Reducing In-Hospital Patient Falls
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"One of the directions the center is taking is to do more across the healthcare system for safety a continuum of care," says C. Patrick Chaulk, MD, MPH, executive director and president of the Maryland center.
"This is really reflected in this collaborative because you've got handoffs to long-term care facilities and home health care, or you return to the hospital," Chaulk says. "We are trying to figure out how we can direct our work to be more comprehensive in the healthcare system and not—which is often the case—focused on hospitals."
The center still is in its first year collecting data related to falls, but some new trends have emerged, for example: identifying medications such as diuretics that could be used well before bedtime to avoid causing individuals to get up late at night when they are sleepy and more prone to fall.
Preventing falls inside a healthcare facility often can get a boost at the community level, as researchers at the UCLA Center for Health Policy Research have found out. For instance, fewer than half of all seniors they studied were found to be seeing a doctor after a fall. Those who declined medical attention were far less likely to engage in widely recommended activities—such as a review of their medications or getting a cane or walker—that might prevent repeated falls, according to center researchers.
"It should be an important part of a routine screening in primary care to ask an older adult if they have fallen in the last six months," says Steven P. Wallace, PhD, a professor and associate director of the center. Detecting someone who has fallen and "bringing them back for a later date for a scheduled time to do a comprehensive assessment can make a big difference in their life."
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