The LACE index identifies patients that are at risk for re-admission or death within thirty days of discharge. It incorporates four parameters. "L" stands for the length of stay of the index admission. "A" stands for the acuity of the admission. Specifically, if the patient is admitted through the Emergency Department vs. an elective admission. "C" stands for co-morbidities, incorporating the Charlson Co-Morbidity Index. "E" stands for the number of Emergency Department visits within the last 6 months.
LACE sores range from 1-19 and as mentioned above predict the rate of re-admission or death within thirty days of discharge. Below is an example of how to calculate the LACE index. A score of 0 - 4 = Low; 5 - 9 = Moderate; and a score of ≥ 10 = High risk of re-admission.
The document outlines several key principles of family medicine according to various experts and organizations. It discusses that family medicine is the specialty focused on comprehensive primary care for patients and their families. Some of the core principles mentioned include that the family physician acts as a skilled clinician, values the patient-physician relationship, provides community-based care, and coordinates care as a resource to their practice population. The principles aim to emphasize whole-person care, prevention, and management of common medical issues.
BreakingBad NewsAn Essential skill to be acquired by every gynaecologist . ...Lifecare Centre
This document discusses breaking bad news to patients in the field of gynecology. It notes that delivering bad news is a difficult but essential skill for gynecologists. Examples of bad news include cancer diagnoses, infertility issues, stillbirths, neonatal deaths, and deaths on the operating table. The document provides guidelines for how to effectively break bad news, including preparing in advance, building rapport with patients, communicating clearly and empathetically, addressing emotional reactions, and encouraging acceptance. It emphasizes the importance of communication skills, sensitivity, and maintaining composure in difficult situations.
Reducing Medical Error and increasing patient safety Reducing Medical Error...MedicineAndHealth
Medical errors are common and result in many deaths each year. Around half of adverse events in hospitals are preventable. Errors often occur due to systemic issues rather than individual negligence. To improve patient safety, healthcare systems must be designed with a focus on safety, adopting principles such as encouraging reporting of errors without punishment, and continual learning and improvement from past errors and near misses.
The document provides an overview of palliative care, including:
1) It defines palliative care as the active total care of persons with advanced, progressive diseases, with a focus on controlling symptoms physically, psychologically, socially, and spiritually to improve quality of life.
2) It discusses the physical, psychological, social, and spiritual components of palliative care, highlighting how an interdisciplinary team assesses and manages symptoms using evidence-based guidelines while contextualizing treatment plans to patient's disease status and goals.
3) It emphasizes the importance of addressing psychological, social, and spiritual well-being through open communication, social support, spiritual assessments, and consideration of patients' and families' beliefs, relationships
Breaking Bad News https://www.youtube.com/watch?v=AK1r-1gJkSkImad Hassan
This document provides information and guidance on effectively breaking bad news to patients. It discusses why mastering this skill is important, as effective communication can improve patient outcomes. It defines bad news as any information that drastically changes a patient's view of their future. The document recommends using empathy and active listening skills when delivering bad news. It presents the SPIKES protocol as a framework, including setting, perception, invitation, knowledge, emotions, and strategy/summary. Examples of conditions requiring bad news and techniques like the "sandwich method" are provided. The overall message is the importance of compassion and ensuring patients understand their diagnosis and future options.
The LACE index identifies patients that are at risk for re-admission or death within thirty days of discharge. It incorporates four parameters. "L" stands for the length of stay of the index admission. "A" stands for the acuity of the admission. Specifically, if the patient is admitted through the Emergency Department vs. an elective admission. "C" stands for co-morbidities, incorporating the Charlson Co-Morbidity Index. "E" stands for the number of Emergency Department visits within the last 6 months.
LACE sores range from 1-19 and as mentioned above predict the rate of re-admission or death within thirty days of discharge. Below is an example of how to calculate the LACE index. A score of 0 - 4 = Low; 5 - 9 = Moderate; and a score of ≥ 10 = High risk of re-admission.
The document outlines several key principles of family medicine according to various experts and organizations. It discusses that family medicine is the specialty focused on comprehensive primary care for patients and their families. Some of the core principles mentioned include that the family physician acts as a skilled clinician, values the patient-physician relationship, provides community-based care, and coordinates care as a resource to their practice population. The principles aim to emphasize whole-person care, prevention, and management of common medical issues.
BreakingBad NewsAn Essential skill to be acquired by every gynaecologist . ...Lifecare Centre
This document discusses breaking bad news to patients in the field of gynecology. It notes that delivering bad news is a difficult but essential skill for gynecologists. Examples of bad news include cancer diagnoses, infertility issues, stillbirths, neonatal deaths, and deaths on the operating table. The document provides guidelines for how to effectively break bad news, including preparing in advance, building rapport with patients, communicating clearly and empathetically, addressing emotional reactions, and encouraging acceptance. It emphasizes the importance of communication skills, sensitivity, and maintaining composure in difficult situations.
Reducing Medical Error and increasing patient safety Reducing Medical Error...MedicineAndHealth
Medical errors are common and result in many deaths each year. Around half of adverse events in hospitals are preventable. Errors often occur due to systemic issues rather than individual negligence. To improve patient safety, healthcare systems must be designed with a focus on safety, adopting principles such as encouraging reporting of errors without punishment, and continual learning and improvement from past errors and near misses.
The document provides an overview of palliative care, including:
1) It defines palliative care as the active total care of persons with advanced, progressive diseases, with a focus on controlling symptoms physically, psychologically, socially, and spiritually to improve quality of life.
2) It discusses the physical, psychological, social, and spiritual components of palliative care, highlighting how an interdisciplinary team assesses and manages symptoms using evidence-based guidelines while contextualizing treatment plans to patient's disease status and goals.
3) It emphasizes the importance of addressing psychological, social, and spiritual well-being through open communication, social support, spiritual assessments, and consideration of patients' and families' beliefs, relationships
Breaking Bad News https://www.youtube.com/watch?v=AK1r-1gJkSkImad Hassan
This document provides information and guidance on effectively breaking bad news to patients. It discusses why mastering this skill is important, as effective communication can improve patient outcomes. It defines bad news as any information that drastically changes a patient's view of their future. The document recommends using empathy and active listening skills when delivering bad news. It presents the SPIKES protocol as a framework, including setting, perception, invitation, knowledge, emotions, and strategy/summary. Examples of conditions requiring bad news and techniques like the "sandwich method" are provided. The overall message is the importance of compassion and ensuring patients understand their diagnosis and future options.
Medical Errors within the U.S. Healthcare SystemTerry Coulon
The document proposes an "All Hands on Deck" plan to reduce medical errors in hospitals. The 4 part plan involves teams analyzing error data, implementing a voluntary reporting bill in all states, increased oversight of health business groups, and FDA approval of health IT systems. It aims to comprehensively target errors at state and federal levels. If rejected by Congress, an alternative plan involves information sessions at hospitals ranked high for errors. The plan's benefits include its collaborative approach across agencies and states. Its costs are under $1 million, but it does not address nursing home errors or ensure hospitals' budget support.
IMPORTANT COMMITTEE LIST for a hospital going for NABH /JCI by Dr.Mahboob ali...Healthcare consultant
The document lists 13 committees that are important for a hospital seeking accreditation from NABH or JCI. The committees meet with varying frequencies from monthly to yearly and are chaired by senior staff such as the Chairman, Medical Director, and Safety Officer. The committees include members from departments like Quality, Nursing, Pharmacy to oversee functions such as safety, infection control, mortality, ethics, and blood transfusion.
Mental illness stigma ppt slides - cultural infoJoe Tinkham
This document discusses mental illness stigma in several non-Western cultures. It finds that most cultures exhibit somatization of emotional distress and idioms of distress that are culturally specific. Treatment often focuses on pharmacotherapy due to stigma, and families prefer to keep mental illness private. While biomedical views are more common in urban areas, traditional beliefs involving spirit possession or witchcraft remain influential, especially rurally. Integrating biomedical and traditional views into mental healthcare may help reduce stigma.
This document is a checklist used to assess standards and measurable elements for inpatient care at a healthcare facility. It covers areas like scope of service, patient safety goals, assessment of patients, patient and family education, and patient and family rights. For each standard, staff are asked questions to determine if the element is met, not met, not applicable, or not tested. Remarks can also be included. The goal is to evaluate areas like patient identification, communication, safety of medications, infection control, fall risk reduction, documentation, consent processes, privacy and more.
Introducing Comprehensive, Concurrent Patient Safety Surveillance for Hospita...Health Catalyst
Health Catalyst is excited to announce the Patient Safety Monitor™ Suite: Surveillance Module, the industry’s first comprehensive patient safety application to use predictive and text analytics combined with concurrent clinician review of data to help monitor, detect, predict and prevent threats to patients before harm can occur.
The Patient Safety Monitor Suite leverages AI and machine learning to quickly identify patterns of harm, learn from those patterns, and suggest strategies to eliminate patient safety risks and hazards. This potent combination of AI, machine learning, text analytics and near real-time data from multiple IT systems enables the Patient Safety Monitor Suite to predict harm events and guide clinical interventions while the patient is still in the hospital.
In this webinar you will learn how the Surveillance Module can provide:
* Greater clarity to the types, numbers, and causes of adverse events, enabling leaders to quickly prioritize improvement efforts.
* Improved patient outcomes such as reduced morbidity, mortality, and length-of-stay, and increased quality-of-life and satisfaction.
* Bottom-line cost savings and improved brand recognition related to unnecessary or preventable high-cost care and reduced/eliminated penalties.
* The ability for clinicians and infection preventionists to focus on patient care instead of burdensome manual data extraction, aggregation, and reporting.
The emergency room is staffed 24 hours a day by emergency physicians and nurses to provide urgent medical care outside regular clinic hours. The pre-admission screening process includes a full history, physical exam, nursing assessment, and diagnostic testing. Patients in the emergency room have rights to treatment, informed consent, privacy, confidentiality, involvement in care decisions, and access to protective services.
This document discusses a case involving a patient who received incompatible blood products during treatment for injuries from a car accident and later died. A root cause analysis found the nurse was pressured into administering the wrong blood by a surgeon during a busy period in the emergency department. The document then outlines considerations for addressing accountability and promoting a culture of safety, including defining disruptive behavior, just culture principles, and tools for evaluating safety culture such as leadership rounds. It provides example scripts and guidelines for conducting leadership rounds to openly discuss safety issues with frontline staff.
Religion and spirituality in palliative careJenny Story
The document discusses religion and spirituality in palliative care. It covers different perspectives on religion from various religious backgrounds and their views on life, death, and the afterlife. Spirituality is defined as relating to an individual's vital essence, and plays an important role when physical existence is threatened. Providing spiritual and religious care is important in palliative care, and involves assessing patient needs, addressing common concerns like fear of death, and connecting patients to clergy. Music can also be used to address spiritual needs. The roles of the palliative care team in meeting religious needs of patients and families are examined.
This document discusses whether health data constitutes big data. It identifies several sources of health data, such as clinical data, medical publications, and genomic data. While health data storage is projected to reach 25,000 petabytes by 2020, health data only accounts for 30% of the world's total data storage compared to other data-rich domains. However, the healthcare system has not fully optimized the potential benefits of big data due to issues like a lack of data integration and standardization. While health data is large, it is not as big as data from other domains that have more successfully harnessed the value of big data analytics.
This document introduces the concept of patient safety and discusses occurrence variance reporting (OVR) and international patient safety goals. It notes that medical errors injure 1 in 25 hospital patients and kill 44,000-98,000 people per year in the US. The goals of patient safety are to detect safety issues, implement preventive actions, and reduce risks. OVR involves voluntary reporting of process variations to improve quality and prevent recurrences. It identifies adverse events, near misses, and sentinel events. The six international patient safety goals focus on correctly identifying patients, improving communication, increasing medication safety, ensuring correct surgical procedures, reducing healthcare-associated infections, and decreasing falls.
Summary – Future Health Solutions in Emerging Market Service (Vietnam), Team ...Team Finland Future Watch
This document summarizes the key findings of a study on the healthcare market in Vietnam. It finds that while public healthcare has improved due to increased investment, more is needed especially in rural areas. The population is growing more health conscious and mobile penetration is high, indicating potential for mHealth adoption. However, infrastructure and literacy challenges exist, especially for ethnic minorities. The report also finds openness to personalized medicine among patients, but concerns around cost and accuracy. It provides demographic details on Vietnam's population distribution and diversity.
The document discusses the International Patient Safety Goals (IPSG) which were developed by the Joint Commission International to help improve patient safety. It provides background on how the IPSG were adapted from the National Patient Safety Goals established by the Joint Commission. The document then outlines several of the IPSG, including proper patient identification, improving staff communication, reducing risks associated with medications, and preventing wrong site/procedure surgery. The goals are aimed at reducing common safety issues and medical errors in healthcare facilities.
This document discusses strategies for dealing with difficult patients. It begins by exploring what can make interactions difficult, such as fear, conflict, surprise, and change. It then discusses why we tend to avoid difficult interactions and notes that the label of "difficult" is subjective. The document outlines tips for minimizing difficult interactions, such as knowing your purpose and using assertive, cooperative language. It provides examples of responding assertively in patient interactions. The document also examines factors that can influence doctor-patient communication and strategies for dealing with difficult patients, such as understanding their perspective, apologizing, and taking responsibility. It stresses the importance of physician self-care as well.
Joint Commission International 6th Edition standards interpretation FAQ'sJoven Botin Bilbao
Joint Commission International (JCI) works to improve patient safety and quality of health care in the international community by offering education, publications, advisory services, and international accreditation and certification.
Description of the Call:
Objectives:
•To describe the need from a national perspective for improved quality of falls prevention processes.
•To introduce the use of an audit tool and complementary data base which allows teams to collect patient level data on specific falls prevention and management quality processes.
•To demonstrate how this data can be easily submitted and analyzed through the Patient Safety Metrics system and used to accelerate your quality improvement initiatives
1.To briefly describe the need for improved quality of admission falls prevention processes.
2.To introduce the use of a tool which allow teams to collect patient level data on specific admission falls quality determinants.
3.To demonstrate how this data can be easily submitted and analyzed through the Patient Safety Metrics system.
Watch the webinar: http://bit.ly/1KGkRgr
Medical Errors within the U.S. Healthcare SystemTerry Coulon
The document proposes an "All Hands on Deck" plan to reduce medical errors in hospitals. The 4 part plan involves teams analyzing error data, implementing a voluntary reporting bill in all states, increased oversight of health business groups, and FDA approval of health IT systems. It aims to comprehensively target errors at state and federal levels. If rejected by Congress, an alternative plan involves information sessions at hospitals ranked high for errors. The plan's benefits include its collaborative approach across agencies and states. Its costs are under $1 million, but it does not address nursing home errors or ensure hospitals' budget support.
IMPORTANT COMMITTEE LIST for a hospital going for NABH /JCI by Dr.Mahboob ali...Healthcare consultant
The document lists 13 committees that are important for a hospital seeking accreditation from NABH or JCI. The committees meet with varying frequencies from monthly to yearly and are chaired by senior staff such as the Chairman, Medical Director, and Safety Officer. The committees include members from departments like Quality, Nursing, Pharmacy to oversee functions such as safety, infection control, mortality, ethics, and blood transfusion.
Mental illness stigma ppt slides - cultural infoJoe Tinkham
This document discusses mental illness stigma in several non-Western cultures. It finds that most cultures exhibit somatization of emotional distress and idioms of distress that are culturally specific. Treatment often focuses on pharmacotherapy due to stigma, and families prefer to keep mental illness private. While biomedical views are more common in urban areas, traditional beliefs involving spirit possession or witchcraft remain influential, especially rurally. Integrating biomedical and traditional views into mental healthcare may help reduce stigma.
This document is a checklist used to assess standards and measurable elements for inpatient care at a healthcare facility. It covers areas like scope of service, patient safety goals, assessment of patients, patient and family education, and patient and family rights. For each standard, staff are asked questions to determine if the element is met, not met, not applicable, or not tested. Remarks can also be included. The goal is to evaluate areas like patient identification, communication, safety of medications, infection control, fall risk reduction, documentation, consent processes, privacy and more.
Introducing Comprehensive, Concurrent Patient Safety Surveillance for Hospita...Health Catalyst
Health Catalyst is excited to announce the Patient Safety Monitor™ Suite: Surveillance Module, the industry’s first comprehensive patient safety application to use predictive and text analytics combined with concurrent clinician review of data to help monitor, detect, predict and prevent threats to patients before harm can occur.
The Patient Safety Monitor Suite leverages AI and machine learning to quickly identify patterns of harm, learn from those patterns, and suggest strategies to eliminate patient safety risks and hazards. This potent combination of AI, machine learning, text analytics and near real-time data from multiple IT systems enables the Patient Safety Monitor Suite to predict harm events and guide clinical interventions while the patient is still in the hospital.
In this webinar you will learn how the Surveillance Module can provide:
* Greater clarity to the types, numbers, and causes of adverse events, enabling leaders to quickly prioritize improvement efforts.
* Improved patient outcomes such as reduced morbidity, mortality, and length-of-stay, and increased quality-of-life and satisfaction.
* Bottom-line cost savings and improved brand recognition related to unnecessary or preventable high-cost care and reduced/eliminated penalties.
* The ability for clinicians and infection preventionists to focus on patient care instead of burdensome manual data extraction, aggregation, and reporting.
The emergency room is staffed 24 hours a day by emergency physicians and nurses to provide urgent medical care outside regular clinic hours. The pre-admission screening process includes a full history, physical exam, nursing assessment, and diagnostic testing. Patients in the emergency room have rights to treatment, informed consent, privacy, confidentiality, involvement in care decisions, and access to protective services.
This document discusses a case involving a patient who received incompatible blood products during treatment for injuries from a car accident and later died. A root cause analysis found the nurse was pressured into administering the wrong blood by a surgeon during a busy period in the emergency department. The document then outlines considerations for addressing accountability and promoting a culture of safety, including defining disruptive behavior, just culture principles, and tools for evaluating safety culture such as leadership rounds. It provides example scripts and guidelines for conducting leadership rounds to openly discuss safety issues with frontline staff.
Religion and spirituality in palliative careJenny Story
The document discusses religion and spirituality in palliative care. It covers different perspectives on religion from various religious backgrounds and their views on life, death, and the afterlife. Spirituality is defined as relating to an individual's vital essence, and plays an important role when physical existence is threatened. Providing spiritual and religious care is important in palliative care, and involves assessing patient needs, addressing common concerns like fear of death, and connecting patients to clergy. Music can also be used to address spiritual needs. The roles of the palliative care team in meeting religious needs of patients and families are examined.
This document discusses whether health data constitutes big data. It identifies several sources of health data, such as clinical data, medical publications, and genomic data. While health data storage is projected to reach 25,000 petabytes by 2020, health data only accounts for 30% of the world's total data storage compared to other data-rich domains. However, the healthcare system has not fully optimized the potential benefits of big data due to issues like a lack of data integration and standardization. While health data is large, it is not as big as data from other domains that have more successfully harnessed the value of big data analytics.
This document introduces the concept of patient safety and discusses occurrence variance reporting (OVR) and international patient safety goals. It notes that medical errors injure 1 in 25 hospital patients and kill 44,000-98,000 people per year in the US. The goals of patient safety are to detect safety issues, implement preventive actions, and reduce risks. OVR involves voluntary reporting of process variations to improve quality and prevent recurrences. It identifies adverse events, near misses, and sentinel events. The six international patient safety goals focus on correctly identifying patients, improving communication, increasing medication safety, ensuring correct surgical procedures, reducing healthcare-associated infections, and decreasing falls.
Summary – Future Health Solutions in Emerging Market Service (Vietnam), Team ...Team Finland Future Watch
This document summarizes the key findings of a study on the healthcare market in Vietnam. It finds that while public healthcare has improved due to increased investment, more is needed especially in rural areas. The population is growing more health conscious and mobile penetration is high, indicating potential for mHealth adoption. However, infrastructure and literacy challenges exist, especially for ethnic minorities. The report also finds openness to personalized medicine among patients, but concerns around cost and accuracy. It provides demographic details on Vietnam's population distribution and diversity.
The document discusses the International Patient Safety Goals (IPSG) which were developed by the Joint Commission International to help improve patient safety. It provides background on how the IPSG were adapted from the National Patient Safety Goals established by the Joint Commission. The document then outlines several of the IPSG, including proper patient identification, improving staff communication, reducing risks associated with medications, and preventing wrong site/procedure surgery. The goals are aimed at reducing common safety issues and medical errors in healthcare facilities.
This document discusses strategies for dealing with difficult patients. It begins by exploring what can make interactions difficult, such as fear, conflict, surprise, and change. It then discusses why we tend to avoid difficult interactions and notes that the label of "difficult" is subjective. The document outlines tips for minimizing difficult interactions, such as knowing your purpose and using assertive, cooperative language. It provides examples of responding assertively in patient interactions. The document also examines factors that can influence doctor-patient communication and strategies for dealing with difficult patients, such as understanding their perspective, apologizing, and taking responsibility. It stresses the importance of physician self-care as well.
Joint Commission International 6th Edition standards interpretation FAQ'sJoven Botin Bilbao
Joint Commission International (JCI) works to improve patient safety and quality of health care in the international community by offering education, publications, advisory services, and international accreditation and certification.
Description of the Call:
Objectives:
•To describe the need from a national perspective for improved quality of falls prevention processes.
•To introduce the use of an audit tool and complementary data base which allows teams to collect patient level data on specific falls prevention and management quality processes.
•To demonstrate how this data can be easily submitted and analyzed through the Patient Safety Metrics system and used to accelerate your quality improvement initiatives
1.To briefly describe the need for improved quality of admission falls prevention processes.
2.To introduce the use of a tool which allow teams to collect patient level data on specific admission falls quality determinants.
3.To demonstrate how this data can be easily submitted and analyzed through the Patient Safety Metrics system.
Watch the webinar: http://bit.ly/1KGkRgr
The document introduces the Falls Audit Tool for home care. It discusses why falls prevention is important for older adults, noting that falls are a leading cause of injury and that repeated falls can negatively impact independence and health. It then provides an overview of the Falls Audit Tool, which is used to retrospectively review client charts and measure falls prevention processes. The tool consists of a series of columns to record information about risk assessments, care planning, interventions, monitoring after falls, and more. Guidance is provided on how to complete the audit accurately and submit data through the Patient Safety Metrics system.
This document provides guidelines for developing a fall risk prevention protocol. It outlines assessing patient risk through a falls risk assessment tool, identifying low, moderate, and high-risk patients, and implementing prevention measures tailored to each risk level. These include safety equipment, frequent monitoring, limiting mobility without assistance, and educating patients and families. The protocol also describes procedures for responding to falls, notifying doctors, and increasing safety measures for cognitively impaired patients who fall. The goal is to comprehensively reduce fall risk through standardized assessment and individualized prevention plans.
Dan Baden from the CDC gave a presentation about using games and innovation for public health. He discussed several past and current CDC efforts using games, including HealthBound which simulates policy decisions, virtual reality training for resilience, and Whyville which modeled disease spread. He highlighted the CDC's goals of addressing "winnable battles" in public health like healthcare-associated infections. Baden also described the CDC's innovation fund and opportunities to partner with game developers to create new public health games.
This document discusses hand hygiene and fall prevention in healthcare settings. It provides information on the importance of hand hygiene in reducing healthcare-associated infections and antimicrobial resistance. It outlines best practices for when hand hygiene should be performed. It also discusses the impact of falls among elderly patients, risk factors, and multi-factorial prevention approaches including education, environmental modifications, and patient-centered care. A study is summarized that showed implementing person-centered care, including soothing lighting and monitoring high-risk patients, significantly reduced falls on a geriatric psychiatric unit.
FSMA Intentional Adulteration (IA) Rule with Rod Wheeler - Feb. 2019SafetyChain Software
Join special guest Rod Wheeler, CEO of The
Global Food Defense Institute, as he clarifies FSMA’s IA rule
requirements and serves up tools that help large food
manufacturers and processors identify their vulnerabilities in
two days or less.
Food companies will gain a clear understanding of IA compliance requirements and the knowledge they need to write their food security and defense plans including:
- How to conduct your own vulnerability assessment in 2 days
or less
- Using the FDA’s Food Defense Mitigation Strategies
database...It’s easy!
- What security countermeasures are available to consider to
mitigate the risk of intentional tampering at a food plant
- Using your vulnerability assessment to help build your Food
Defense Plans
About the Presenter, Rod Wheeler
Rod Wheeler Global Food Defense Institute
Rod Wheeler is the Founder and CEO of The Global Food
Defense Institute, the only global firm that focuses solely on
food defense, intentional adulteration (IA), tampering, and
intelligence. As a former Crime Analyst for the Fox News
Channel and frequent guest on several national and
international news outlets, he is a leading expert on food
security, terrorism and crime.
This document outlines a fall prevention program with the goals of decreasing falls and fall-related injuries. It defines a fall and identifies intrinsic and extrinsic risk factors. The program involves comprehensive patient assessments to determine individualized fall risk levels, monitoring, care plans, staff education, and environmental safety improvements. It also provides guidance on responding to falls, post-fall care, documenting falls, and analyzing fall data trends to continually improve the program.
This document outlines a fall prevention program for a hospital. It defines what constitutes a fall, notes that falls are common among elderly and confused patients and can result in serious injury. It stresses the importance of identifying patients at risk of falls through assessment tools like the Morse Fall Scale and implementing prevention strategies like hourly rounding, ensuring call lights and other items are within reach, and using devices to prevent falls for high-risk patients. The overall goal is to prevent falls and injuries to increase patient safety and reduce healthcare costs from fall-related injuries.
Capstone Project Change Proposal Presentation for Faculty Review a.docxbartholomeocoombs
Capstone Project Change Proposal Presentation for Faculty Review and Feedback
Assessment Description
Create a 10-15 slide Power Point presentation of your evidence-based intervention and change proposal to be disseminated to an interprofessional audience of leaders and stakeholders. Include the intervention, evidence-based literature, objectives, resources needed, anticipated measurable outcomes, and how the intervention would be evaluated. Submit the presentation in the digital classroom for feedback from the instructor.
PICOT Question (See other file uploaded)
Interventions
Falling incidences can cause several complications, including health care costs, severe health issues, immobility, etc. With the severity of this issue, appropriate interventions should take place. In this context, proper monitoring is one of the significant interventions to prevent this incidence (Huang et al., 2020). Hence, incorporating educated and efficient technicians while providing patient care can be an essential step. Yet, due to decreased mobility or functionality, older people often require help in doing basic activities, in this aspect, providing help to the patients while changing to hospital-approved gowns (Liu-Ambrose et al., 2019). In addition, one significant and effective intervention is providing quick education to the patient regarding fall prevention strategies (Radecki, Reynolds & Kara, 2018). Another critical aspect is providing a safe environment for clinical care. Outpatient clinics should improve their workflow and environmental condition, such as removing hazardous materials, and keeping the floor clean and dry, so that the clinic can provide a safe area for older patients. These interventions can help prevent falls (Guirguis-Blake et al., 2018).
Benchmark - Capstone Change Project Objectives
1. Prevent elderly falls in an outpatient radiology clinic.
Rationale: Falls occur as age advances due to individual risk factors or environmental factors. For example, gait or balance deficits, chronic conditions, medications, and footwear the patient is wearing. Assisting these patient populations can prevent falls in the department.
2. Educate patients and people in the community on how to prevent falls.
Rationale: Educate patients regarding physical changes and chronic health conditions that cause or probability of falls.
3. Provide a safe environment for clinical care in the outpatient clinical setting.
Rationale: Design the clinical area accessible to patients in wheelchairs, with assistive devices, and with mobility deficits. Have handrails on walls and hallways for support, clean, non-skid floors, and lighted pathways in hallways, rooms, and bathrooms.
4. A patient care technician (PCT) is available in the outpatient clinical area for patients.
Rationale: Having a PCT in the clinical area, especially around the dressing rooms, would benefit the patients needing help when changing to hospital-approved gowns and monitoring patients for risk.
Falls are a major issue and collecting information about falls in the IIMS system allows for targeted prevention strategies. It is important to identify patient risk factors for falls through screening and put appropriate prevention measures in place, such as mobility aids, supplements for osteoporosis, and reviewing medications that could increase fall risk. Staff should communicate fall risks and prevention plans to ensure consistent care that keeps patients safe from falls.
This document introduces an infection control checklist and site assessment approach for community-based and mobile dental care settings developed by the Organization for Safety, Asepsis and Prevention (OSAP). It describes OSAP forming a national advisory group to create the checklist and assessment based on three levels of anticipated contact and risk. The checklist and site assessment tools offer guidance for infection control in resource-limited settings outside the typical dental practice.
"Home healthcare needs tools & protocols to support a higher degree of post-acute care in the home
* Clinical supervisors complete the assessment in their EHR while video conferencing with the client/patient"
The document provides an orientation for a new employee at SECURE Energy. It welcomes the employee to SECURE and outlines that Level 2 orientation will cover topics like emergency response plans, ergonomics, confined spaces, fall protection, and more. It notes that this orientation provides knowledge of SECURE's health and safety system but that on-the-job training will provide more details over the coming months. The employee is welcomed again to grow with SECURE.
The document provides information on falls prevention for healthcare providers. It discusses an example of an elderly patient who fell in the hospital and later died from her injuries. It outlines four key elements of falls prevention: creating a safe environment, assessing patient risk, reducing identified risks, and evaluating interventions. It emphasizes that all staff, not just direct caregivers, have a role to play in falls prevention.
The document provides an orientation for a new employee at SECURE Energy. It welcomes the employee to SECURE and outlines that safety is a shared responsibility. It informs the employee that they have completed Level 1 orientation and are ready for Level 2, which will cover topics specific to their position such as emergency response plans and safety procedures. It emphasizes that this orientation supplements ongoing workplace training. The employee is welcomed again and encouraged to grow with the company.
This document provides a step-by-step hazard management tool to help workplaces recognize, assess, and control workplace hazards. It was developed by several Ontario health and safety organizations. The tool involves recognizing hazards, assessing their likelihood and severity of harm, establishing control priorities, implementing controls, and ongoing evaluation of hazards and controls. Effective hazard management requires a team approach and supports Ontario's Internal Responsibility System which makes all parties responsible for workplace health and safety.
This document discusses a case study on preventing patient falls at a hospital. It found that falls decreased after implementing a fall prevention program that included a fall risk assessment tool, staff training, patient education, and safety interventions. Initially there were 7 falls reported in 6 months, which increased to 14 falls in the next 6 months as incident reporting improved. After the prevention program, falls decreased to 4 in the next 6 months. The program analyzed causes of falls and found major reasons were falls from beds, to bathrooms at night without assistance, and due to patients' medical conditions.
Developing a Comprehensive Farm Safety & Health Management PlanJohn Shutske
All farms should have a workplace safety and health plan. Increasingly, these plans are required by insurers, regulators, or other stakeholders and can become an important "value added" to your operation viewed in the eyes of good employees. Covers written "policy" development, and a process for identifying, prioritizing, and taking action to control hazards and risk. The action framework is the Safety Hierarchy of control measures, suggesting that physical/engineered changes to workplace processes, systems, and components are far more effective than other measures, though all must be considered together.
Similar to Falls Prevention/Injury Reduction Getting Started Kit – 2nd Edition – What’s New in Fall Best Practices? (20)
As patients and families impacted by harm, we imagine progressive approaches in responding to patient safety incidents – focused on restoring health and repairing trust.
We can change how we respond to healthcare harm by shifting the focus away from what happened, towards who has been affected and in what way. This is your opportunity to hear about innovative approaches in Canada, New Zealand, and the United States that appreciate these human impacts.
This interactive webinar is hosted by Patients for Patient Safety Canada, the patient-led program of the Canadian Patient Safety Institute and the Canadian arm of the World Health Organization Patients for Patient Safety Global Network.
This interactive webinar is part of the world tour series designed by the World Health Organization's Patients for Patient Safety (PFPS) Global Network and hosted by Patients for Patient Safety Canada, the patient-led program of the Canadian Patient Safety Institute, a WHO Collaborating Centre on Patient Safety and Patient Engagement.
The goal of this virtual discussion is to explore practical solutions for keeping seniors safe. The ideas are drawn from real life experiences noting how COVID-19 impacted seniors, their loved ones as well as healthcare workers and leaders.
The focus of the discussion is on identifying safety risks together with practical solutions for seniors who live at home, in residences and long-term care facilities.
After hearing the perspectives of patients, providers and leaders from Indigenous communities on how they perceive safety and what solutions are/ can be implemented, we will leave the session with at least one practical idea for engaging all patients, families and/or the public in improving patient safety.
Healthcare providers and leaders will address three types of silences in healthcare: organizational silence, patient-related silence, and provider to provider silence.
Read More: www.conquersilence.ca
This document discusses teamwork in healthcare and its importance for patient safety. It describes how teamwork skills are often taught through simulations but clinical experience is limited for undergraduates. The intervention described uses a film about a patient falling through the cracks followed by workshops using scenarios to practice and debrief teamwork skills. Key concepts emphasized include shared understanding of goals and plans, involving patients as part of the team, and skills like adaptation, trust, and psychological safety. The overall goal is to apply teamwork knowledge to improve patient outcomes and safety.
Enhanced Recovery After Surgery (ERAS®) is the Enhanced Recovery After Surgery (ERAS®) is the implementation of patient-focused, standardized, evidencefocused, standardized, evidencefocused, standardized, evidencefocused, standardized, evidencefocused, standardized, evidencefocused, standardized, evidence-based, interdisciplinary perioperative guidelines.
Learn more about Enhanced Recovery Canada:
http://ow.ly/hR3j30jsnjR
Dr. Dee Mangin, Professor of Family Medicine and the Associate Chair and Director, Research, at McMaster University, will join practicing pharmacist, and Vice President, Pharmacy Affairs, Sandra Hanna of the Neighbourhood Pharmacy Association of Canada to discuss medication risks, deprescribing and the dangers of polypharmacy in this one hour webinar. Learn more at www.asklistentalk.ca
Joshua Myers, Terry Brock - Fraser Health (BC) - We Want to Hear from You: Fraser Health Real-Time Experience Survey
Leading organizations in Canada invite, listen and act on feedback from patients in their care to improve the safety and quality of care. Explore the three award-winning practices linked below then join us in a conversation to learn more about each approach and reflect on how you may apply it in your organization. This webinar promises practical ideas to help you engage patients in making care safer.
Leading organizations in Canada invite, listen and act on feedback from patients in their care to improve the safety and quality of care. Explore the three award-winning practices linked below then join us in a conversation to learn more about each approach and reflect on how you may apply it in your organization. This webinar promises practical ideas to help you engage patients in making care safer.
Cathy Masuda, Leslie Louie - BC Children's Hospital, an Agency of the Provincial Health Services Authority -Patient's View: Engaging Patients and Families in Patient Safety Incident Reporting
Leading organizations in Canada invite, listen and act on feedback from patients in their care to improve the safety and quality of care. Explore the three award-winning practices linked below then join us in a conversation to learn more about each approach and reflect on how you may apply it in your organization. This webinar promises practical ideas to help you engage patients in making care safer.
Alberta Health Services: Family Volunteers or Advisors Gathering Real-time Patient Experiences
Leading organizations in Canada invite, listen and act on feedback from patients in their care to improve the safety and quality of care. Explore the three award-winning practices linked below then join us in a conversation to learn more about each approach and reflect on how you may apply it in your organization. This webinar promises practical ideas to help you engage patients in making care safer.
This final webinar will emphasise the importance of understanding the problem before brainstorming solutions to better ensure a match between barriers and the solutions.
MORE INFO: http://bit.ly/2KctiLH
This webinar provides an overview of key frameworks for identifying barriers and enablers to implementation, with a focus on the Theoretical Domains Framework (TDF). The TDF synthesizes 128 constructs from 33 theories of behavior change into 12 domains to understand factors influencing healthcare professionals' behaviors. The webinar uses a case study of improving physician hand hygiene to demonstrate how the TDF can be applied to identify potential barriers within domains like Knowledge, Skills, Social Influences, and Environmental Context & Resources.
The fifth webinar continues the momentum of the series as it focuses on providing concrete approaches for identifying barriers and enablers, emphasising behaviour change approaches.
READ MORE: http://bit.ly/2LOwbj0
Please join CPSI as we conclude our Human Factors webinar series with our final presentation Collaborative "Spaces" and Health Information Technology Design
Professor Benedetta Allegranzi,World Health Organisation
Dr. Benedetta Allegranzi is a specialist in infectious diseases, tropical medicine, infection prevention and control and hospital epidemiology. She currently works at the World Health Organization HQ (Service Delivery and Safety department), leading the "Clean Care is Safer Care" programme. Since 2013, Dr Allegranzi has gathered the title of professor of infectious diseases in the official Italian professorship list and is adjunct professor attached to the Institute of Global Health at the Faculty of Medicine, University of Geneva, Switzerland. She closely collaborates with the team at the IPC and WHO Collaborating Center on Patient Safety, University of Geneva Hospitals (Geneva, Switzerland), as well as with the Armstrong Institute for Patient Safety and Quality, John Hopkins University, (Baltimore, USA) for clinical research projects. She is currently involved in the leadership on the WHO Ebola Response in the field of IPC and supervises IPC activities in Sierra Leone and Guinea. She has experience in clinical management of infectious diseases and tropical medicine, and clinical research in healthcare settings in both developing and developed countries. She has thorough skills and experience in training and education.
She is also the author or coauthor of more than 150 scientific publications, including articles published in high-profile medical journal such as the Lancet, Lancet Infectious Diseases, New England Journal of Medicine and the WHO Bulletin, and six book chapters.
Lori Moore joined GOJO Industries in 2013 as a Clinical Application Specialist. In this position, she provided leadership and support to healthcare organizations as they implemented electronic compliance monitoring (ECM) to more accurately measure hand hygiene performance. She has been a trusted partner to hospital key stakeholders in the development, design and implementation of hand hygiene improvement efforts. Areas of expertise include root cause analysis with targeted solutions, just-in-time coaching and ECM software data analytics. In January 2017, she transitioned to the position of Clinical Educator for Healthcare.
She began her professional career in healthcare in 2010 as a registered nurse in the medical intensive care unit at the Cleveland Clinic Foundation (where she continues to work on the weekends). Her passion for patient safety and quality of care sparked her interest in infection prevention, and she worked as an infection preventionist prior to joining GOJO.
Lori has a well-rounded academic background which includes a Bachelor’s of Arts in Management from Malone College, a Bachelor’s of Science in Nursing from the University of Akron, and a Master’s degree in Public Health from the University of Akron. She is a member of the Association for Professionals in Infection Control and Epidemiology, American Society of Professionals in Patient Safety, and the American Medical Writers Association. She has also earned the credential of Certified Health Education Specialist (CHES) and Certified Professional in Patient Safety (CPPS).
The third interactive webinar in the series builds on the second session by focusing on the question: once we have evidence to justify implementing a new patient safety initiative, what next?
Lecture 6 -- Memory 2015.pptlearning occurs when a stimulus (unconditioned st...AyushGadhvi1
learning occurs when a stimulus (unconditioned stimulus) eliciting a response (unconditioned response) • is paired with another stimulus (conditioned stimulus)
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
DECLARATION OF HELSINKI - History and principlesanaghabharat01
This SlideShare presentation provides a comprehensive overview of the Declaration of Helsinki, a foundational document outlining ethical guidelines for conducting medical research involving human subjects.
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
The skin is the largest organ and its health plays a vital role among the other sense organs. The skin concerns like acne breakout, psoriasis, or anything similar along the lines, finding a qualified and experienced dermatologist becomes paramount.
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
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
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Enter name &
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S’il n’y a pas d’icône de téléphone près de votre nom:
1. Racrochez et
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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
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?
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
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
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 -
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
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
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
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