Measuring Fall Program Outcomes

Article excerpt

Abstract

Nurses help to ensure patient safety, which includes preventing falls and fall related injuries. The aging Veteran population, like the general population, is at risk for falls and fall related injuries whether at home, in hospitals or in long term care facilities. Nurses are leading practice innovations to systematically assess patients' risk for falls and implement population based prevention interventions. To determine the effectiveness of programs, data can be analyzed using a variety of statistical measures to determine program impacts. Thus, data analysis of fall rates by type of fall and severity of fall related injury can help facilities examine the effectiveness of their interventions and program outcomes. Examples of actual fall prevention programs and their approaches to measurement are showcased in this article.

Citation: Quigley, P., Neily, J., Watson, M., Wright, M., Strobel, K., (February 28, 2007). "Measuring Fall Program Outcomes". Online Journal of Issues in Nursing. Vol 12, No. 2. Available: www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No2May07/ArticlePreviousTopic/MeasuringFallProgramOutcomes.aspx

Key words: Falls, fall rates, hip fractures, prevention, quality improvement

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Nurses help ensure patient safety, including prevention of falls and fall related injuries. Patient falls are one of the top five sentinel events for hospitals, long term care, and home care agencies because of loss of function and injury that results. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) defines a sentinel event as an unexpected occurrence involving death or serious injury (e.g., loss of limb or function), or the risk thereof (JCAHO, 2006, para.1).

Fall-related injuries are a serious health issue for the aged population (Centers for Disease Control and Prevention [CDC],2007). Nurses make a major contribution to patient safety by assessing fall risk and designing patient-specific fall prevention interventions that reduce risk and prevent falls and fall-related injury. Falls have been linked to nurse staffing patterns and thus, some falls are preventable (Potter, Barr, McSweeney, & Sledge 2003). Knowledge of fall prevention program deployment and evaluation using statistical analysis can help nurses design and test effectiveness of fall prevention programs. This article describes exemplars of development and evaluation of fall prevention programs.

Statistics Related to Falls in United States

"Among people 65 years and older, falls are the leading cause of injury deaths and the most common cause of nonfatal injuries and hospital admissions for trauma" (CDC,2007, para.1 ). For this population, more than half of all falls happen at home (CDC, 2006b). Fractures are the major category of injuries produced by falls with 87% of all fractures in older adults resulting from falls (Magaziner et al., 2000). Fall rates for residents of long-term care facilities are almost three times higher than for residents living in homes, and more frequently result in fracture, laceration, or the need for acute hospital care (Eakman et al., 2002). Recent estimates of fall incidence during an acute care admission range from an average rate of first falls of 2.2 per 1000 patient days (Magaziner et al.,) to an average fall rate on medical/surgical units of 3.6 falls per 1000 patient days (Donaldson, Brown, Aydin, Bolton & Rutledge, 2005). These estimates are probably under-representative of actual fall rates because not all falls are reported.

Social and economic burden of falls and fall related consequences is great. The total cost of fall injuries for adults aged 65 and older in 1994 was $27.3 billion; by 2020 it is estimated the cost will be $43.8 billion (CDC, 2006b). Reports from the CDC (2005) note that fall-related deaths are higher among men than among women and that the incidence of fall-related injuries in the aging U. …