The Cost For Treating Fall Related Injuries

During hospitalizations, falls are amongst the highest preventable consistent adverse events. Preventing such undesirable events, enhances patient overall experience, as well as increased trust in the health care professional team (Fragata, 2011). The importance of fall prevention lies with the many serious unfavorable health outcomes it can pose on the patient. Falls have the potential increase length of hospital stay, limit mobility, independence, but can ultimately lead to health deterioration, including death. Worldwide, falls are the second leading cause of accidental death. In addition to the life-threatening health and safety risks falls have to the patient, it also as a financial impact,

The Center for Disease Control (CDC) reported that more than one third of adults 65 and older fall each year. Half of the elderly people, who fall, do so repeatedly. Aside from the health problems related to falls, nearly $20 billion of direct medical costs are associated with fatal and non-fatal falls (Larson & Bergmann, 2008).

Every year, about one third of everyone over the age of 65 falls, and do not report it to their doctors. Falls are the leading cause of fatal and nonfatal injuries in older people (Falls Among Older Adults). Falls become more common as people age because their bones become more brittle and their muscle mass decreases. In society today, the baby boomers are aging, which means falls will continue to increase in frequency. When a person falls, it doesn’t just affect the victim; it affects everyone. In 2012, approximately $30 billion went towards medical costs that were associated with falls (Falls Among Older Adults). To prevent more people being injured and more money being spent, there has to be a change.

The widespread falls among the geriatric population reduce their quality of life and take away their functional independence. Lee et al (2013) state that falls leads to the rise in mortality rates and morbidity complications such as fractures and disabilities,1 out of 3 elderly persons in a community setting falls in a year. About 87% of all fractures in the elderly are due to falls. Several of the risk factors that are associated with falls are visual impairments, cognitive impairments, and health-related problems: arthritis, orthostatic, back pains, lack of balance-weakening muscles, previous falls, polypharmacy or psychoactive drugs (Lee et al, 2013).

As the United States population is advancing in age, the amount of patient falls and medical costs are estimated to increase. Approximately 700,000 patients fall per year in the hospital, which one-third of those falls could have been prevented (AHRQ, 2012). Prolonged hospital stays related to fall injuries is very costly. In 2013, a total of $34 billion dollars was paid due to falls by patients and insurance companies (CDC, 2015). Examples of injuries that can occur as a result of falls are fractures, lacerations, or internal bleeding (AHRQ, 2012). Studies also show

Falls are the leading cause of emergency room visits and unintentional death in Americans 65+ years old. (Centers For Disease Control & Prevention)

Falls are considered a leading cause of mortality and injury among older adults and majority of the falls occurs while hospitalized. One would think being in the hospital would be one of the safest places for older adults as far as fall prevention is concern due to the fact that hospitals provide staffing around the clock for patients but more and more falls have been occurring in the hospital especially in the older adult population. Fall is an unintended descent to the ground. It raises public and family care liability; it also decreases patient’s functioning because it causes pain and suffering, and increases medical costs (Saverino et al, 2015). The Center for Disease Control

Elimination of patient falls is not an easy task otherwise they would have been eliminated by now. Patient falls unfortunately continue to be a challenge and occur within the hospital and nursing home settings at alarming and sometimes deadly rates. The Center for Disease Control estimates that 1,800 older adults living in nursing homes die each year from fall-related injuries. Survivors frequently sustain injuries resulting in permanent disability and reduced quality of life. Annually, a typical nursing home with 100 beds reports 100 to 200 falls and many falls go unreported (CDC, 2015). Falls occur more often in nursing homes because patients are generally weaker, have more chronic illnesses, have difficulty ambulating, memory issues,

The Centers for Medicare and Medicaid Services (CMS) has identified eight adverse conditions, and inpatient injurious falls continues to be the most common adverse condition (as cited in Tzeng, Hu & Yin, 2016). The inpatient falls in the “US hospitals range from 3.3 to 11.5 falls per 1,000 patient days” (as cited in Bouldin et al, 2013, p.13). Roughly 25% of patients are injured when they fall (Bouldin et al, 2013). Since 2005, the USA’s National Patient Safety Goal listed fall prevention as a goal (Bennett, Ockerby, Stinson, Willcocks, & Chalmers, 2014). Since 2008, hospitals no longer receive payments from CMS for health care cost connected to inpatient falls (Bouldin et al, 2013). CMS views inpatient injurious falls as injuries that should never occur (Bouldin et al., 2013). There is no doubt that quality improvement must continue to address inpatient injurious falls. Preventing falls and implementing interventions to lower the rates of falls is a major concern for hospitals and must be included in any quality improvement measure.

Elimination of patient falls is not an easy task otherwise they would have been eliminated by now. Patient falls unfortunately continue to be a challenge and occur within the hospital and nursing home settings at alarming and sometimes deadly rates. The Center for Disease Control estimates that 1,800 older adults living in nursing homes die each year from fall-related injuries. Survivors frequently sustain injuries resulting in permanent disability and reduced quality of life. Annually, a typical nursing home with 100 beds reports 100 to 200 falls and many falls go unreported (CDC, 2015). Falls occur more often in nursing homes because patients are generally weaker, have more chronic illnesses, have difficulty ambulating, memory issues,

Elderly people are highly susceptible to falling, as more than one in four people over the age of 65 fall at least once a year, and many will fall more than just once (NSW Health, 2011). More than half of the elderly living in aged care facilities fall at least once a year. In 2009, 26% of NSW residents who were aged 65 or over, fell at least once (NSW Health, 2011). Approximately 27,000 hospital admissions and at least 400 deaths of over 65 year olds were due to falls (NSW Health, 2011). More of these hospitalisations were for aged care residents than other elderly people. As well as this, hospitals generally have over 1400 falls cases per year, and aged care facilities experience reports of falls from 60% of residents (Victorian Quality Council Secretariat, 2014). In hospital and aged care settings, there are a variety of falls risks, and causative factors that may lead to falls. For example, there are environmental (extrinsic) and personal (intrinsic) factors (Victorian

My target population for this project was geared towards the elderly group. "About 40% of this age group living at home will fall at least once each year, and about 1 in 40 of them will be hospitalized. Of those admitted to the hospital after a fall, only about half will be alive a year later."(Rubenstein, 2006) This group although not the highest incidence of falls but rather the highest susceptibility to injury from falls.

According to the Joint Commission Resources-JCR (2005), there is no universally accepted definition of a fall. Thus several definitions have been floated over time in an attempt to define the same. One such definition of a fall is "an untoward event that results in the patient or resident coming to rest unintentionally on the ground or another lower surface" (Joint Commission Resources, 2005). Falls are regarded common causes of injury at every age. However, it is important to note that for seniors, falls can have serious consequences. This is more so the case given that a fall can bring about pain, trauma, or even death. With that in mind, the primary purpose of this program remains the reduction of falls and hence the aversion of related injuries amongst the concerned patients. Of key importance remains the identification of patients who appear to be at high risk of falling. This way, appropriate strategies can be developed to reduce the injuries related to inpatient falls.

Falls in the elderly is a significant health problem, which can lead to severe issues such as morbidity and mortality. The topic of falls within the elderly was chosen so that the many interventions, risks, and awareness strategies can be further explored within this paper. Throughout clinical practice I was intrigued by the number of patients that have fallen and the strategies that health care organizations take to prevent falls. However, I was concerned by the lack of awareness in the community related to falls in the elderly. The topic of falls in the elderly is multifactor in the sense that there are many intersectional factors that can result in falls. The significant impact of falls in the elderly and the consequences that falls have

Falling is inevitable at some point in life, and although most of the time falls are not serious, some can be life-threatening. Falls are a danger to both physical and psychological well-being because they may diminish a person’s ability to maintain an active and independent lifestyle.1 There are many factors that place individuals at risk for falls such as age, muscle weakness, difficulty with balance or walking, psychological diagnosis, and several medical conditions.1,2 Approximately one-third of people over the age of 65 fall at least once a year.3 Individuals that are status post stroke are at an increased risk of falls, making falls assessment and prevention a common priority for clinicians treating this population.1,2 Therefore, to direct the experimental methods and build on a basis of previous literature on this topic, the search began using OneSearch, CINAHL, PubMed, and