C229: Older Adults Prevention of injury related to Falls Sample

Prevention of Falls in Florida Nursing Homes

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Introduction

A1. Problem: Prevention of Falls in Florida Nursing Homes

Nursing homes provide critical care for our elderly population; however, often, this population is found to trip, lose balance and even fall, possibly every day, because of their elderly and other chronic conditions. These falls often prove fatal to these elderly populations. Because it has proven to be an issue, health practitioners need to formulate and implement programs and policies that, after implementation, will ensure the safety of the elderly in nursing homes from falls. This paper will examine, investigate and analyze falls among the elderly in nursing homes across Florida. Additionally, the paper will implement fall prevention protocols within Florida within a reasonable timeline while considering stakeholders within the implementation plan. 

A1a. Explanation of the Fall Problem 

Falls in elderly people cause serious injuries and may also cause accidental deaths; therefore, falling is a real threat to their lives. Causes range between aging, poor eyesight, poor hearing, and other underlying conditions which improve their likelihood of falling. The falls affect the strength and balance of these elderly people. The underlying factors that can lead to falls include; depression, sleep problems, and high blood pressure. Other medicines that treat diabetes and other conditions can also make these elderly people lose their balance and fall. 

A2. Investigation of the Fall Problem

The research presents that many mortality rates among the elderly might be related to falls and injuries resulting from falls. According to the Agency for Healthcare Research and Quality (AHRQ), in an annual timeline, over one million elderly falls into nursing homes, which brings about fractures, cuts, or internal bleeding, which may be fatal for the delicate lives of these elderly people (Dokur et al., 2018). However, the research also shows that 75% of these falls are preventable through policy formulation and safety improvements in nursing homes (WHO, 2022). My focus is to develop policies, including education and equipment designs, to address the problem of reducing injuries in the elderly population. Falls can be very damaging health-wise to this generation.

For nursing home workers, an incident report must be written for every fall. My knowledge of elderly falls is vast, and these falls can cause injuries that may lead to bone surgeries, fractures which include skull fractures which may cause death to the patient. Nursing homes have little modification, which may prevent falls; however, the little modification is seldomly used by the nursing home staff.  

A2a. Evidence to Substantiate the Fall Problem

According to CDC Injury Prevention and control report, one out of four older adults fall annually in the United States. According to the fact sheets of the CDC report, “about 36 million falls are reported every year with a mortality rate amounting to over 32,000 deaths” (WHO, 2022). Injuries that have occurred within the nursing homes in, one of every five falls causes injuries and broken bones. Additionally, older women fall more often than men. 

A3. Analyzing the State of the Situation Using Current Data

According to the WHO, a fall is “an event which results in a person coming to rest inadvertently on the ground or floor or other lower level” (WHO, 2022). Sarasota is a city in Sarasota County on the southwestern coast of the United States of Florida. With a favorable humid subtropical climate. Sarasota city boasted a population of 54 842 with 25,209 households. Of this population, 3.9% are under the age of 5, 14.6% are under 18, and 28.0% are 65 years and older. 52.5% of the population are females, while the other is the representation by men. With 28.0% of the population above 65 years, most people in this age bracket live in nursing homes and rehabilitation facilities. The state has over 600 licensed nursing homes with a capacity of 84,448. Among the age bracket 65 years and older, falls and injury is among the essential aspects causing death (Florida Health, 2022). People in this population are vulnerable to chronic diseases which facilitate injury-related falls. Scholarly data reveal that significant falls lead to more than 230,000 hip fractures annually (Sattin, 1992). Therefore, the cost of falls among older people is enormous, leading to a high death toll with expensive hospital stays and other facilities such as nursing homes and rehabilitation facilities. According to WHO, falls are the second leading cause of unintentional injury death worldwide (WHO, 2022). Older adults suffer the most significant fatalities because of their body structure and even the influence of chronic diseases in the deterioration of the body’s immune systems.

A3a. Analyzing the Factors That Might Contribute To the Fall Problem

The state has accredited many falls as a result of insufficient lighting, impairs these older patients making them unable to see obstacles. It is also important to note that most elderly patients in nursing homes have already developed vision problems due to aging and other factors. The second issue that the state noted is wet and slippery floors which are a result of stagnant water or cleaning, which happens from day to day (Dokur et al., 2018). Another fall-causing misconduct is improper maintenance of wheelchairs which break or fall because of mechanical damage and cause falls to this population. 

The state noted improper usage of walking aids or walkers, which must be given with prompt instruction and staff who teaches them how to use them. Most nursing homes in Florida also failed to perform proper fall risk assessments such that their environment may be established within a plan that adequately considered falls as a priority (Shrestha et al., 2020). Other nursing homes also failed to provide persons who are to assist patients who are amputated with walking. This was noticed in many nursing homes as the management pointed out the costly human resources needed for a one-to-one patient monitor. 

Additionally, worrying about other facilities indicated a failure to install or respond to an emergency call from these patients when they have had a problem. This is also accompanied by a failure to provide precautions such as bed alarms, fall mats, low beds, and non-skid socks, which help maintain their balance. The state also noted that anti-anxiety medications and other sedatives given to this elderly population cause fall because they take a toll on the physical ability of the body to maintain stability. 

A4. Proposed Solution or Innovation for the Fall Prevention and their Justifications. 

Prevention of elderly people needs a complex approach, such as introducing policies and procedures, educational programs, and hiring sufficient and qualified staff. Some of the policies include;

1. Introduction of specific lighting criteria in all nursing homes that also can be powered by solar to prevent falls when there is a solar outage. 
2. All individuals, including the staff of any nursing home, be given non-skid socks that will help them with slippery floors. 
3. Every month, wheelchairs are maintained to prevent future falls. 
4. The nursing home should maintain a fall risk assessment which can be used to formulate other internal policies within the nursing home. 
5. The nursing home should also provide a one-to-one person to assist these elderly patients with mobility and other activities.
6. All nursing homes are to install alarm systems and check on other precautions such as; bed alarms, fall mats, low beds, and non-skid socks.
7. Importantly, isolate patients in safer environments that have been administering anti-anxiety medication and sedatives.  

Nursing homes yield their finances from non-profit organizations, the government, and donors. All these stakeholders must be informed with a plan of how to improve the lives of elders by formulating the solutions above. To achieve this, monetary input must be available. Below is a budget for maintaining the 453 nursing homes in Florida. 

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Budget

A5. Recommended Resources to Implement the Proposed Video Monitoring. Cost-Benefits

Analysis

According to the CDC, “about 36 million falls are reported yearly with a mortality rate amounting to over 32,000 deaths”(WHO, 2022) One patient with a fractured joint treatment may be charged a few hundred dollars to $10,000, considering the damage. On average, that is 360 billion U.S. dollars that are used every year to treat fractured bones resulting from falls. The rough estimate of the cost-benefit analysis is the net benefit of 350 billion U.S. dollars after successfully incorporating all these developmental plans. 

 A6. Timeline

Identify key stakeholders and/or appropriate partners that are important for the implementation of your solution or innovation, and engagement with the key stakeholders and/or appropriate partners

The stakeholders in this project include; a non-profit organization, the government, and donors. Upon submission of our project proposal, a total number of 9 non-profit organizations were able to support our project with a maximum of $200000. Donors across the board decided to help in the installation of alarm systems and the provision of preventive wear. In its next fiscal year, the government allocated a maximum of $500000 to every nursing home in Florida. Stakeholders are to be engaged until the completion of the project. They are to access progress reports and verify accountability. They are also to check and question the quality of each of the following policy implementations. 

Implementation

After the proposed activities and policies are completed, let it be made a law that annually, the government checks on the above policies for compliance. Additionally, check the fall assessment records to identify other grey areas that need to be implemented. Infrastructure improvement will help these elderly populations to use the necessary systems to prevent falls. Importantly, lighting, preventive wear, wheelchair maintenance, hiring, and installation of alarm systems must be formulated into law such that it is made a must for every nursing home to provide their clients with the necessary services to prevent falls. 

Explain how you fulfilled the following roles during your process of investigation and proposal development:

1. Scientist

As a scientist, I identified and came up with solutions to improve the quality of life of the elderly population across Florida. 

• Detective 

As a detective, I identified the faulty areas and addressed them without bias.     

• Manager 

As a manager of the healing environment, I organized and managed to get stakeholders who will and have assisted immensely towards the competition of this project. 

References

Dokur, M., Petekkaya, E., & Karadag, M. (2018). Media-based clinical research on selfie- related injuries and deaths. 

Florida Health. (2022). Florida Injury Surveillance System | Florida Department of Health. Floridahealth.gov. Retrieved 14 September 2022, from https://www.floridahealth.gov/statistics-and-data/florida-injury-surveillance- system/index.html#factsheets. 

Sattin, R. W. (1992). Falls among older persons: a public health perspective. Annual review of public health, 13(1), 489-508. 

Shrestha, S., Morshed, S. A., Pradhananga, N., & Lv, X. (2020, November). Leveraging accident investigation reports as leading indicators of construction safety using text classification. In Construction Research Congress 2020: Safety, Workforce and Education (pp. 490-498). 

WHO. (2022). Falls. Who.int. Retrieved 14 September 2022, from https://www.who.int/news- room/fact-sheets/detail/falls.