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DIRECTOR'S CORNERADVICE COLUMN
Tuesday, February 05, 2013 9:00 AM
Navigating the Health Care System
with Dr. Carolyn Clancy

New Tools Help Health Providers Reduce Patients’ Risk of Falls

By Carolyn M. Clancy, M.D.

February 5, 2013

For older adults, falls are serious, whether they take place in the home or in a health care setting.

More than one-third of adults over age 65 fall each year. Falls can cause bone fractures, disability, and even death. Among people 75 and older, falls are far more likely to cause admissions into a long-term care facility than for adults 10 years younger, Federal data show.

An estimated 500,000 falls Exit Disclaimer happen each year in U.S. hospitals, causing 150,000 injuries. Patients have a higher risk of falls if they--

  • Have weak muscles or problems walking.
  • Take drugs or a combination of drugs that make them sleepy.
  • Use a cane or walker.
  • Have chronic conditions.
  • Need to use the bathroom frequently.

Health care providers have known for a long time that falls among patients are a serious problem. But they haven’t always agreed on the best way to prevent them. 

This is changing, which means you or your loved ones may be safer from falls in the future.

Today, many hospitals and long-term care settings use new programs based on scientific evidence of what works best. The goal is to make sure clinicians understand the risk of falls, identify which patients have the higher risk, and take steps to reduce patients’ risk.  

One program is an AHRQ-funded project (PDF File, Plugin Software Help) from a Wisconsin health system, a health technology company, and a university-based school of nursing. They developed a computerized program with four individual care plans, based on patients’ risk for a fall and their ability to follow instructions on how to prevent one.  

The program helps nurses develop fall-prevention plans that match patients’ needs and that can go in patients’ electronic health records.

For example, the program identifies patients who are usually at low risk for falls but who may have an injury or condition that increases their risk. 

For these patients, steps to reduce falls include--

  • Making sure they are carefully watched the first time they get out of bed after surgery or a procedure.
  • Making sure they or a family member understand the need to call and wait for help before doing something that could cause a fall.
  • Helping them identify hazards or behaviors that make a fall more likely.
  • Learning safer approaches before they leave the hospital.

Some patients are at a high risk of falling but can follow steps on how to prevent a fall.

For these patients, steps to reduce falls include-- 

  • Making sure they understand why they should use a walker or other device to help them move safely.
  • Consulting with the pharmacist or physician to be careful about drugs that can increase the risk of falls.
  • Using an alert system, such as wristbands, signs, or other communication to warn of the risk of falls.

We know that communication and teamwork among health care providers are important to reduce errors and improve patient safety. In fact, up to 70 percent of medical errors, including falls, are due to breakdowns in communication among health care teams.

To address this need, AHRQ and the Department of Defense have developed a teamwork system specifically for long-term care settings. Known as TeamSTEPPS®, the system is based on more than 20 years of research into how teamwork improves safety. It is used in hundreds of hospitals across the United States.

Early results show that TeamSTEPPS improves safety and quality in long-term care settings. For example, staff using teamwork skills reduced the rate of serious pressure ulcers among nursing home residents by 48 percent.

Reducing the risk of falls in hospitals and long-term care settings is an important goal. New tools can help health providers--and their patients--attain it. 

I’m Dr. Carolyn Clancy, and that’s my advice on how to navigate the health care system.

Resources

Agency for Healthcare Research and Quality
Using a Computerized Fall Risk Assessment Process to Tailor Interventions in Acute Care
http://www.ahrq.gov/downloads/pub/advances2/vol1/Advances-Hook_25.pdf [Plugin Software Help]

TeamSTEPPS Long-Term Care Version
http://www.ahrq.gov/teamsteppstools/longtermcare/

Centers for Disease Control and Prevention
Falls Among Older Adults: An Overview
http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html

National Patient Safety Foundation
Key Facts about Patient Safety
http://www.npsf.org/for-patients-consumers/patients-and-consumers-key-facts-about-patient-safety/#Fal Exit Disclaimer

Current as of February 2013


Internet Citation:

New Tools Help Health Providers Reduce Patients’ Risk of Falls. Navigating the Health Care System: Advice Columns from Dr. Carolyn Clancy, February 5, 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/consumer/cc/cc020513.htm


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