Interdisciplinary Fall Prevention for Geriatrics

In a recent CDC Morbidity and Mortality Weekly Report, Moreland & Lee (2021) analyzed 2018 U.S. data which revealed individuals 65 and older had 2.4 million emergency department visits and more than 700,000 hospitalizations due to unintentional injuries. Greater than 90% of these injuries were related to falls. This shows the importance of an effective interdisciplinary fall prevention and balance program for the geriatric population.

• The Therapy Outcomes in Post-Acute Care Settings (TOPS) study commissioned by the American Occupational Therapy Association and the American Physical Therapy Association showed that for all post-acute care settings, patients who received OT and PT were less likely to be readmitted to the hospital (AOTA & APTA, 2021).
• Interdisciplinary team (IDT) post-fall huddle may reduce risk of repeated falls (Jones, et al., 2019).

IDT Post-Fall Investigation/Huddle:

• Involve resident whenever possible at the location of the fall.
• Include an interdisciplinary gathering as soon as possible after the fall in order to:
  – Identify key acute/chronic symptoms and review past medical history.
  – Identify environmental elements.
  – Identify possible system causes.
• Determine the difference compared to when resident performed same activity and did not fall.
• Determine last resident assessment using purposeful rounding – 5 P’s of rounding (ACP, 2020):
  – Pain – Is your resident experiencing pain?
  – Personal Needs – Does your resident need assistance with personal care?
  – Position – Is your resident in a comfortable position?
  – Placement – Are all your resident’s essential items within easy reach?
  – Prevent Falls – Always provide person-centered care.

IDT Implementation and Fall Prevention:

• Evaluate quality of communication related to resident fall risks.
• Evaluate resident and family knowledge of fall prevention and interventions.
• Communicate results of family/resident conferences.
• Collectively review, identify, and analyze trends in resident falls throughout the facility.
• Review and revise policies and procedures; educate staff on new policies and procedures.

ACP’s Interdisciplinary Fall Prevention & Balance Program:
Targets residents with fall risk and can accelerate outcomes through evidence-based nursing and therapy education. The program also incorporates clinical pathways and innovative rehab technologies.

References:
Accelerated Care Plus (ACP) Corporation. (2020). The 5 P’s of Fall Prevention. MRK 0584
American Occupational Therapy Association (AOTA) and American Physical Therapy Association (APTA). (2021). Therapy Outcomes in Post-Acute Care Settings (TOPS).
https://www.apta.org/article/2021/04/05/apta-aota-joint-statement/tops-study-summary
Jones, K. J., Crowe, J., Allen, J. A., Skinner, A. M., High, R., Kennel, V., & Reiter-Palmon, R. (2019). The impact of post-fall huddles on repeat fall rates and perceptions of safety culture: a quasi-experimental evaluation of a patient
safety demonstration project. BMC health services research, 19(1), 650. https://doi.org/10.1186/s12913-019-4453-y
Moreland, B., & Lee, R. (2021). Emergency Department Visits and Hospitalizations for Selected Nonfatal Injuries Among Adults Aged ≥65 Years – United States, 2018. MMWR. Morbidity and mortality
weekly report, 70(18), 661–666. https://doi.org/10.15585/mmwr.mm7018a1