Each year, somewhere between 700,000 to 1,000,000 people in the United States fall while a patient in the hospital.
The good news is that close to one-third of falls can be prevented, according to the Agency for Healthcare Research and Quality. Research shows that falls can be prevented by managing a patient’s underlying fall risk factors, such as problems walking, medication side effects, confusion, frequent toileting needs and others.
SAFETY IS A PRIORITY
Baystate Medical Center has long made patient safety a priority, and recognizing the fact that falls are the most common adverse events in hospitals, has been focusing attention on reducing, and eventually eliminating, patient falls.
In an effort to raise awareness and encourage the engagement of patients, families, health care providers, and the public in patient safety, the National Patient Safety Foundation (NPSF) has designated March 13-19 as Patient Safety Awareness Week. This year’s campaign, “United for Patient Safety,” aims to improve the safety of the health care system for patients and the workforce, and seeks to instill the message that “every day is patient safety day.”
Recently, a pilot project at Baystate called ACE – Acute Care for Elders, tailored to the specific needs of hospitalized older adults, resulted in the reduction of delirium, a common problem for elder patients, a reduction in the use of antipsychotic drugs, reduced length of stay and hospital readmission, as well as in the number of falls on the ACE unit.
“Our attention in reducing falls for elderly patients on the ACE unit focused on the medications they were taking, which can increase their risk for falling because they cause side effects like dizziness. We also watched out closely for those patients, some of whom when getting up from lying down or sitting, are at risk for falling because of a drop in their blood pressure. And, a large emphasis was placed on keeping our elder patients mobile, in other words up and walking, which can play a big role in reducing falls,” said Virginia Chipps, unit manager on Springfield 3, where the pilot project is centered.
NEW FALLS PREVENTION PROGRAM
Baystate Medical Center also recently introduced a new hospital-wide falls prevention effort where employees, whether a nurse, doctor or other support staff on a unit, “watch for yellow.” Patients who are at risk for falls are now given yellow socks to wear while in the hospital, along with a wristband, and there are also door placards identifying them as “at risk.”
“The idea is to make it easier for anyone on a hospital unit to watch for falls risk patients, who may need assistance. And, it’s not just the clinical staff, everyone can help prevent falls,” said Chipps.
Outside of the hospital, falls continue to be a major threat for those ages 65 and older, one-third of whom fall each year and sustain serious injuries, such as head trauma, lacerations or fractures. Also, every 29 minutes an older adult dies from a fall.
“Geriatrics is all about a team based approach to improve outcomes for patients and families. Falls are a common and sometimes devastating problem for seniors. The key is to get a prompt, thoughtful and broad evaluation of all the problems that may be contributing to falls, such as poor vision, balance problems, hazards in the home, or drugs or alcohol that can impair a person’s walking,” said Dr. Maura Brennan, chief of Baystate’s Geriatrics & Post-Acute Medicine Division, and medical director of Hospice for Baystate Visiting Nurse Association & Hospice.
“Then, the name of the game is to improve as many of those factors as possible. The time to focus on the problem is before an injury. Prevention is critical and the key to maintaining independence and joy in life for older adults,” she added.
FALLS SAFETY AT HOME
Healthinaging.org, the official foundation of the American Geriatrics Society, recommends the following tips for making your home safe from falls:
• Keep cords away from areas where you walk.
• Remove loose carpets and rugs or tack down the carpets and only use rugs with nonskid backing.
• Add lights in dimly lit areas and at the top and bottom of stairs.
• Use nightlights in bedrooms, halls and bathrooms.
• Clean up clutter – especially near staircases.
• Put hand rails on both sides of any steps or stairs in or outside of your home.
• Add “grab bars” near the toilet and bath tub, and no slip decals or a rubber mat in the tub or shower.
• Wear firm shoes that are not slippery on the bottom.
• Don’t walk around in loose slippers or socks.
It’s a good idea to talk with your doctor if you have been experiencing falls, which could be the sign of a new medical problem that needs attention, or that a medication might need to be changed.