It Starts with You … Preventing Falls Improving Lives

1. Fall Risk Assessment It Starts with You… Preventing Falls Improving Lives 2014 Fall Prevention Education Series brought to you by the Washington State Hospital Association

2. Why focus on preventing falls? 30% of Inpatient Falls Result in Serious Injury • Preventing falls: • Increases patient trust • Improves care • Improves patient satisfaction • Decreases unnecessary costs for both the patient and the hospital Reduces Risk of Injury to the Caregiver

3. What can I do to prevent falls? Leadership & Frontline Staff Involvement Identify Fall & Injury Risk Patients Fall Prevention Interventions Patient/Family Engagement & Culture Monitor Performance

4. What is a Fall Risk Assessment? Screening tool to help determine patient’s level of fall risk

5. Example: Morse Fall Scale

6. Example: STRATIFY Assessment

7. Example: Hendrich II Fall Model

8. Why should I do a Fall Risk Assessment? • Allows implementation of appropriate interventions and a follow-up plan • Notifies all pertinent health care staff of risk • Highlights risk concerns for each patient • Reduces potential of serious harm • Standardizes the process of risk identification

9. Is it really that important? YES Patients don’t know if they are at high risk for falls Draws information out of patients Standardized approach for all patients

10. Which patients are at highest risk for falling? • History of Falls • Decreased independence with mobility and transfers • Impaired Cognition • Toileting Needs • Advanced Age • Environmental Factors such as call light location, room layout and clutter, IV and other tubing/wires

11. When and how often to do aFall Risk Assessment? • Initial fall risk on admission • Reassess with patient condition or medication change • At shift change and patient rounds

12. I have completed a Fall Risk Assessment on my patient. What next? • Develop individualized fall prevention plans for each patient • Follow the policy in your hospital • Learn about your hospitals Fall Prevention program • Engage patients and families in developing the plan

13. Mrs. Saul Demographic Information: 73 years old female Admitted with: Confusion, fever, and a UTI Social Situation: Lives at home alone Her granddaughter, Skyler, checks-in every 3-4 days Medications: High blood pressure and cholesterol, low dose aspirin, and a multi-vitamin. Fall History: Once, 2 months ago, with no serious injuries Additional Observations: Mrs. Saul is weak, dehydrated, and is unable to follow simple commands or answer basic questions

14. Mrs. Saul Which aspects of this case study are fall risk factors? • History of falls • Cognitive impairment • Age consideration • Current medications • Family situation • Diagnosis and Symptoms

15. Mrs. Saul What information is missing? What else would you need to assess in order to determine if Mrs. Saul is a high fall risk? • Mobility issues • Elimination • Medications • Environmental factors

16. Mrs. Saul What risk factors are you noticing that would need to be considered when developing your intervention plan/care plan for this patient? • Impaired cognition • Dehydration and Medication • Weakness • Previous fall • Increased need for toileting

17. Mrs. Saul How often should you review the falls risk and update interventions on this patient? • Change in patient condition • Change in medications • Shift change or Staff change • Post-fall

18. What have we learned? • Complete fall risk assessment • Know risk factors • Initiate a care plan for each patient • Reassess patient’s fall risk when indicated • Engage patients and families in assessment and prevention • Include patient risk and care plan • with your colleagues

19. Other presentations available in this series Fall Risk Assessment Fall Prevention Interventions, Patient and Family Engagement Post-Fall Huddles and Data Analysis Brought to you by the Washington State Hospital Association

20. Resources