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Persistent Polypharmacy And Fall Injury Risk: The Health, Aging And Body Composition Study, Lingshu Xue, Robert M. Boudreau, Julie M. Donohue, Janice C. Zgibor, Zachary A. Marcum, Tina Costacou, Anne B. Newman, Teresa M. Waters, Elsa S. Strotmeyer

Health Management and Policy Faculty Publications

Background

Older adults receive treatment for fall injuries in both inpatient and outpatient settings. The effect of persistent polypharmacy (i.e. using multiple medications over a long period) on fall injuries is understudied, particularly for outpatient injuries. We examined the association between persistent polypharmacy and treated fall injury risk from inpatient and outpatient settings in community-dwelling older adults.

Methods

The Health, Aging and Body Composition Study included 1764 community-dwelling adults (age 73.6 ± 2.9 years; 52% women; 38% black) with Medicare Fee-For-Service (FFS) claims at or within 6 months after 1998/99 clinic visit. Incident fall injuries (N = 545 in …

Change In Falls And Sitter Cost Post Implementation Of Remote Centralized Video Monitoring In Hospitalized Adult Patients, April Nicole Dougherty

DNP Projects

PURPOSE: Falls are the leading cause of injury in hospitalized patients. Patient sitter programs are proven to be an effective way to reduce falls in hospitalized patients. Innovative technologies have been examined that provide a safe and cost-effective way to reduce sitter costs and prevent falls. An innovative technology option is a remote centralized video monitoring system containing one video monitoring technician watching and verbally redirecting multiple patients at one time using mobile cameras. The purpose of this project is to evaluate the implementation of a remote centralized video monitoring system for adult patients in the acute care hospital setting. …

Artificial Gravity As A Countermeasure To The Cardiovascular Deconditioning Of Spaceflight: Gender Perspectives, Joyce M. Evans, Charles F. Knapp, Nandu Goswami

Biomedical Engineering Faculty Publications

Space flight-induced physiological deconditioning resulting from decreased gravitational input, decreased plasma volume, and disruption of regulatory mechanisms is a significant problem in returning astronauts as well as in normal aging. Here we review effects of a promising countermeasure on cardiovascular systems of healthy men and women undergoing Earth-based models of space-flight. This countermeasure is produced by a centrifuge and called artificial gravity (AG). Numerous studies have determined that AG improves orthostatic tolerance (as assessed by various protocols) of healthy ambulatory men, of men deconditioned by bed rest or by immersion (both wet and dry) and, in one case, following spaceflight. …

A Systems Approach To The Problem Of Falls In Old Age, Patrick A. Dillon

Theses and Dissertations--Gerontology

The problem of falls in old age is enormously costly and disruptive for the older individual, others, and society, and its severity is likely to intensify as our population ages. This dissertation takes a systems-oriented approach toward the falls problem and is presented in two parts. The first part critically develops a new approach to the problem of falls. The second part describes an empirical study that applies this new approach in a pragmatic manner.

Conventional fall prevention strategies employ a reductionist approach to the problem of falls. This approach is questioned because it corresponds poorly to the holistic nature …

Evaluation Of Serum Vitamin D Levels In Older Adults Who Fall And Sustain A Fracture: A Retrospective Chart Review, Suzanne L. Pilon

DNP Projects

Purpose: This practice inquiry project was designed to (i) evaluate serum vitamin D levels in individuals aged 65 years and older who had fallen and sustained a fracture and (ii) identify if the serum vitamin D levels were within therapeutic range.

Background: Older adults are at increased risk of falling and sustaining a fracture as a result of falls. Vitamin D has been shown to be effective in fall prevention yet vitamin D is deficient in the older population worldwide. Evaluating current serum vitamin D levels in older adults who fall and sustain a fracture may provide additional insight in …

Arborists Die After Falling, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

To Prevent Arborists Injuries:

• Never allow an aerial lift to be used as a crane or material lifting device.
• All trees and limbs should be inspected for structural weakness such as rot, before work starts.
• Arborists should wear appropriate personal protective equipment while performing tree trimming activities.

Special Factors for Aerial Lifts:

• Do not exceed the boom and basket load limits specified by the manufacturer.
• When working from an aerial lift, use a body harness that is properly attached.

Residential Tree Trimmers Killed While Working, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

To prevent tree trimmer injuries:

• Tree trimming or cutting should not be performed without appropriate safety training.
• Appropriate personal protective equipment should be worn at all times while removing trees.
• All trees and limbs should be inspected for structural weakness before work commences.
• Safe work procedures should be used for climbing, felling, topping, and pruning trees.
• A jobsite hazard assessment should be performed to identify hazards so that hazards can be controlled for.

Workers Killed While Working With Granite, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

To prevent injuries while working with granite:

• A job hazard analysis should be conducted each day before work commences.
• Employees should be trained in proper material handling procedures that include handling and transport of granite slabs.
• Use slab carts or slab racks to transport granite slabs and use tie-downs to secure the granite slabs to the forklift.
• Work should only be performed when the general contractor has a competent person on the job site.

Workers Killed In Falls From Ladders, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

To prevent falls from ladders while working:

• Make sure that an extension or straight ladder are erected according to the “4 to 1” rule of thumb.
• Safe work practices should be established by the employer for ascending and descending extension or straight ladders with materials and/ or equipment.
• All non-self-supporting ladders should be secured at the top and stabilized at the bottom.
• While working from ladders, workers should wear appropriate footwear.

Kentucky Residential Roofing Falls, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

To prevent falls while working on roofs:

• Always use appropriate guardrail, scaffold, or fall protection systems.
• Both employers and subcontractors should provide comprehensive site-specific fall protection training for their employees.
• Conduct a thorough assessment in and around the work area to identify existing and potential fall hazards prior to the start of work.

Caidas Desde Techos Residenciales En Kentucky, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

Para prevenir caídas mientras trabaja sobre techos:

• Siempre use sistema con baranda de protección, instale un andamio, y haga uso de un sistema contra caídas apropiado.
• Tanto empleadores como subcontratistas deberán proporcionar a sus empleados entrenamiento específico y completo sobre protección contra caídas acorde con el sito de trabajo.
• Conduzca una valoración cuidadosa dentro y alrededor del área de trabajo para identificar cualquier riesgo potencial de caída, antes de iniciar las labores.

28-Year-Old Man Dies After Falling With Lift, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

On June 27, 2003, a 28-year-old male sound technician died due to injuries received after falling approximately 50 feet from a lift. Three men (one chief sound engineer and two sound technicians) were sent to repair a sound system in a school gymnasium. Upon arriving and assessing the situation, the three diagnosed that a particular speaker, located in the rafters, should be removed from its location. Using a 30-year-old telescoping, self-leveling lift belonging to the school, the chief engineer used controls located at the base of the lift, to hoist the two sound technicians to the speaker in the rafter. …

Mientras Trabaja, No Se Caiga!, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

Para prevenir caídas durante en trabajo:

• Siempre use el sistema apropiado de caídas. Hacer una evaluación meticulosa dentro y alrededor del área de trabajo, para identificar los riesgos existentes y potenciales de caídas.
• Los empleadores y los subcontratistas deben proveer de un entrenamiento de protección de caídas a sus empleados, en un lugar en especifico.
• Poner señales de alerta enfrente del área de trabajo y alrededor de los perímetros donde el riesgo ha sido identificado.
• No se ubique en una situación de potencialmente riesgoso. Los trabajadores siempre necesitan estar alerta.

While Working, Don't Take The Fall!, Kentucky Injury Prevention And Research Center

Kentucky Haz Alerts--Falls

To prevent falls while working:

• Always use appropriate fall protection systems.
• Conduct a thorough assessment in and around the work area to identify existing and potential fall hazards.
• Both employers and subcontractors should provide comprehensive fall protection training for their employees, that is site specific.
• Place warning signs in front of work areas and around perimeters where fall hazards have been identified.
• Don’t place yourself in a potentially hazardous situation. Workers should always stay alert.

Two Laborers Die From A Scaffolding Fall Inside A Water Tank, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

Two 20 year-old laborers died after falling approximately 25 feet from suspension scaffolding while preparing the inside of a municipal water tank for painting. Neither laborer was wearing fall personal protection equipment at the time of the fatal incident. The laborers were preparing the inside of a 200,000-gallon water tank for painting when one end of the scaffolding dropped after a support cable slipped. The job foreman arrived at the job site and entered the tank to check on the laborers. He found both laborers on the tank floor. Laborer 1 had respiratory vital signs but Laborer 2 did not. …

Brick Mason Dies From Fall Through Scaffolding, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

A 62 year-old male brick mason (victim) died after he fell approximately 55 feet through masonry scaffolding. He worked for a masonry subcontracting company contracted to do the masonry work on a new building. The victim was performing ongoing work laying brick at the construction site. At approximately 7:15 AM the victim entered the building he was bricking and ascended to the 4th floor where he reached his workstation. He stepped out of an opening from the building onto the scaffolding outside. As he did so, he stepped over two mason boards (20 inches combined width), which were closest to …

Construction Worker Dies After Being Struck By A Falling Excavator Bucket, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Other

A 44-year-old construction worker (victim) was killed when a 36-inch-wide bucket weighing more than 1000 pounds, detached from its quick release coupler and fell from an excavator, landing on him as he was working in a trench. The victim and another worker had been in the trench preparing it for a pre-formed concrete manhole that they were about to install. Their supervisor (the excavator operator) sat and waited in the excavator, with the engine running, and the bucket raised a few feet above ground level so that it would be out of the way. The second man in the trench …

Lumber Company Employee Falls 48" From Storage Rack To His Death, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

In October 1998, a 58-year-old male truck driver/yard worker died of traumatic head injuries when he fell 48" from a storage rack. The employee had climbed onto the storage rack to retrieve 3/4" round molding, 8 feet in length for a customer to load into his truck. The employee placed his feet on pine boards that were being stored on the middle row and was trying to retrieve molding being stored above (approximately 9 feet off the floor). After he cut the bundle string to release the individual molding pieces, he began to pull the pieces out which were being …

Electrician Dies In 6-Foot Fall From Ladder, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

A 51-year-old male electrician (the victim) died after falling approximately six feet to the concrete floor of a fertilizer plant. The victim had been doing electrical work while standing on an aluminum extension ladder at a switch box attached to a steel post near a rear exit of the plant. His co-worker, who was approximately 20 feet away, heard him hit the floor, but did not see him fall. The co-worker ran for help. A 911 call was placed at 8:46 am, and Emergency Medical Services (EMS) personnel arrived in three minutes. The victim was transported to the local hospital, …

Welder Dies After 30-Foot Fall From Steel Structure, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

A 31-year-old welder working at a construction site died after falling 30 feet. The victim, along with two co-workers, was on an I-beam structure preparing to weld handrails when the incident occurred. The victim informed his two co-workers that he was going to talk with another person on the crew and left the area. He was wearing a hard hat, full-body safety harness with two shock-absorbing lanyards, and steel-toed shoes. He went down one level and crossed a roped-off area, stepping onto a steel-grate floor. The unsecured flooring moved, and the victim fell 30 feet to the dirt floor below. …

Maintenance Worker Killed In 25-Foot Fall From I-Beam, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

A 25-year-old maintenance worker at a steel distribution company died as the result of a fall from a steel I-beam he had repeatedly climbed to reach the top of a disabled crane. This worker and another had been attempting to repair the crane, and had found it necessary to climb up and down several times for various reasons (see below). Each time the victim had shimmied down and back up the I-beam rather than using the fixed ladder some distance away. When the fall occurred, he was on his way back up and somehow lost his grip on the beam. …

Worker Killed In Fall From Oil Tank, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

A 50-year-old male was killed when he fell from the top of a 12-foot high oil tank. The victim was an oil gauger for a company that transports crude oil. His job was to obtain samples of the oil to check its quality. On the day of the incident he was to check the oil at a site located about 100 miles from his office. He was an experienced gauger and had been to this site many times before. This company owned four cylinder-shaped oil tanks. Three of the tanks were 15 feet high and one was 12 feet high …

Demolition Foreman Dies After 35-Foot Fall Through Hole In Flat Roof, Kentucky Injury Prevention And Research Center

Fatality Case Reports--Falls

A 51-year-old male demolition foreman (the victim) died from head injuries sustained when he fell through a hole in a flat roof to a concrete floor. At about 3:25 pm the victim was on the roof to retrieve a four by eight sheet of 3/4" plywood to be used at another location on the plant site. After moving the plywood, partially exposing the hole, the victim fell 35 feet to a concrete floor. There were no witnesses to the fall. He was found by the site supervisor approximately one-half hour later. Emergency medical personnel were called. Co-workers at the scene …