In 2019, 844 fall-related adverse events were reported to CHWAPI. In 2020, that number dropped to 574 falls for the same period.
Conducting an effective fall prevention policy is a large-scale project. But when the statistics show a decline in falls, we can say to ourselves that somewhere, the efforts made are having quite positive effects.
By reducing the number of falls, we reduce their consequences, such as fractures, bruises and everything that can happen during a fall.
The CHWAPI teams have understood this well. Moreover, all fall prevention measures have enabled the institution to obtain Canada accreditation.
A benchmark in fall prevention
First, the CHWAPI set up screening using a so-called Morse scale to identify patients at risk. The risk of falling is made visible by a bracelet that complements the identification bracelet. A marker is also added to the computerized care record.
Then, a series of activities were integrated into the Electronic Health Record (EHR), such as following up on a patient who has fallen to find out what has been done and follow the patient’s progress.
Finally, a supportive care plan is required to know and explain the pathologies that can lead to a potential risk of falls. It is the know-how, interpersonal skills and experience of the caregiver and other specialists that broaden the scope of knowledge.
Multidisciplinary management of falls
The management and the training courses organized encourage the staff to be vigilant and to apply the universal recommendations and the specific recommendations. Training and stimulation are also offered at the medical level, on the subject of multiple medications, for example.
The CHWAPI offers information by media, with document management that compiles all the recommendations, posters, brochures … Sabrina, the occupational therapist, has created two brochures: the first on recommendations during hospitalization and the second, on the recommendations for the layout of the home when the patient leaves.
A root cause analysis is also carried out to measure the responsibilities of the caregiver, the patient (or his/her state of health) and possibly the general environment.
Better Understanding of Elderly Patients Through Aging Mechanism Combinations
Caregivers of CHWAPI could experience the limitations of the older patient using combinations of aging mechanisms. These
combinations include several elements that limit a person’s mobility capabilities. It is a rich teaching experience that caregivers go through to tell themselves that they will one day have to combat this heaviness and immobility.
An event like this allows for great staff buy-in, in the sense that quality can only be achieved if the patient is put at the center of attention.
Caregivers will be more vigilant in their efforts, when leaving the room without forgetting to relocate the patient and to secure his movements after treatment.
A strategy of rehabilitation of patients to prevent them from falling
Soon, exercises with the physiotherapist will be offered to integrate an assessment of the patient’s ability to be mobile, through an examination called the Tinetti.
The goal of rehabilitation is to regain part of their ability to be mobile as a process of empowerment. We can, in rehabilitation, in geriatrics, imagine that the patients who return are bedridden and that they can be put back on their feet in complete safety.
From a medical point of view, the CHWAPI will offer treatment for weaknesses, both for the anti-osteoporotic medication and the dietetic aspect: food supplements that make it possible to build more muscle strength in patients.
The know-how, the interpersonal skills, and the experience of the caregiver to broaden the field of knowledge.
To ensure the transfer of knowledge, the approach developed by the CHWAPI is to return to the teams.
Concretely, the films recorded by ISA can be shown to caregivers to collect their analysis and find out their points of view.
This type of focus group is an opportunity to explain the reason for the fall and to check what can be done better in relation to the care. Does it have to do with patients who do not listen to staff recommendations? Are the falls related to night tables with defective brakes? In this case, it is no longer the nurse who should be made responsible, but the organization, the department that buys the night tables, or the chairs that do not have an armrest, for example.
Better communication with the family members
In the CHWAPI falls prevention policy, the patient becomes a partner and therefore, it is important to integrate educational aspects into all the measures put in place.
The education targets patients, families and finally, the clinical nursing approach to help develop an interest in fall prevention.
The reaction time following the fall is also important to put it in the home context, since the person is alone. You have to be able to react quickly and not wait 24 or 48 hours before going to check if the patient has fallen.