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Dr. Vicky Scott
Hélène Riverin
Brenda Dusek
Falls Prevention/Injur...
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Date: Tuesday June 25, 2013
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Falls Prevention/Injury Reduction Getting
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2nd Edition
What’s New in Fall Best Practi...
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Falls Prevention/Injury Reduction
Intervention Model – What’s New?
www.saferhealthcarenow.ca
Dr. Fabio Feldman
Presenters
Dr. Vicky Scott Hélène
Riverin
Brenda
Dusek
www.saferhealthcarenow.ca
A Fall?
An event that results in a person coming to rest inadvertently on the
ground or floor or...
www.saferhealthcarenow.ca
A Near Fall?
A slip, trip, stumble or loss of balance such that the individual
starts to fall bu...
www.saferhealthcarenow.ca
What is a Fall Injury?
An injury that results from a fall, which may or may not require
treatmen...
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SAFE ENVIRONMENT, ASSIST WITH MOBILITY, FALL RISK REDUCTION, ENGAGE CLIENT AND FAMILY
• Assess a...
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Prevention: Universal Fall Precautions (SAFE)
www.saferhealthcarenow.ca
Multifactorial Risk Assessment – What’s New?
Risk Factors for Falling:
Use of adapted BBSE MODEL...
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Fall Risk Factor
Assessment Tools – What’s NEW?
More explanation of categories and classificatio...
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Screening Parameter
Screening Tool and Approach Chart- Figure 5
Screening parameter
Appropriate ...
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Screening parameter Appropriate Screening Tool(s) and Approach
Screen for cognitive
impairment
E...
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Screening parameter Appropriate Screening Tool(s) and Approach
Screen for hearing and visual acu...
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EXAMPLE: Long Term Care,
CSSS de la Vieille-Capitale;
2013.
A logo is used according to the scor...
www.saferhealthcarenow.ca
Implement Interventions for Those at Risk for Falling
Canadian Fall Prevention Curriculum Model ...
www.saferhealthcarenow.ca
Interventions Known to Modify Fall Risk Factors- Figure 7
Risk Factors for Falls Interventions k...
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Interventions Known to Modify Fall Risk Factors- Figure 7
Medication reviews should include revi...
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Define the
Problem
Identify Fall Risk
Factors
Examine
Fall Prevention/
Injury Reduction
Best Pra...
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Restraint Use
Home Health Care
Policy and Procedures – Restraint Use
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Individualize Interventions
for
Those at High Risk of a Fall-Related Injury
•Figure 9 Risk Fall,...
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Individualize Interventions
for
Those at High Risk of a Fall-Related Injury
•Additional focus
in...
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Individualize Interventions
for
Those at High Risk of a Fall-Related Injury
•Additional focus in...
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Individualize Interventions
for
Those at High Risk of a Fall-Related Injury
•Additional focus
in...
www.saferhealthcarenow.ca
New Indicators
There are now seven measures for Acute Care and 8 Measures for Long Term Care:
NE...
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New Indicators
There are now six measures for Home Health Care:
NEW: 6. (NEW) Restraint Use (Bal...
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GSK – 2nd Edition available at:
http://www.saferhealthcarenow.ca/EN/Interventions/Falls/Pages/
r...
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Special Thank You
SHN Falls Intervention Faculty 2013
Cheryl Sadowski, PhD
Faculty of Pharmacy &...
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Special Thank You
SHN Falls Intervention Faculty 2013
Susan McAlpine, B.Sc.P.T.
Physiotherapist,...
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Special Thank You
SHN Falls Intervention Faculty 2013
Helene Riverin
Conseillère clinicienne en ...
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• Special Thanks to:
– Falls Prevention/Injury
Reduction Intervention
Faculty
– Guest Speakers
–...
of 38

Falls Prevention/Injury Reduction Getting Started Kit – 2nd Edition – What’s New in Fall Best Practices?

Introduce Falls Prevention/Injury Reduction Getting Started Kit – 2nd Edition with specific focus on whats new: 1.Falls Prevention/Injury Reduction Intervention Model 2.Fall Risk Factors 3.Screening Tools 4.Success Measures
Published on: Mar 3, 2016
Published in: Health & Medicine      Technology      Economy & Finance      
Source: www.slideshare.net


Transcripts - Falls Prevention/Injury Reduction Getting Started Kit – 2nd Edition – What’s New in Fall Best Practices?

  • 1. www.saferhealthcarenow.ca Presenters: Dr. Fabio Feldman Dr. Vicky Scott Hélène Riverin Brenda Dusek Falls Prevention/Injury Reduction Getting Started Kit – 2nd Edition What’s New in Fall Best Practices?
  • 2. www.saferhealthcarenow.ca Date: Tuesday June 25, 2013 Time 9:00 a.m. – 10:00 a.m. PDT 10:00 a.m. – 11:00 a.m. MDT 11:00 a.m. – 12:00 p.m. CDT 12:00 p.m. – 1:00 p.m. EDT 1:00 p.m. – 2:00 p.m. ADT 1:30 p.m. – 2:30 p.m. NDT National Call Dial in and WebEx Link Information Please dial in and/or log on 15 minutes prior to call start time. Wherever possible, please join with others in your region/team to participate in this call. Toll-Free Dial In: 1-877-668-4490 WebEx link: Click here to register! https://cpsi-icsp.webex.com/cpsi-icsp/j.php?J=962361303 Event Number: 962 361 303
  • 3. You Joined Incorrectly!  There is NO phone icon beside your name. You will be unable to join the breakout sessions. You Joined Correctly!  There IS a phone icon beside your name. You will be able to join the breakout sessions. Have you joined the Call Correctly? If there is NO phone icon beside your name: 1. Hang up and disconnect from WebEx. 2. Rejoin using original link. Enter name & Email & click on Join Now 3. A popup will display the phone information. Direct Line Enter number Line with Extension “ I will call in”
  • 4. www.saferhealthcarenow.ca Êtes-vous connecté correctement?? S’il n’y a pas d’icône de téléphone près de votre nom: 1. Racrochez et déconnectez-vous de WebEx. 2. Reconnectez-vous en utilisant le lien original. Entrez nom & courriel & cliquez sur: Join Now 3. Une boîte de dialogue affichera les informations téléphoniques. Vous n’êtes pas bien connectés!  On ne voit pas d’ icône de téléphone près de votre nom. Vous ne pourrez vous joindre aux salles d’exercise virtuelles (Breakout sessions Vous êtes bien connectés!  On voit un icône de téléphone près de votre nom. Vous pourrez vous joindre aux salles d’exercise virtuelles (Breakout sessions). Ligne directe: Entrez votre numéro Ligne avec poste, choisir: “ I will call in”
  • 5. www.saferhealthcarenow.ca Falls Prevention/Injury Reduction Getting Started Kit 2nd Edition What’s New in Fall Best Practices Hosts Brenda Dusek RNAO iaBPG Program Manager Falls Intervention Lead National Call Host Gina Peck Administrative Assistant/Office Coordinator, Atlantic Canada Canadian Patient Safety Institute Technical Support Hélène Riverin, Safety and Improvement Advisor Quebec French Support
  • 6. www.saferhealthcarenow.ca Question Raise Hand ICON
  • 7. www.saferhealthcarenow.ca Or… Write Question Type your message here and click ‘send’ or use enter on your keyboard. Select ‘send to’
  • 8. www.saferhealthcarenow.ca Falls Prevention/Injury Reduction Intervention Model – What’s New?
  • 9. www.saferhealthcarenow.ca Dr. Fabio Feldman Presenters Dr. Vicky Scott Hélène Riverin Brenda Dusek
  • 10. www.saferhealthcarenow.ca A Fall? An event that results in a person coming to rest inadvertently on the ground or floor or other lower level, with or without injury – which includes: •Unwitnessed fall = where the client is able/unable to explain the events and there is evidence to support that a fall has occurred. What’s New? Definition Adjustments
  • 11. www.saferhealthcarenow.ca A Near Fall? A slip, trip, stumble or loss of balance such that the individual starts to fall but is either able to recover (witnessed or unwitnessed) and remains upright because their balance recovery mechanisms were activated and/or caught by staff/other persons, or they were eased to the ground or floor or other lower level, by staff/other persons e.g. could not stop or prevent falling to the ground, floor or lower surface. What’s New? Definition Adjustments
  • 12. www.saferhealthcarenow.ca What is a Fall Injury? An injury that results from a fall, which may or may not require treatment. The injury can be temporary or permanent and vary in the severity of harm. What’s New? Definition Adjustments
  • 13. www.saferhealthcarenow.ca SAFE ENVIRONMENT, ASSIST WITH MOBILITY, FALL RISK REDUCTION, ENGAGE CLIENT AND FAMILY • Assess all clients on admission, on a regular schedule, and following change of status and following a fall MULTIFACTORIAL RISK ASSESSMENT • Communicate the results of the fall risk assessment to the client and family, and healthcare team • Educate all staff on fall prevention/injury reduction strategies and on specific fall risk factors • Educate all clients who have been assessed at high risk for a fall and fall-related injury and their family regarding fall risk status COMMUNICATION AND EDUCATION ABOUT FALL RISK IMPLEMENT INTERVENTIONS FOR THOSE AT RISK OF FALLING • Implement individualized interventions targeted to the client-specific risk factors. • Modify the environment and provide personal protective devices INDIVIDUALIZE INTERVENTIONS FOR THOSE AT HIGH RISK OF A FALL-RELATED INJURY •Client Level: •Create an individualized care plan based on identified risk factors •Organizational Level: •Develop policies for fall prevention/injury reduction management, that includes: HCP and organization role responsibilities for fall risk assessment •Develop an approach for regular safety checks •Investigate falls, near falls (includes unwitnessed) to determine contributing factors Prevention: Universal Fall Precautions (SAFE) Falls Prevention/Injury Reduction Intervention Model What’s New?
  • 14. www.saferhealthcarenow.ca Prevention: Universal Fall Precautions (SAFE)
  • 15. www.saferhealthcarenow.ca Multifactorial Risk Assessment – What’s New? Risk Factors for Falling: Use of adapted BBSE MODEL of fall-related risk factors: Scott,, V. (2012). Fall Prevention Programming: Designing, implementing and evaluating Fall Prevention Programs for older Adults. Raleigh, North Carolina: Lulu Publishing. What’s New Increased focus on: (Intrinsic) Risk Factors Biological  Pertain to the human body  Multiple factors increases fall risk  advancing age  chronic disabilities  visual impairment  inadequate hydration and/or nutrition (Extrinsic) Risk Factors Behavioural  Understanding the association between risk factors and a person’s actions, emotions & that increase the risk  multiple medications  Inadequate hydration/nutrition Social and Economic Conditions/circumstances that permit/shape health:  social isolation  poor support networks  socially deprived populations  culture and ethnicity  low income (below $15,000)  living conditions e.g. supports  income impacts on food choices Environmental  associated hazards within our physical surroundings  home hazards  support aids: balance, visual etc  accessibility
  • 16. www.saferhealthcarenow.ca Fall Risk Factor Assessment Tools – What’s NEW? More explanation of categories and classifications for fall risk assessment tools: Categories: 1. Multifactorial tools 2. Functional mobility tools 3. Environmental Hazard Checklists Classifications: •Quick Screening •Comprehensive
  • 17. www.saferhealthcarenow.ca Screening Parameter Screening Tool and Approach Chart- Figure 5 Screening parameter Appropriate Screening Tool(s) and Approach Screen for physical and functional status (*See examples of tools in Appendix D*) Some examples of tools that could be used to screen for physical or functional status include Quick Screen:  *Timed Up and Go  Sit-to-Stand  Tandem Stance  Functional Reach Other Assessment tools  Scott Fall Risk Screen Tool (SFRS)©  *Berg Balance Scale  Fullerton Advanced Balance (FAB) scale  Stop walking when talking  The BESTest (balance evaluation system test  * Tinetti Performance Oriented Mobility Assessment (POMA)  Walking speed
  • 18. www.saferhealthcarenow.ca Screening parameter Appropriate Screening Tool(s) and Approach Screen for cognitive impairment Examples of tools that could be used to screen for cognitive impairment include:  Mini-Mental Status Exam (MMSE)  Confusion Assessment Method (CAM)  Mini Cog available at  Montreal Cognitive Assessment (MoCA) Screen for osteoporosis Osteoporosis screening and intervention are imperative to prevent fractures in all men and women over the age of 50 years. When risk factors for osteoporosis – consider BMD testing Further facts and statistics are available at http://www.osteoporosis.ca/index.php/ci_id/8867/la_id/1.htm Fracture Risk Assessment Tools:  The Canadian WHO Fracture Risk Assessment Tool (FRAX); and  Canadian Association of Radiologist and Osteoporosis Canada (CAROC) Both can be accessed at http://www.osteoporosis.ca/multimedia/tools.html. Screening Parameter Screening Tool and Approach Chart – Figure 5
  • 19. www.saferhealthcarenow.ca Screening parameter Appropriate Screening Tool(s) and Approach Screen for hearing and visual acuity Vision screening tools provide a quick and easy approach to vision assessment to determine if visual impairment. •A Vision Screening Kit available at: Misericordia Health Centre which focuses on Falls Prevention & Vision screening @ http://www.misericordia.mb.ca/AboutUs/VisionScreening.html  The Centre for Eye Research Australia has examples of vision screening tools: http://www.cera.org.au/our-work/resources/vision- screening-tools. Example kit contents:  Vision Screening Booklet  Pinhole  E Card Booklet (Near and Distance visual acuity)  Matching Card  E Card Tests: o Distance –6/6, 6/12, 6/18, 6/60, 3/60 o Near – N8, N20, N48 Screen for malnutrition (*See examples of tools in Appendix E*) and dehydration Assess current nutrition risk with valid tools such as: *MST, *SCREEN© or *MNA-SF®. Several recommendations to improve food intake can be made based on screening tool risk factors; Refer high risk clients who require a full assessment to a dietitian. Screening Parameter Screening Tool and Approach Chart – Figure 5
  • 20. www.saferhealthcarenow.ca EXAMPLE: Long Term Care, CSSS de la Vieille-Capitale; 2013. A logo is used according to the score •Client screened with the Scott Fall Risk Screening Tool •All identified risks addressed •Score above 12 on the screening tool = high risk of falling and unsafe ambulation •Surveillance increased •Identifier used Communication of Fall Risk -
  • 21. www.saferhealthcarenow.ca Implement Interventions for Those at Risk for Falling Canadian Fall Prevention Curriculum Model - BEEEACH Reproduced with permission Vicky Scott, PhD; 2013.
  • 22. www.saferhealthcarenow.ca Interventions Known to Modify Fall Risk Factors- Figure 7 Risk Factors for Falls Interventions known to modify risk based on fall risk factor Age, over 80 years of age Fear of falling  Encourage the individual to verbalize feelings.  Strengthen self-efficacy related to transfers and ambulation by providing verbal encouragement about capabilities and demonstrating to the individual their ability to perform safely. History of previous falls or near falls  Identify the client as being at risk for a fall or near fall reoccurrence.  Communicate risk by use of a visual identifier.  Address causes of falls based on past fall assessment.  Further assess physical function, balance etc. Acute illness, such as UTI, pneumonia, etc.  Treat acute condition and re-evaluate risk factors. Increase observation- e.g. nurse rounding. Chronic illness and or conditions, such as stroke (balance/mobility/limb paralysis), hypotension, postural (orthostatic) or Post-prandial hypotension, depression, etc.  Treat chronic condition and re-evaluate risk factors.  Educate client on the risks associated with condition e.g. change in posture leading to postural orthostatic hypotension.
  • 23. www.saferhealthcarenow.ca Interventions Known to Modify Fall Risk Factors- Figure 7 Medication reviews should include review of the client’s medical conditions/diagnoses/health problems and medications prescribed which includes: 1. Use of: •non-prescription medications •natural health products 2. Description of how the client is actually taking the drug products 3. Identification of any: •condition not treated or undertreated •drug product taken without an indication •drug being misused (e.g. excessive duration or dose) •high-risk medication being used with the potential to increase the risk of falling (See Appendix B) 4. Treatment for bone health including over the counter Calcium and Vitamin D (Prevention and Treatment of Osteoporosis Section )
  • 24. www.saferhealthcarenow.ca Define the Problem Identify Fall Risk Factors Examine Fall Prevention/ Injury Reduction Best Practices Implement the Fall Prevention/ Injury Reduction Program Evaluate Fall Prevention/ Injury Reduction Program Adapted: A Public Health Approach to Fall Prevention Among Older Persons in Canada Model Figure 8 Public Health Approach Model Adapted with permission, Elsevier Limited, The Boulevard, Langford Lane, Kidlington,Oxford, OX5 1GB,UK ; Authors: Vicky Scott, Brandon Wagar, Alison Sum, Sarah Metcalfe, Lori Wagar; 2013. Organization Strategies - Implementation
  • 25. www.saferhealthcarenow.ca Restraint Use Home Health Care Policy and Procedures – Restraint Use
  • 26. www.saferhealthcarenow.ca Individualize Interventions for Those at High Risk of a Fall-Related Injury •Figure 9 Risk Fall, Hip Fracture and Severity of fall Injury: This chart reviews factors that increase risk for fall or hip fracture or factors that potentiate severity of injury •Figure 10 Chart focus on Interventions that prevent or minimize risk/ severity of injury •Additional focus in this section on Osteoporosis – pharmacological interventions & exercise, injury site protection
  • 27. www.saferhealthcarenow.ca Individualize Interventions for Those at High Risk of a Fall-Related Injury •Additional focus in this section on: Osteoporosis – pharmacological interventions
  • 28. www.saferhealthcarenow.ca Individualize Interventions for Those at High Risk of a Fall-Related Injury •Additional focus in this section on Exercise
  • 29. www.saferhealthcarenow.ca Individualize Interventions for Those at High Risk of a Fall-Related Injury •Additional focus in this section on Hip Protectors
  • 30. www.saferhealthcarenow.ca New Indicators There are now seven measures for Acute Care and 8 Measures for Long Term Care: NEW: 8. (# 8 Long Term Care but # 7 for Acute Care): Injury Rate related to falls (Fall Related INJURY Rate) per 1000 patient/resident days (Outcome Measure) Measuring the Success of Fall Prevention/Injury Reduction Programs Total Number of Injuries (Fall related INJURY) related to falls reported this Month Total Number of Patient/Resident Days on the Facility or Unit within the Facility this month x 1000 = Injury Rate related to falls (Falls Related Injury Rate) per 1000 Patient/Resident Days
  • 31. www.saferhealthcarenow.ca New Indicators There are now six measures for Home Health Care: NEW: 6. (NEW) Restraint Use (Balancing Measure) Measuring the Success of Fall Prevention/Injury Reduction Programs Total Number of Clients Receiving Home Health Care with Restraints Applied Total Number of Clients Receiving Home Health Care in the same time period x 100 = Percentage of Clients with Restraints
  • 32. www.saferhealthcarenow.ca GSK – 2nd Edition available at: http://www.saferhealthcarenow.ca/EN/Interventions/Falls/Pages/ resources.aspx
  • 33. www.saferhealthcarenow.ca Questions Raise Hand ICON
  • 34. www.saferhealthcarenow.ca Or… Write Question Type your message here and click ‘send’ or use enter on your keyboard. Select ‘send to’
  • 35. www.saferhealthcarenow.ca Special Thank You SHN Falls Intervention Faculty 2013 Cheryl Sadowski, PhD Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta Donna Davis Co-chair, Patients for Patient Safety Canada, Carievale, Saskatchewan Brenda Dusek RN, BN, MN Program Manager, IABPG, RNAO, Toronto, Ontario Fabio Feldman, PhD Manager, Seniors Fall and Injury Prevention, Fraser Health Authority Kimberly Fraser, PhD Assistant Professor, Faculty of Nursing, University of Alberta, Edmonton, AB Nadine Glenn CPSI, SIA SHN Heather Keller RD, PhD Schlegel Research Chair Nutrition & Aging Department of Kinesiology, University of Waterloo, Ontario Anne MacLaurin, RN, BSCN, MN CPSI, Project Manager, SHN
  • 36. www.saferhealthcarenow.ca Special Thank You SHN Falls Intervention Faculty 2013 Susan McAlpine, B.Sc.P.T. Physiotherapist, CSSS d’Argenteuil, Lachute, Quebec Coordinator of Clinical Education, Physical Rehabilitation Program, Dawson College, Montreal, QC Heather McConnell Associate Director, IABPG, RNAO Alexandra Papaioannou, BScN, MSc, CIHR, MD Eli Lilly Chair Professor of Medicine McMaster University, Hamilton Health Sciences, Ontario Vanina Dal Bello-Haas, PT, PhD School of Rehabilitation Science, McMaster University, Hamilton, Ontario Rayma O’Donnell Director of Care Services, York Manor, Fredericton, New Brunswick Carla Marie Purcell, RN, BScN, Clinical Nurse Educator, Capital Health, Halifax, Nova Scotia
  • 37. www.saferhealthcarenow.ca Special Thank You SHN Falls Intervention Faculty 2013 Helene Riverin Conseillère clinicienne en physiothérapie, CSSS de la Vieille-Capitale, Quebec Vicky Scott, PhD Senior Advisor on Fall & Injury Prevention, British Columbia Injury Research & Prevention Unit and Ministry of Health Services, Victoria, BC Laura M. Wagner, RN, PhD, Adjunct Scientist, Rotman Research Institute, Baycrest, Toronto, ON
  • 38. www.saferhealthcarenow.ca • Special Thanks to: – Falls Prevention/Injury Reduction Intervention Faculty – Guest Speakers – Technical Support – Especially our call participants Thank You

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