M. Catherine Wollman – Fall Prevention Challenges: Real Solutions to Reduce Falls, Prevent Injuries and Limit Liability

Outline

How to Prevent Falls Before They Occur

• Who is likely to fall?
• Which risk factors can we modify?
• Precipitating causes – what to watch for
• Institutional barriers – avoiding 1:1s
• Important implications of co-morbidities
• The benefits of vitamin D

Fall Risk Assessment

• Current guidelines
• Who should we screen?
• Multi-factorial causes of falls
• Recommended fall risk assessments
• Fall Prevention Strategies

• What works and what does not
• Addressing alarm fatigue
• Avoiding 1:1s
• Effective evidence-based interventions
• Education & assistive devices

Putting Together a Successful Fall Prevention Program

• Patient specific interventions
• Developing a multidisciplinary program: Roles & responsibilities
• Fall rounds

Patient Evaluation

• History
• Physical exam
• Evaluation tools (POMA tool, Get up and go test, Functional reach test, Berg balance test, Short physical performance battery)
• Diagnostic tests
• Review of Gait Disorders (video)

What to do When a Patient Falls: Hands-On Evaluation

• Assess need for immediate medical care
• Evaluate for acute illness/preceding factors
• Communication with caregivers
• Common injuries
• Goals of care

• Difficult Situations

• Frequent fallers – when injury prevention is your goal!
• Anticoagulation risks
• Prolonged time on floor
• What to do when fractures occur
• Head trauma management

Preventing Risk and Limiting Liability

• Home safety evaluations
• Communication and documentation
• Quality improvement opportunities
• High-risk scenarios: Case studies
• Addressing family concerns with falls
• Managing poor outcomes

Fall Prevention Plan Development

• Apply what we have learned
• Solutions for your biggest challenges!