Identifying a Problem: Falls among Elderly Patients in Health Facilities
Identifying a Problem: Falls among Elderly Patients in Health Facilities
Falls among the elderly population is fast becoming a societal concern. The World Health Organization projects that unless there is a concerted effort to address the issue, incidents of falls among the elderly will reach epidemic proportions (Homann et al., 2013). In health facilities, despite the presence of nurses and other health personnel, incidents of falls are still taking place. The time of day that such incidents occur is in the morning when patients wake up and go to the bathroom. It has also been noted that patients who are older, those aged 82 and above, are less likely to have falls compared to those below 82 years old. The reason noted is that the older patients are less mobile while those slightly younger can roll over in their beds or slip in their chairs (Nabeshima et al., 2007).
There are different factors that contribute to the occurrence of falls. One is the age of the patients. Another is the patient’s treatment. The elderly admitted to health facilities may receive various medications, such as treatments for hypertension, cancer, and others. Some of the drugs they take in can result in drowsiness or lightheadedness, which in turn contribute to loss of balance and falls.
Impact of problem on work environment
Incidents of falls among the elderly can lead to a more stressed staff as each would have to be on heightened alert or needs to be very observant to prevent falls. However, since these incidents are becoming frequent, it could also become trivialized and easily ignored by both patients and doctors (Boch et al., 2011). Generally, though, the issue has become a major concern and staff may be developing or testing new devices that address the issue.
The elderly stays in health facilities to be treated for their ailments. When such patient experiences a fall, his/her hospitalization may be extended due to injuries sustained from the fall. Sometimes, the fall may not present major injuries and may therefore be just taken for granted. However, for the elderly, any form of trauma can delay his/her recuperation. Researchers have noted that hospitalization costs resulting from falls have reached millions annually. For example, in the UK, the figures are 92 million pounds a year (da Costa et al., 2012).
Significance to nursing profession
Nurses are the primary caregivers in the health system. They are the ones who deal directly with the patients and attend to patients’ needs in various locations, whether hospitals, health centers, or nursing homes. Since the elderly population is continuously increasing, nurses would be attending to health issues of the elderly in their present and future professional lives. The issue of falls is very much relevant to the nursing profession. They are professionally mandated to provide excellent service to their patients, thus they have to be aware and informed about the issue. Since, the nurses are at the frontlines of health care, they are also the ones who shall implement, test, and assess the effectiveness of strategies and devices that are geared towards preventing falls among the elderly.
Solution to the problem
The issue of falls among elderly patients needs to have solutions coming from different directions. As mentioned by the WHO, the effort needs to be a concerted one. Therefore, there has to be collaboration from technology, policy, implementation, and user-effectiveness. The device or mechanism can be developed from the technology side. There are already devices in the market that are being tested to assess their effectiveness in either preventing falls or issuing alarms immediately after the fall. Policy is important because guidelines on how to assess risks and how to implement strategies would come from these mandates. Implementation is the nurses’ turf, and it is important that there are clear standards to follow to ensure that everyone on the team knows the procedures. They can also provide critical feedback. Nurses, too, facilitate the feedback from the users, because they are the ones who interact with the elderly.
The specific solution that I would like to recommend is to evaluate all existing devices that are being used now to prevent the falls among the elderly. Identify all the strong and weak points of such devices. The information has to be gathered from the actual users. The result of this particular survey will then be collated and distributed to health facilities as guidelines in their services to the elderly patients they cater.
References
Bloch, F., Gautier, V., Noury, N., Lundy, J.E., Poujaud, J., Claessens, Y. E. & Rigaud, A.S. (2011). Evaluation under real-life conditions of a stand-alone fall detector for the elderly subjects (Bloch et al., 2011). Annals of Physical and Rehabilitation Medicine, 54 (2011):391–398.
da Costa BR, Rutjes, AWS, Mendy A, Freund-Heritage R, Vieira ER. (2012) Can Falls Risk Prediction Tools Correctly Identify Fall-Prone Elderly Rehabilitation Inpatients? A Systematic Review and Meta-Analysis. PLoS ONE 7(7): e41061. doi:10.1371/journal.pone.0041061.
Homann, B., Plaschg, A., Grundner, M., Haubenhofer, A., Griedl, T., Ivanic, G., Hofer, E., Fazekas, F. & Homann, C.N. (2013).The impact of neurological disorders on the risk for falls in the community dwelling elderly: case-controlled study. BMJ Open ;3(11):e003367. doi: 10.1136/bmjopen-2013-003367.
Nabeshima, A., Hagihara, A., Hayashi, K., Nabeshima, S. & Okochi, J. (2007). Identifying interacting predictors of falling among hospitalized elderly in Japan: A signal detection approach. Geriatrics Gerontology International, 7:160-166. doi: 10.1111/j.1447-0594.2007.00391.x
