CAMDEN — Quarry Hill is piloting a new set of strategies aimed at reducing the risk of dangerous and costly falls and fall-related injuries among seniors.
Carmen Edwards, manager of Quarry Hill’s Gardens nursing care center, said the program stems from recommendations hammered out over the past two years by the Fall Prevention Workgroup. Initiated by the MaineHealth network of health care providers, the group includes representatives from Pen Bay Healthcare — Quarry Hill’s parent organization — and other network members across the state. The initiative dovetails with Pen Bay Healthcare’s emphasis on safe patient and family centered care, an approach that seeks to optimize health care outcomes by honoring the unique needs of each patient and his or her family.
Edwards said the Falls Management Program, as developed by the group, has two parts. The first focuses on the immediate response to a patient or resident who falls. It calls for nurses and other caregivers to evaluate and monitor the individual for the first 72 hours, investigate and record the circumstances surrounding the fall, alert Quarry Hill’s on-site senior services physician or other attending physician and take steps to prevent future incidents. In the second phase, caregivers complete a full assessment of the individual’s risk of falling, devise a preventive plan of care, and monitor results.
Among the useful tools to emerge from the group, according to Edwards, is the Tracking Record for Improving Patient Safet, or TRIPS. To be completed by a nurse immediately following a fall, the four-page TRIPS yields a detailed record of the accident and any contributing factors as well as any resulting injuries. At Quarry Hill (where nursing center staff adopted TRIPS when it was developed almost two years ago), nurse managers review TRIPS forms as they are submitted, making immediate adjustments whenever possible to reduce fall risk. An interdisciplinary Falls Prevention Group meets biweekly to continue the search for patterns in the data.
Edwards gave an example: “TRIPS forms might reveal that a person’s falls tend to happen in the early afternoon. We’d then take a close look at issues that might be affecting the person around that time – sleep schedule, medication schedule, etc. — and try to identify and address factors that could have increased the likelihood of a fall.”
According to the Centers for Disease Control and Prevention, falls are the leading cause of injury-related death in adults age 65 and older. Twenty to 30 percent of seniors who fall suffer moderate to severe injuries such as lacerations, hip fractures or head trauma. Such injuries often make it hard for older people to continue living independently and increase the risk of early death.
What’s more, statistics show that falls among the elderly come at a high price. In 2000, the CDC estimates, direct medical costs of fatal and non-fatal falls combined totaled more than $19 billion.
Edwards stressed that while the goals of the Falls Management Program — to
minimize injury due to falling, improve treatment outcomes and contain costs — remain consistent from provider to provider, each organization will likely pick and choose which recommendations to implement.
“It’s a tool book, not a rule book,” she said.
Participating organizations will continue piloting the recommendations until Sept. 30. At that time, the work group will meet again to review results, make any necessary adjustments to the program, and commit to its continued implementation.