Nursing Homes Need to Avoid Accidents Including Falls
Nursing Homes Need to Avoid Accidents Including Falls – according to an article from:
Advanced Practice Nursing eJournal, dated September 10, 2008; Falls are common among older adults. One third of adults over 64 years old, living outside of institutions, fall each year, and the likelihood of falling continues to rise with older age. Among the elderly, falls cause significant morbidity and mortality, and often contribute to functional decline, depression, social isolation, and nursing home admission. Compared with community-dwelling elders, nursing home residents generally have more comorbidities and advanced disease, including dementia. It is not surprising then that nursing home residents are nearly 3 times more likely to fall than elders living in the community.
Nursing Homes Need to Avoid Accidents Including Falls – The article continues: Fall Prevention – Risk Assessment
The first step to preventing a fall is to determine the risk. Although there are many fall risk assessment tools in the literature, no single tool is valid in all practice settings and most are not well validated. Nevertheless, the logic of identifying elders at risk for falls is undeniable because many risk factors are well documented. An assessment should be completed so that risk factors can be minimized, if not eliminated. Selecting the most appropriate tool for nursing home residents should be based on 2 criteria: The tool should address the most common risk factors, and it should be simple and practical to use.
Resident Falls Risk Assessment
The Minimum Data Set (MDS) is an interdisciplinary assessment tool required by federal regulations for use in nursing homes. The MDS identifies some of the risk factors for falls, including a history of falls, dizziness, wandering, restraint use, and use of drugs in high-risk classes. As its name implies, the MDS is not a comprehensive assessment tool, and yet it is too lengthy for quick fall risk assessments. So in addition to the MDS, many nursing homes use 1-page tools that are commercially available, posted on the Internet, or that have been created within the facility. At a minimum, any quick tool should include the following:
1. A history of falls;
2. Cognition, including fluctuating mental status;
7. Use of high-risk medications (eg, antihypertensives, diuretics, and hypoglycemics);
8. Use of assistive devices for transfer or ambulation;
9. Attached equipment (eg, catheters, intravenous lines, and oxygen); and
10. Familiarity with the environment.
For residents with a history of falls, it is helpful to determine the circumstances of previous falls, although this information may not be available. Are there common characteristics to the falls? For example, have the falls happened when she was using the bathroom, at the same time of day, when her blood sugars were low, or when she was wearing her high heels or not wearing her glasses?
Protect Seniors – Report Elder Abuse and Neglect – Falls and Fall Injuries
Federal Regulations Require that the Nursing Home Resident Receives adequate supervision and assistive devices to prevent all accidents including falls. Nursing Homes must ensure that the resident receives adequate supervision and assistive devices to prevent accidents. (42 CFR §483.25 (h))
(h) Accidents. The facility must ensure that—
(1) The resident environment remains as free of accident hazards as is possible; and
(2) Each resident receives adequate supervision and assistance devices to prevent accidents.
As an attorney who practices in the area of elder abuse and neglect primarily in nursing homes and other types of elder care facilities, I have handled numerous cases where falls have lead to serious permanent injury or frequently in the death of the resident. Unlike many types of accidents, falls are often preventable with adequate and trained staff providing proper care and monitoring. Even if the actual fall event is an accident many facilities fail to take the necessary required steps to protect the interests of the vulnerable adult, by not adequately responding to the fall event.
Frequently falls result in the breaking of a bone, many times at the level of a joint such as in the hip or knee. The injury may result in the resident becoming bedridden or confined to a wheelchair for rehabilitative care. The loss in ambulation can then lead to many other risk factors such as bed sores from the pressure of laying on the same area for extended periods of time, and loss of muscle strength, leading to additional falls. Fall injuries can also lead to death months after the incident from complications such as pneumonia.
Avoiding falls is very important and should be one of the primary focuses in the nursing home. To protect the residents the nursing home should be frequently monitoring the resident to determine the risks for falling and taking interventions to reduce the change of a fall incident. The effectiveness of the interventions should be evaluated to ensure the effectiveness of safety interventions and if they need to be modified. This is important if there is any sudden change in a resident’s ability to function physically and changes with the cognitive or behavior status of the resident. These changes could be due to an underlying medical condition which needs to be addressed, or problems with medication or numerous other issues. Assessments needed to be performed by a qualified RN nurse, not lower level nursing staff, who should instead be making observations, and reporting their finding to those qualified to implement appropriate safety measures.
This website is not intended to provide legal advice as each situation is different and specific factual information must be obtained before an attorney is able to assess the legal questions relevant to your situation.
If you or a loved one has suffered a fall injury from neglect or abuse in a nursing home or other care facility that serves the elderly in Minnesota please call Kenneth LaBore for a free consultation and information regarding the obligations of the facility and your rights as a resident or concerned family member. To contact Attorney Kenneth L. LaBore, directly please send an email to Klabore@MNnursinghomeneglect.com or call Ken at 612-743-9048 or toll free at 1-888-452-6589.