive validity of the MFS was assessed through sensitivity and specificity, positive and negative predictive values, the ROC area under the curve (AUC) and also the Youden Index. Results: The cut-off point of 45 was identified as the optimal cut-off value, where 78% of the participants were identified as true positives and 22% as false negatives. It presented an OR of 3.8 (95%CI=2.17-6.51). Conclusion: The MFS is a good instrument for identifying patients with high fall risk in hospital settings, particularly in medical and surgical, long-term and palliative care inpatient wards. Keywords: accidental falls; risk management; hospital services. Resumo Resumen Enquadramento: A Escala de Quedas de Morse (MFS) é uma Marco contextual: la Escala de Caídas de Morse (MFS) es una escala de avaliação do risco de queda, desenhada para adultos e escala para evaluar el riesgo de caídas, diseñada para adultos y amplamente utilizada no nosso país. A escala deve ser calibrada ampliamente utilizada en Portugal. La escala debe ser calibrada para cada contexto para que as estratégias de prevenção sejam para cada contexto, con el fin de que las estrategias de prevención dirigidas aos doentes que estão em maior risco. se dirijan a los pacientes que están en mayor riesgo. Objetivo: Analisar o ponto de corte da escala que melhor Objetivo: identificar el punto de corte de la escala que mejor discrimine as pessoas sem risco das com risco de queda quando discrimine a las personas que no tienen riesgo de caída de las que internadas em contexto hospitalar. sí lo tienen cuando están internas en un contexto hospitalario. Metodologia: Foi utilizada para definir o melhor ponto de corte Metodología: para determinar el mejor punto de corte, se utilizó a receiver operator curve (ROC). A validade preditiva da MFS la curva del receptor operador (ROC). La validez predictiva de la foi avaliada através da sensibilidade e especificidade, do valor MFS se evaluó por medio de la sensibilidad y la especificidad, del preditivo positivo e negativo, da área abaixo da curva (AUC) de ROC e ainda através do Índice de Youden. valor predictivo positivo y negativo, del área bajo la curva (AUC) Resultados: O ponto de corte 45 foi identificado como o melhor de ROC y también a través del Índice de Youden. ponto de corte, no qual 78% dos participantes são identificados Resultados: el punto de corte de 45 fue identificado como como verdadeiros positivos e 22% como falsos negativos e el mejor punto de corte, en el que se identifica el 78 % de los apresenta um OR de 3,8 (IC95%=2,17-6,51). participantes como verdaderos positivos y el 22 % como falsos Conclusão: A MFS revela ser um bom instrumento para negativos, y tiene un OR de 3,8 (IC95%=2,17-6,51). identificar doentes com alto risco de queda, em contexto Conclusión: la MFS es un buen instrumento para identificar hospitalar, particularmente em internamentos médico-cirúrgicos, pacientes con alto riesgo de caídas en el ámbito hospitalario, de cuidados continuados e paliativos. sobre todo en pacientes hospitalizados en servicios médicos y quirúrgicos, así como de cuidados continuos y paliativos. Palavras-chave: acidentes por quedas; controle do risco; serviços hospitalares. Palabras clave: accidentes por caídas; control de riesgo; servicios hospitalarios. * Enfermeira Especialista em Saúde Infantil e Pediátrica. Aluna do Doutoramento em Enfermagem do Instituto de Ciências da Saúde da Universidade Católica Portuguesa. Morada: Avenida Lusíada, 100, 1500-650 Lisboa, Portugal [[email protected]]. ** Professora Coordenadora, Escola Superior de Enfermagem do Porto. Doutora em Ciências da Educação, 4200-072 Porto, Portugal[[email protected]]." *** Professora Adjunta. Doutora em Ciências da Educação. Escola Superior de Enfermagem do Received for publication: 10.04.13 Porto, 4200-072 Porto, Portugal[[email protected]]. Accepted for publication: 18.01.14 Revista de Enfermagem Referência Série IV - n.° 1 - Fev./Mar. 2014 pp.63-72 Introduction specificity scores (true negatives, or the proportion of non-fallers correctly classified as without or Fall risk assessment scales are tools that assign low fall risk), as well as the positive predictive numerical values to various risk factors. They are values (likelihood that a person assessed with fall added up to assess the patient’s likelihood of falling. risk has of falling) and negative predictive values Assessing the predictive validity of scales (Morse, (likelihood that a person assessed with no fall risk has 2009) allows to identify whether they fulfil their of not falling). purpose, i.e., if they distinguish well enough between The purpose of this study was to analyse the cut-off patients with and without risk of falling in a given point of the MFS for acute adult inpatient services of a population (Oliver, Healey, & Haines, 2010). The hospital in central Lisbon. Morse Fall Sacle (MFS) is one of most commonly used scales, taking into account its extensive development and comparative studies in patients hospitalised in Theoretical Framework different hospitals (Schwendimann, De Geest, & Milisen, 2006). Lamb, Jorstad-Stein, Hauer, and Becker (2005) define As any other assessment tool, a fall risk assessment accidental fall as an unexpected event in which the scale needs to be culturally and linguistically adapted patient comes to rest on the ground, floor, or lower and validated for Portuguese to be used in our level. Falls are the most common non-fatal injuries contexts (Almeida, Abreu, & Mendes, 2010). Ideally, in acute care hospitals (Perell, Nelson, Goldman, scales should be calibrated for each unit, so that fall Prieto-Lewis, & Rubenstein, 2001), affecting mainly prevention strategies are targeted to those most at the elderly (Oliver, 2007) and being an adverse event risk, i.e., the cut-off points or values that distinguish that is preventable. Simple risk assessment scales between patients with and without fall risk may can predict up to 70% of falls (Oliver, Daly, Martin, & differ depending on whether the scale is being used McMurdo, 2004). The first stage of any fall intervention in acute or chronic care settings. Even within the program is risk assessment. The nurse ought to same organisation, the scale may have different cut- use adequate assessment tools to identify both real off points (Morse, 2009). Fall risk varies according to and potential risks for patients, a competence that the type of patient, the different periods of the day is defined by the Ordem dos Enfermeiros (Nurses and the patient’s situation (Morse, 2009). The cut-off Association) (2004) at care management level within points as defined by the author of the scale are set the safe environment domain. The MFS is one of the between 25 and 55 points, suggesting that the high most widely disseminated and used scales in Portugal fall risk cut-off point in acute or surgical care settings (Soares & Almeida, 2008). Its predictive validity and where few patients have a high fall risk, is set at score interrater reliability have been demonstrated (Morse, 25. On the contrary, in hospitals or units for patients 2006; Morse, 2009). with chronic or cerebrovascular diseases, the author The MFS is described by its author as a simple and suggests that the high risk of falling be at score 45. quick method to assess the patient’s likelihood of Morse (2009) also recommends that the cut-off point falling, and counts with two decades of research. It of the scale should not to be above 55 points. This was developed by Janice Morse in 1985 in Canada, at value was identified by Schwendimann et al. (2006) the University of Alberta, to identify fall-prone patients in a cohort prospective study carried out in two (Morse, Morse, & Tylko, 1989). medicine inpatient departments of a hospital for The scale was developed based on a study composed acute patients as the most appropriate cut-off point of a random sample of 100 fallers and 100 non-fallers. for patients hospitalised in these services. The scale consists of six assessment items: (1) According to Morse (2009), the best method to define previous history of falling; (2) secondary diagnosis; the cut-off point is to assess the fall risk of patients (3) ambulatory aid; (4) intravenous therapy; (5) gait who are hospitalised in a given service and analyse and transferring; (6) mental status. the distribution of risk, thus obtaining the scale’s Items 1, 2, 4 and 6 are measured on a dichotomous sensitivity scores (true positives, or the proportion scale (No/Yes). A ‘No’ answer is always scored zero, of fallers correctly classified as high fall risk) and the while a “Yes” answer is scored 15 (in items 2 and 6), 20 Revista de Enfermagem Referência - IV - n.° 1 - 2014 Study of the cut-off point of the Morse Fall Scale (MFS) 64 (item 4) or 25 (item 1). Possible answers for item 3 are associated with a confidence interval of [0.80; 0.88].
Load more

Recommended publications
  • Nursing Service Guidelines FALL PREVENTION MULTIDISCIPLINARY FALL PREVENTION
    Nursing Service Guidelines FALL PREVENTION Title: MULTIDISCIPLINARY FALL PREVENTION Responsibility: Multidisciplinary staff need to take an active role in fall prevention. Equipment: Fall identification wrist bands, fall identification materials, and fall prevention equipment. Purpose: Since research has identified that numerous intrinsic and extrinsic variables can contribute to a patient’s risk of falling during a hospitalization, it is essential to determine the risk factors that place the patient at the greatest (highest) risk. By utilizing strategies that take into consideration the fall risk assessment score, clinical judgement, medication management, the patients mental status, and the patients ability to ambulate, it is intended that this approach will help prevent patient falls. The purpose of this guideline is to provide multidisciplinary staff with fall risk assessment tools that can be used to assist them in properly identifying those patients at risk for falling and determining interventions. General Information: A fall is defined as any unplanned descent to the floor, with or without injury (National Database of Nursing Quality Indicators [NDNQI], 2015). A fall may be either unassisted or assisted (where someone helps to ‘break’ the fall by helping the patient to the floor) and the NDNQI definition also includes falls where a patient lands on a surface where you would not expect to find the patient. University of Toledo Medical Center’s (UTMCs) fall injury level categories: • None • Minor (dressing, ice, cleaning, or elevation) • Moderate (suturing, splinting, or steri-strips/skin glue) • Major* (surgery, casting, traction, or neuro consult) • Death* (died as a result of injuries sustained from the fall) *if a patient’s fall has a major injury level or results in a death, the department manager or house supervisor and Quality Management need to be notified immediately.
    [Show full text]
  • Assessment of Fall Risk in Patients Receiving Palliative Care Consultations
    University of Michigan Health System Part IV Maintenance of Certification Program [Form 5/19/15] Report on a QI Project Eligible for Part IV MOC Assessment of Fall Risk in Patients Receiving Palliative Care Consultations Instructions Determine eligibility. Before starting to complete this report, go to the UMHS MOC website [ocpd.med.umich.edu], click on “Part IV Credit Designation,” and review sections 1 and 2. Complete and submit a “QI Project Preliminary Worksheet for Part IV Eligibility.” Staff from the UMHS Part IV MOC Program will review the worksheet with you to explain any adjustments needed to be eligible. (The approved Worksheet provides an outline to complete this report.) Completing the report. The report documents completion of each phase of the QI project. Final confirmation of Part IV MOC for a project occurs when the full report is submitted and approved. An option for preliminary review (recommended) is to complete a description of activities through the intervention phase and submit the partially completed report. (Complete at least items 1-16 and 27a-b.) Staff from the UMHS Part IV MOC Program will provide a preliminary review, checking that the information is sufficiently clear, but not overly detailed. This simplifies completion and review of descriptions of remaining activities. Questions are in bold font and answers should be in regular font (generally immediately below the questions). To check boxes electronically, either put an “X” in front of a box or copy and paste “ ” over the blank box. For further information and to submit completed applications, contact either: Grant Greenberg, MD, UMHS Part IV Program Lead, 763-936-1671, [email protected] R.
    [Show full text]
  • Identification of High Fall Risk Patients in Acute Rehab
    Running head: HIGH FALL RISK IN ARU 1 Identification of High Fall Risk Patients in Acute Rehab Vanessa Vonderhaar-Picard DNP, MEd, RN, CNML An evidence-based doctoral project presented to the Department of Nursing at Mount St. Joseph University in partial fulfillment of the Degree: Doctor of Nursing Practice Date: May 14, 2019 Susan A. Johnson, PhD, RN - DNP Advisor Copyright by Vanessa Vonderhaar-Picard DNP, MEd, RN, CNML 2019 2 HIGH FALL RISK IN ARU Identification of High Fall Risk Patients in Acute Rehab Vanessa M. Vonderhaar-Picard Mount St. Joseph University 3 HIGH FALL RISK IN ARU Table of Contents Executive Summary………………………………………………………………….……………5 Introduction………………………………………………………………………………………. 6 Problem……………………………………………………………………………………………6 PICOT Question…………………………………………………………………………..…….....9 Literature Review……………………………………………………………………………...…10 Search Description……………………………………………………………………….10 Table 1 Literature Review…………………………………………………………….....11 Summary of Levels of Evidence ………………………………………………………...12 Table 2 Level of Evidence……………………………………………………………….12 Falls………………………………………………………………………………………13 Fall Risk………………………………………………………………………………….13 Acute Rehab Risk Factors for Falls……………………………………………………...15 Psychiatric Risk Factors for Falls ……………………………………………………….16 Morse Fall Scale…………………………………………………………………………17 Table 3 Morse Fall Scale………………………………………………………………...18 Edmonson Psychiatric Fall Assessment Tool.…………..……………………………….18 Table 4 Edmonson Psychiatric Fall Assessment Tool…………………………………..20 Comparison of Edmonson and Morse Fall Scales……………………………………….21
    [Show full text]
  • Improving a Fall Prevention and Management Program in an Acute Care Setting Ashlee D
    Eastern Kentucky University Encompass Doctor of Nursing Practice Capstone Projects Baccalaureate and Graduate Nursing 2015 Improving a Fall Prevention and Management Program in an Acute Care Setting Ashlee D. Gallion Eastern Kentucky University, [email protected] Follow this and additional works at: https://encompass.eku.edu/dnpcapstones Part of the Nursing Commons Recommended Citation Gallion, Ashlee D., "Improving a Fall Prevention and Management Program in an Acute Care Setting" (2015). Doctor of Nursing Practice Capstone Projects. 7. https://encompass.eku.edu/dnpcapstones/7 This Open Access Capstone is brought to you for free and open access by the Baccalaureate and Graduate Nursing at Encompass. It has been accepted for inclusion in Doctor of Nursing Practice Capstone Projects by an authorized administrator of Encompass. For more information, please contact [email protected]. Running head: FALL PREVENTION PROGRAM 1 Improving a Fall Prevention and Management Program in an Acute Care Setting Submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice at Eastern Kentucky University By Ashlee D. Gallion Huntington, WV 2015 FALL PREVENTION PROGRAM 2 Abstract In-patient falls are common but preventable adverse events. A patient fall has become a targeted event that hospitals across the country are trying to prevent by implementing new evidence- based strategies and techniques. The purpose of this capstone project was to implement a valid and reliable fall risk assessment tool and a post-fall huddle process. Following a 30-day pilot of the new fall prevention protocol on a medical-surgical unit at the Cabell Huntington Hospital, the documentation of fall risk and post-fall huddles was examined.
    [Show full text]
  • Morse Falls Scale Assessment for Long Term Care Facilities
    Morse Falls Scale Assessment for Long Term Care Facilities Procedure: Obtain a Morse Fall Scale Score by using the variables and numeric values listed in the “Morse Fall Scale” table below. (Note: Each variable is given a score and the sum of the scores is the Morse Fall Scale Score. Do not omit or change any of the variables. Use only the numeric values listed for each variable. Making changes in this scale will result in a loss of validity. The “Total” value obtained must be recorded in the patient’s medical record. Morse Fall Scale This icon indicates primary consideration for the Moore Balance Brace. Variables Numeric Values Score Variables Numeric Values Score 1. History of falling No - 0 Yes - 25 5. Gait Normal/bed rest/wheelchair 0 2. Secondary diagnosis: Dizziness, Weak 10 Parkinsons, Neuropathy, No - 0 Yes - 25 Impaired 15 Osteoarthritis, Hypertension 6. Mental status 3. Ambulatory aid Oriented to own ability 0 None/bed rest/nurse assist 0 Overestimates or forgets 15 Crutches/cane/walker 15 limitations Furniture 30 4. IV or IV Access No - 0 Yes - 20 Total: 1. History of falling c. With an impaired gait (score 20), the patient may have difficulty This is scored as 25 if the patient has fallen during the present hospital rising from the chair, attempting to get up by pushing on the arms of admission or if there was an immediate history of physiological falls, such the chair and/or bouncing (i.e., by using several attempts to rise). The as from seizures or an impaired gait prior to admission.
    [Show full text]
  • Session 1: Measuring the Right Thing NASRM 2016 1
    Session 1: Measuring the Right Thing NASRM 2016 MEASURING THE RIGHT THING FOR THE RIGHT REASON Ilene Warner‐Maron PhD, RN‐BC CWCN CALA NHA FCPP Assistant Professor and Co‐Director of MS in Aging and Long‐Term Care Administration Philadelphia College of Osteopathic Medicine What is the Value of Risk Assessment Tools in Clinical Practice? • To assist clinicians in making quantitative or qualitative estimates of risk within a given situation • To understand the magnitude of the potential loss and probability that loss will occur • To provide meaningful interventions to minimize the risk of harm or a condition arising in a health care environment The Process of Risk Assessment • Establish a context by understanding the environment, definitions, operations • Identify the risk hazards, internal and external, intrinsic and extrinsic to the individual • Analyze the contributing factors and risk of exposure to the risk • Evaluate and prioritize the characteristics of risk in order to determine which patient/resident needs to have interventions • Tackle the risk by implementing interventions and assessing the effectiveness of those interventions 1 Session 1: Measuring the Right Thing NASRM 2016 Barriers to Accurate Risk Assessments • A lack of understand the components of the risk assessment; a belief that assessments are “self‐ explanatory” • An inability to use the risk assessment appropriate to the setting • A missed opportunity to appreciate the risks in a given individual patient/resident • A lack of support to use nursing judgment • Chaotic
    [Show full text]
  • Reducing Falls and Injuries from Falls
    Reducing Harm | Improving Healthcare | Protecting Canadians REDUCING FALLS AND INJURIES FROM FALLS Getting Started Kit Effective​ March 14, 2019, the Canadian Patient Safety Institute has archived the Reducing Falls and Injury from Falls intervention. For additional inquiries, please contact [email protected] June 2013 (Measures Revised April 2015) www.saferhealthcarenow.ca Safer Healthcare Now! Reducing Falls and Injuries from Falls Getting Started Kit Safer Healthcare Now! We invite you to join Safer Healthcare Now! to help improve the safety of the Canadian healthcare system. Safer Healthcare Now! is a national program supporting Canadian healthcare organizations to improve safety through the use of quality improvement methods and the integration of evidence in practice. To learn more about this intervention, to find out how to join Safer Healthcare Now! And to gain access to additional resources, contacts, and tools, visit our website at www.saferhealthcarenow.ca This Getting Started Kit (GSK) has been written to help engage your interdisciplinary teams in a dynamic approach for improving quality and safety while providing a basis for getting started. This Getting Started Kit represents the most current evidence, knowledge and practice, as of the date of publication and includes what has been learned since the first kit was released in 2010. We remain open to working consultatively on updating the content, as more evidence emerges, as together we make healthcare safer in Canada. Note: The Getting Started Kits for all interventions used by Safer Healthcare Now! are available in both French and English. This document is in the public domain and may be used and reprinted without permission provided appropriate reference is made to Safer Healthcare Now! As of June 1, 2016, Safer Healthcare Now! is no longer collecting data and Patient Safety Metrics is no longer available.
    [Show full text]
  • Reducing Inpatient Falls and Fall Related Injuries in Acute Care Settings Channing Williams Langston University
    Langston University Digital Commons @ Langston University McCabe Thesis Collection Student Works 5-2008 Reducing Inpatient Falls and Fall Related Injuries in Acute Care Settings Channing Williams Langston University Nikita Lewis Langston University Victoria Thomas Langston University Follow this and additional works at: http://dclu.langston.edu/mccabe_theses Part of the Geriatric Nursing Commons Recommended Citation Williams, Channing; Lewis, Nikita; and Thomas, Victoria, "Reducing Inpatient Falls and Fall Related Injuries in Acute Care Settings" (2008). McCabe Thesis Collection. Paper 44. This Thesis is brought to you for free and open access by the Student Works at Digital Commons @ Langston University. It has been accepted for inclusion in McCabe Thesis Collection by an authorized administrator of Digital Commons @ Langston University. For more information, please contact [email protected]. Signature Page Thesis Approved: Thesis Committee Chairperson UJJw1bl 8ro!DP.t 85/v [!J Thesis Committee Member • Dean of the Honors Program Vice President for Academic Affairs Inpatient Falls, I Reducing Inpatient Falls and Fall Related Injuries in Acute Care Settings Channing Williams, Nikita Lewis & Victoria Thomas Langston University Inpatient Falls, 2 Reducing Inpatient Falls and Fall Related Injuries in Acute Care Settings Introduction Falls are a continually rising issue in today's healthcare. In acute care settings, patient falls make up 38% of all adverse events in which include physical injury, undesirable emotional and financial outcomes for the client (Angn, Mordiffi, Wong, Devi, & Evans, 2007). Falls in the hospitals lead to fear, pain, decreased healing, longer in-patient stays, further health-related complications. Falls may also cause patient discomfort and affect quality of life.
    [Show full text]
  • Case Study: Implementing a Fall Risk Reduction Program 1 University of Nebraska Medical Center
    CAPTURE Collaboration and Proactive Teamwork Used to Reduce Falls Monthly Collaborative Call #4 February 26, 2013 2:00 – 2:30 p.m. CST Case Study: Implementing A Fall Risk Reduction Program 1 University of Nebraska Medical Center AGENDA • Housekeeping • Case study: Methodist Health System Fall Risk Reduction Program • Event Reports • Malfunctioning chair alarm • Consider the whole patient when assessing fall risk • Lessons to share with the community • Barriers and Successes in Implementation 2 University of Nebraska Medical Center Housekeeping Collecting employee names for Perceptions of Support for Fall Risk Reduction Survey 1. Personnel who provide direct patient care (nursing, therapists, imaging) 2. Personnel who regularly provide services in patient rooms (e.g. housekeeping, phlebotomy) 3. Members of the Fall Risk Reduction Team 4. Senior leaders/managers/supervisors Combing CAPTURE Falls Lessons Learned with CAH Quality Conference September 2013 3 University of Nebraska Medical Center Case Study: Methodist Health System The Fall Risk Assessment includes four components and a critical care option: 1. The Morse Fall Scale (MFS) 2. Medication Predisposing Risk Factors for Falls 3. Known Faller assessment: fallen in the past 30 days; admitted because of a fall or fracture; and/or have they fallen while in the hospital? 4. Number of Falls in past 24 hours 5. Critical Care when patients are on continuous sedation or comatose and the MFS can not be administered. 4 University of Nebraska Medical Center 5 University of Nebraska Medical Center Sensitivity and Specificity of the MFS • Comprehensive literature review in 2002 • Morse Fall Scale Selected • Determining Level of Risk—specificity & sensitivity (cut off score) • 2003 conducted a Specificity and Sensitivity of the Morse Fall Scale on Three Medical / Surgical Units study.
    [Show full text]
  • Fall Rates and Relevance to Nursing Sensitive Outcomes
    Session 6: Pathways to Improvement: Program Evaluation Pat Quigley, PhD, MPH, ARNP, CRRN, FAAN, FAANP Review process of program evaluation. Formulate measurable fall-related outcomes that build upon NDNQI data. Differentiate types of falls as a basis for analysis of program effectiveness at patient, unit and organizational levels. Compare proactive vs. reactive approaches to fall and injury prevention. Clinical Question or Idea Patient Idea Literature Review Innovation Product Evaluation Networking at Conferences & Meetings Informing Clinical Decision-Making Achieving agreement on the aim of a project is critical for maintaining progress. Teams make better progress when they are very specific about their aims. Examples of Aims Increase the percentage of staff Reducing the rate Reducing the rate on our unit who of injuries due to of falls in our are educated about falls in our facility facility by 40% in our falls by 50% in 7 seven months prevention months protocol to 100% in 2 months What are we trying to accomplish? How will we know that a change is an improvement? What change can we make that will result in improvement? ACT PLAN STUDY DO Measure Measure Process Outcome 10 Have others that have some knowledge about the change review comment on its feasibility. Test the change on the members of the team that helped developed it before introducing the change to others. Conduct the test in one facility or office in the organization, or with one patient. Conduct the test over a short time period. Test the change on a small group of volunteers. Changes That Result in Improvement A P S D A P • Hunches S D • Theories • Ideas Overall Aim: Decrease Falls Rate by 40% in 7 months Develop Develop Develop Develop Staff and Patient assessment knowledge environmental specific Education protocol of falls assessment interventions for fallers Seek usefulness, not perfection.
    [Show full text]
  • Preventing Falls in Hospitals: a Toolkit for Improving Quality of Care
    Preventing Falls in Hospitals A Toolkit for Improving Quality of Care The information in this toolkit is intended to assist service providers and hospitals in developing falls prevention protocols. This toolkit is intended as a reference and not as a substitute for professional judgment. The opinions expressed in this document are those of the authors and do not necessarily reflect the views of AHRQ. No statement in this toolkit should be construed as an official position of AHRQ or the U.S. Department of Health and Human Services. In addition, AHRQ or U.S. Department of Health and Human Services endorsement of any derivative product may not be stated or implied. Preventing Falls in Hospitals A Toolkit for Improving Quality of Care Prepared for: Agency for Healthcare Research and Quality 540 Gaither Road Rockville, MD 20850 www.ahrq.gov Prepared by: RAND Corporation Boston University School of Public Health ECRI Institute Contract No. HHSA290201000017I TO #1 AHRQ Publication No. 13-0015-EF January 2013 Authors RAND Corporation David A. Ganz, M.D., Ph.D., VA Greater Los Angeles Healthcare System, University of California at Los Angeles, and RAND Corporation Christina Huang, M.P.H., RAND Corporation Debra Saliba, M.D., M.P.H., VA Greater Los Angeles Healthcare System, UCLA/JH Borun Center for Gerontological Research, and RAND Corporation Victoria Shier, M.P.A., RAND Corporation Boston University School of Public Health Dan Berlowitz, M.D., M.P.H., Bedford VA Hospital and Boston University School of Public Health Carol VanDeusen Lukas, Ed.D., VA Boston Healthcare System and Boston University School of Public Health ECRI Institute Kathryn Pelczarski, B.S.
    [Show full text]
  • Matney 2C.Pptx
    Standardizing Nursing data using LOINC and SNOMED CT Item Type Conference/Congress; Poster/Presentation Authors Matney, Susan A. Publication Date 2015-07-22 Abstract Objectives • Describe the drivers for standardization of healthcare data (including nursing) • Provide and Overview of LOINC and SNOMED CT • Examine initial efforts to create a nursing problem list subset to complement ... Keywords standard terminology; LOINC; Nursing informatics; Medicine-- Terminology; Medical Informatics; Meaningful Use; SNOMED CT; Logical Observation Identifiers Names and Codes Download date 26/09/2021 05:38:25 Item License https://creativecommons.org/licenses/by-nc-nd/4.0/ Link to Item http://hdl.handle.net/10713/5511 Standardizing Nursing data using LOINC and SNOMED CT Susan Matney, PhD, RN-C, FAAN 3M Health InformaEon Systems SINI Presentation – July 22, 2015 1 Objecves • Describe the drivers for standardizaon of healthcare data (including nursing) • Provide and Overview of LOINC and SNOMED CT • Examine ini&al efforts to create a nursing problem list subset to complement the meaningful use problem list using SNOMED CT. • Illustrate how SNOMED CT and LOINC can be used to bridge disparate nursing terminologies. Key NaEonal Standards Interoperability Road Map • Goals: Improve quality/lower costs • Driver: Person centered health • Challenges: – Right informaon – Right person – Right &me – Between organizaons – Across products http://www.healthit.gov/sites/default/files/nationwide-interoperability-roadmap-draft-version-1.0.pdf CMS Blueprint https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-instruments hp://www.himss.org/big10 6 Recommendaons Promote Standards and Interoperability 1) Nurses should promote the use of standardized terminologies that address the documentaon needs of the en&re care team regardless of care seng.
    [Show full text]