Introduction
Falls among the elderly population staying in nursing homes are common though preventable adverse incidents. According to the Joint Commission (2015), the number of people aged 65 and older is growing at a rapid pace, which corresponds to an increased risk of this group getting injuries from falling. For instance, the Centers for Disease Control and Prevention (2017) report that “each year at least 300,000 older people are hospitalized for hip fractures (…) more than 95% of hip fractures are caused by falling” (para. 5-6). Therefore, fall prevention in elderly homes is one of the primary healthcare concerns for the medical staff working at such establishments. The purpose of the capstone project presented in this paper is to decrease the number of falls in a chosen nursing home by 25% in ten weeks. The approach used for the implementation of this project is an educational intervention focused on patients and their families. When it comes to the medical ecosystem of elderly homes, nurses and nursing aides are the people taking most of the responsibility for the “patients” (visitors), their well-being, and the overall quality of care they receive. This project aims to engage patients and their family members in the fall prevention process.
Problem Statement
Falls are not only associated with morbidity and mortality in the elderly population. They result in immobility, functional dependency, and lower quality of life (Kim et al., 2017). Moreover, in 2015, the total costs for falls totaled around $50 billion (Centers for Disease Control and Prevention, 2017). These statistics demonstrate that falls are related to higher medical costs. Although many falls do not lead to injury, “about 10% result in a major injury such as a fracture, serious soft tissue injury, or traumatic brain injury requiring medical attention” (Kim et al., 2017, p. 200). These injuries make it especially hard for older people to get around and engage in everyday tasks. In addition, many people who fall develop a fear of falling although they have not been injured previously (Centers for Disease Control and Prevention, 2017). In a nursing home, elders have a higher chance of falling (Tzeng & Yin, 2015). Firstly, when a person is less active, their muscles get weaker, which increases the risk of falling and fall-related injuries. Secondly, medication for pain relief and mental changes (e.g. dementia, delirium, etc.) make the chances of falling much higher. Thus, falling in a nursing home setting is an issue worthy of acknowledgment and efforts directed at its resolution.
Question
Is patient and family engagement in fall prevention education an effective approach to reduce the number of falls and fall-related injuries in an elderly home?
Methodology
As for the methodology of the project, pre-intervention data will be collected by project managers during a week before week 1. The documented data will include several falls, fallers, and recurrent fallers (= percentage) in the last 10-week window. The intervention will be patient discussions, educational brochures, Zoom-meetings centered around fall prevention guidelines. There are going to be 3 project managers overseeing the implementation of the project, not including a coordinator responsible for communication with the hospital’s administrative body, senior staff members, etc. The project team will collect mid- and post-intervention data (falls, fallers, recurrent fallers + a staff survey after the intervention) and analyze it using a reliable IT infrastructure.
Timetable
The project will start on February 1st and finish on April 12th. Additionally, it is important to include 2 weeks of preparation to collect data and design educational initiatives directed at patients and their families. The main stages of the project include the preparation stage, the first week of implementation (setting up the educational program and resources, educating the staff on the right methods to deliver fall prevention insights, etc.), weeks 2-10, and a concluding stage, which is needed to summarize the findings. The timetable is quite realistic since it is possible to achieve the objective of reducing falls and fall-related injuries at a chosen facility by 25% in 10 weeks. Project managers will collect data on site every 5 weeks and (week 0, end of week 5, week 10) and present it to the project coordinator. The coordinator will look at the numbers (whether they increase/decrease/stay the same) and assess the project’s progress to make adjustments.
References
Centers for Disease Control and Prevention (2017). Important facts about falls. CDC. Web.
Kim, K. et al. (2017). Evidence-based guidelines for fall prevention in Korea. The Korean Journal of Internal Medicine, 32(1), 199-210.
The Joint Commission (2015). Preventing falls and fall-related injuries in health care facilities. Web.
Tzeng, H., & Yin, C. (2015). Patient engagement in-hospital fall prevention. Nursing Economics, 33(6), 326-334. Web.