Capstone Change Proposal: Falls and Fall-Related Injuries

Benchmark – Capstone Change Proposal
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Benchmark – Capstone Change Proposal
Background
Elderly people residing in nursing homes face a high risk for falls and fall related injuries. For instance, of the 1.6 million residents in America’s nursing facilities, nearly half report fall-related injuries: about a third of these residents fall two or more times annually. Fall-related injuries adversely impact frail older residents by significantly lowering their quality of life as well as ability to function. Nearly a tenth of all elderly residents who fall in nursing homes end up with a serious injury like hip fracture, which increases their risk of death. Moreover, residents who fall but do not succumb to fall-related injuries end up developing a heightened fear of falling, which also limits their ability to function through self-imposed restriction of activity. Falls are a critical health indicator in long-term nursing facilities and also have potential negative consequences for the institutions. For instance, falls and fall-related injuries are tied to increased paperwork for staff, poor patient satisfaction scores, additional care demands by fallers, high insurance premiums, and civil law suits against the nursing home. Falls among elderly residents in nursing homes are caused by a combination of both extrinsic and intrinsic risk factors. Some of the intrinsic factors include behavioral symptoms and risky behaviors, effects of inactivity on strength, acute medical conditions, effects of aging on gait and balance, medication side effects, and chronic diseases.
On the other hand, the extrinsic factors are unsafe built environment, equipment hazards, and unsafe personal care items. Although extrinsic factors can be addressed to reduce risk of falls and fall-related injuries among elderly residents, the intrinsic risk factors are harder to eliminate. For instance, it is impossible to completely eliminate age-related effects or chronic diseases although medical management of these conditions can help reduce residents’ risk of falling. On the other hand, extrinsic risk factors can be addressed by modifying the built environment and equipment. Some of the ways nursing homes can reduce the number of falls and fall-related injuries with relation to extrinsic risk factors include addressing issues of poor lighting, improper footwear, wobbly furniture, ineffective wheelchair brakes, cluttered living space, hard-to-manage clothing, uneven floors and wet areas, inaccessible personal items, and unstable bed wheels. This capstone essay will focus on assisting facilities tackle both intrinsic and extrinsic risk factors using a multifaceted and evidence-based approach to individualized care planning and organizational commitment to comprehensive falls assessment and prevention.
Clinical problem statement
A fall is defined as a sudden, unplanned shift in position that results in a person hitting the ground or another object below his or her initial position. The American Medical Directors Association (AMDA) recognizes falls as a serious cause of injuries and death among elderly individuals residing in long-term c...