Falls and Fall Risk Reduction
Chapter 15
Copyright © 2018, Elsevier Inc. All rights reserved.
Copyright © 2018, Elsevier Inc. All rights reserved.
Leading cause of morbidity and mortality for people older than 65 years of ageFalls and subsequent injuries result in physical and psychosocial consequencesA nursing-sensitive quality indicatorFalls in nursing homes are termed sentinel events and must be reported to the Centers for Medicare & Medicaid Services
Falls and Fall Risk Reduction
Copyright © 2018, Elsevier Inc. All rights reserved.
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Copyright © 2018, Elsevier Inc. All rights reserved.
Copyright © 2018, Elsevier Inc. All rights reserved.
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Copyright © 2018, Elsevier Inc. All rights reserved.
Hip fractureMore than 95% of hip fractures among older adults are caused by fallsAssociated with considerable morbidity and mortalityTraumatic brain injury (TBI)Falls are the leading cause of TBI for older adultsFallophobiaLoss of confidence that leads to reduced physical activity, increased dependency, and social withdrawalAn important predictor of general functional decline and a risk factor for future falls
Consequences of Falls
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Copyright © 2018, Elsevier Inc. All rights reserved.
Etiology is multifactorialMay indicate neurologic, sensory, cardiac, cognitive, medication, or musculoskeletal problems or impending illnessEpisodes of acute illness, infection, or exacerbations of chronic illness are times of high fall risk Majority occur from a combination of intrinsic and extrinsic factors that combine at a certain point in time
Fall Risk Factors
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Copyright © 2018, Elsevier Inc. All rights reserved.
Intrinsic factorsReduced vision and hearingUnsteady gaitCognitive impairmentAcute and chronic illnessesEffects of medicationExtrinsic factorsLack of support equipment in the bathtub and at the toiletHeight of the bedFloor conditionsPoor lightingInappropriate footwearImproper or inadequate assistive devices
Factors Contributing to Falls
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Institutional settingsLimited staffingLack of toileting programsUse of restraints and side railsInadequate staff communication and trainingIncomplete patient assessmentsEnvironmental issuesIncomplete care planningInadequate organizational culture of safety
Factors Contributing to Falls (Cont.)
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Copyright © 2018, Elsevier Inc. All rights reserved.
Especially observed in those older than
85 years of ageAre indicative of an underlying pathological condition such as arthritis, diabetes, dementia, Parkinson’s disease, stroke, alcoholism, and vitamin D deficiencySome underlying pathological conditions cause neurologic damage and result in gait problems
Gait Disturbances
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