Older persons constitute a significant part of the population, and their numbers are increasing due to the tendency of population aging. With age, the risk of falls and, accordingly, injury due to physical, sensory, and cognitive changes increases. One-third of people over 65 and a half over 85 falls each year, and the chance of residents of care homes falling is three times higher in older people living in communities (Cooper, 2017). As a result, there may be a bone fracture, a traumatic brain injury, and increased fear of a new fall (Centers for Disease Control and Prevention (CDC), 2017). Since falls and injuries associated with them can significantly increase mortality and morbidity, and the suffering of older people and their families, prevention is paramount. The purpose of this executive summary is to present the risk assessment and creating a nurses’ committee on incidents investigation as a quality improvement initiative that can reduce the number of falls.
The target audience of the initiative is older adults living in long-term care institutions (LTC). Their weakened health is a factor for the high risk of falls, but they cannot recover as young people, and their condition deteriorates. Additional factors contributing to the falls are vitamin D deficiency, taking drugs that affect the balance, like tranquilizers, poor vision, pain, environmental factors, like improperly placed furniture, and other reasons (CDC, 2017). As part of the quality improvement initiative, when residents settled in the LTC, nurses should conduct a survey and assess the risks of falling. With increased risks, such older adults may receive additional help – crutches or other means. Increased risk should also be taken into account when planning care and medication.
Nurses should also respond to incidents to avoid their recurrence. To do this, they need to investigate the incidents, find the causes, and eliminate them (VanValkenburg, 2018). Interventions may include discussion with a physician of changes in the treatment plan, environmental modification, raising the question of providing safe footwear to patients, and other issues. Risk assessment and the necessary response to incidents are steps towards achieving security.
Improving measures to prevent falls will benefit residents and employees of the LTC. Preventive measures can reduce the number of falls and injuries, contributing to the safety of residents (Cooper, 2017). Reducing injuries will also have a beneficial impact on staff workload, who will be able to devote more time to immediate responsibilities. The risks noticed in time, for example, excessive influence of drugs or lack of vitamins, and the adoption of measures to eliminate them will positively affect the health of older adults. Moreover, care and safety reduce resident anxiety and depression and increase confidence in employees. As a result, more productive work on health, elderly engagement in care, and mutual respect between staff and residents should be expected. Finally, attention to security affects residents’ satisfaction with the services provided and the favorable image of the LTC.
To achieve the best result on the initiative, interprofessional cooperation is required. First, it is necessary to train nurses in the competencies to determine increased risks for falls from geriatric specialists. Doctors of narrow specialties can also contribute to risk assessment, for example, elucidating the quality of vision. Interventions to eliminate the causes of the falls may require the help of various specialists. For example, if adverse environmental factors are identified as insufficient lighting, poor-quality flooring, or lack of handrails, the services of appropriate specialists – electricians, carpenters, and other areas may be necessary. An important area of cooperation can be establishing links with suppliers of products that ensure safety, such as shoes, crutches, and other things. To implement the changes, nurses need permission and support from the LTC administration.
The introduction of the initiative will require the cost of training staff, which will take time from their duties, surcharges for the committee’s work, and services as part of interventions, depending on the reason being eliminated. At the same time, the security of LTC residents will bring more benefits than costs. In particular, about $50 billion of medical expenses goes on consequences of older adults’ falls (Florence et al., 2018). At the same time, each non-fatal incident costs about $9.780, and the fatal $26.340 (“Falls – ages 65 +,” 2018). Thus, preventive measures will help preserve the lives of residents and LTC funds.
This quality improvement initiative can be evaluated in several ways. The primary indicator of efficiency is a decrease in the number of falls and injuries of LTC residents. LTC staff can also conduct self-assessment through questionnaires addressing the effectiveness of measures taken in the institution. Another area of evaluation of the initiative is residents’ level of satisfaction with the security provided to them and the steps taken in this direction. A more detailed assessment is also required to review the inputs to implement the initiative and the potential impact it can produce. During the implementation of innovations, it will also be necessary to assess their conformity with the expectations and the actual effect of the measures taken. Multi-track evaluation helps to better understand the impact of the initiative and its benefits.
Centers for Disease Control and Prevention (CDC). (2017). Important facts about falls. CDC. Web.
Cooper, R. (2017). Reducing falls in a care home. BMJ Quality Improvement Reports, 6(1). Web.
Falls – ages 65+ (2018). America’s Health Ranking. Web.
Florence, C. S., Bergen, G., Atherly, A., Burns, E., Stevens, J., & Drake, C. (2018). Medical costs of fatal and nonfatal falls in older adults. Journal of the American Geriatrics Society, 66(4), 693–698. Web.
VanValkenburg, B. (2018). What you need to know about fall risk interventions. Health Direct. Web.