Medicine and Health Sciences Commons^™

Outpatient Fall Prevention In Ambulatory Adults 65 Years Old And Over, Dorothy L. Osborne-White

Doctor of Nursing Practice (DNP) Scholarly Projects

Abstract

Background: In the United States (U.S.), falls are the leading cause of injury among adults 65 and over, resulting in 36 million falls yearly (Moreland et al., 2020). According to the Centers for Disease Control and Prevention (CDC, 2023), one in four older adults experiences a fall each year. Falls are the world's second most prominent cause of accidental deaths (World Health Organization [WHO], 2021). Falls are the leading cause of both fatal and non-fatal injuries among older adults (Moreland et al., 2020).

Methods: A quality improvement project that included a fall bundle was implemented in a primary clinic. …

Association Of Fall-Related Injuries And Different Diagnoses In Older Adults Of Ontario: A Machine Learning Approach, Sorour Rostampour

Electronic Thesis and Dissertation Repository

Falls are the leading cause of injury-related hospitalizations among older adults in Canada. This study aimed to identify the most informative diagnostic categories associated with fall-related injuries (FRIs) using three machine learning algorithms: decision tree, random forest, and extreme gradient boosting tree (XGBoost). Secondary data from two Ontario health administrative databases (NACRS, DAD) covering the period 2006-2015 were analyzed. Older adults (aged ≥ 65 years) who sought treatment for FRIs in emergency departments (ED) or hospitals, as indicated by Canadian version of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10-CA) codes for falls …

Community-Dwelling Older Adult Fall Prevention Improvement Project, Evan Edminster Bsn, Rn, Cfrn, Tcrn, Cen, Nhdp-Bc

Master's Projects and Capstones

Abstract

Problem: Ground-level falls among community-dwelling adults 60 years and older are significant and contribute to adverse health outcomes such as fractures, functional decline, disability, and death. Additionally, falls among community-dwelling older adults are the number one mechanism of injury seen at a Northern California Level II trauma center. Falls often lead to post-fall fear, activity restriction, and physical deconditioning, further compounding fall risk.

Context: When trauma centers provide targeted outreach and screening for unmanaged health risks such as falls, they reduce unnecessary disability and premature death in the local population. Reducing total fall victim numbers and fall recidivism also …

Strategies To Reduce Fall Rates In A Long-Term Care Facility, Kimberly H. Brewer

Walden Dissertations and Doctoral Studies

AbstractFalls among residents of long-term care facilities (LTCFs) pose significant threats to their health and quality of life, as falls often lead to life-threatening injuries such as traumatic brain injury and hip fractures. The etiology of the falls is multifactorial and complex; thus, interventions to reduce the falls typically combine two or more evidence-based interventions. The objective of this doctorate project was to develop an evidenced-based clinical practice guideline (CPG) outlining a multifaceted, evidenced-based bundled set of interventions for a fall prevention program to reduce falls for elderly patients living in the LTCFs. Lewin’s 3-step model of change was used …

Effectiveness Of A Standardized Fall Assessment Tool In Reducing Falls Among Elder Home Health Clients, Terica M. Woods

Walden Dissertations and Doctoral Studies

Because of the physiological changes that occur with the normal aging process, falls tend to have more serious consequences in individuals age 65 and older. The purpose of this systematic review of literature was to analyze studies that addressed the impact of a multifactorial fall risk assessment tool on decreasing falls in the elderly home health patient population following hospitalization. The conceptual model for this project was Roper, Logan, and Tierney’s activity of daily living model. A narrative analysis was used to analyze 16 selected articles from the CINAHL, ProQuest and MEDLINE databases. Results indicated that implementing fall assessment tools …

Implementing Aromatherapy For Falls Reduction In The Inpatient Hospice Population, Kimberly Kay Pistek

Walden Dissertations and Doctoral Studies

Falls among the elderly is a health concern affecting multiple patients annually. Hospice patients and those with multiple comorbidities are at the greatest risk of falling and sustaining injuries from falls. Aromatherapy has been used for reducing multiple symptoms as well as for decreasing falls. The practice-focused question explored whether an education program on using aromatherapy for fall prevention would increase knowledge of this intervention for an interdisciplinary group of hospice staff. The design was developed using Knowles's theory of andragogy and Bloom's taxonomy. Thirteen staff members from the same facility participated in the education program. The program was targeted …

Physical Activity And Fall Prevention In Older Adults, An Educational Intervention, Caleb Daniel Knight

Family Medicine Clerkship Student Projects

Falls in adults over 65 years of age constitute a significant health burden in our country, and this age group is growing rapidly. Falls are addressed with a multifactorial approach, addressing comorbidities, medications, and the physical environment, however, an effective point of intervention accessible by most older adults is physical activity. A brief educational presentation about the morbidity and mortality associated with falls, and the protective effects of physical activity, was provided to Meadowbrook Healthcare subacute nursing home residents in Plattsburgh, NY. Questions were encouraged and answered afterwards, and copies of the presentation were left for the residents to review …

Improving Fall Prevention Strategies In An Acute-Care Setting, Sylvia B. Boye-Doe

Walden Dissertations and Doctoral Studies

Falls with or without injuries among the elderly have become a public health concern, with falls among adults age 65 years and older increasing every year. Nurses play a role in ensuring patient safety by following fall prevention guidelines. The purpose of this evidence-based study was to implement the RE-AIM evaluation tool to determine the impact of the Safe Five program on staff compliance with the program; patients' awareness of the need for falls prevention; and falls among older adults, ages 65 years and older, admitted to an acute care nursing unit. The literature supports implementing a falls prevention program …

Fall Prevention In A Neurological Care Unit, Claudeth Jeffrey

Walden Dissertations and Doctoral Studies

Patient falls are an ongoing concern for health systems in the US and in the setting where this project took place. Inpatient falls affect consumers and health providers because falls often result in patient morbidity and mortality, legal risk, increased length of stay, and increased costs. The purpose of this project was to evaluate the existing fall prevention protocol at the site where this project took place and to make recommendations for an evidenced-based fall prevention protocol. The professional practice model was the conceptual model that guided the exploratory descriptive project. A review of the site's fall prevention policies and …

The Role Of Postural Stability And Other Factors In Distal Radius Fracture, Sheena Saju Philip

Electronic Thesis and Dissertation Repository

The objective of the thesis was to describe the factors leading to falls in distal radius fracture (DRF) events, explore patient perceived risk of falls, and postural stability. A mixed method study described the type of fall in DRF patients (n= 1454) and patient perceived contributing factors (n=29). A prospective cohort study examined the postural stability and related fall risk of DRF participants (n=137) in Biodex Balance System (BBS) and compared to normative values. Environmental factors were a major contributor to DRF events. Older adults (44 to 65 years) had the highest rate of DRF (female: male ratio of 2:1). …

Fall Safety Bundle, Baili Denise Campbell

Walden Dissertations and Doctoral Studies

The Centers for Medicare and Medicaid Services (CMS) report thousands of falls in hospitals each year. The CMS does not reimburse hospitals for fall related injuries, costing the hospital system organization for which this DNP project was designed millions of dollars each year. Framed within the Iowa model of evidence-based practice and using a team approach, the purpose of this project was to develop an evidence-based (EB) fall safety bundle for use by nursing staff and a curriculum to educate staff on prevention strategies. The components of the EB fall bundle kit were approved by the stakeholder committee. Evaluation of …

Post-Fall Decision Making Among Older Women Living In Continuing Care Retirement Communities: A Mixed Methods Study, Caroline D. Bergeron

Theses and Dissertations

Introduction: One in every three adults over the age of 65 experiences a fall every year, with women experiencing more falls than men. Falls can affect how older women perceive themselves and their independence. The purpose of this study was to examine older women's health decision making after experiencing a fall. Methods: I conducted semi-structured interviews with 17 older women living independently in continuing care retirement communities (CCRCs) who had experienced a fall within the previous six months and 11 individuals the women identified as being involved in their post-fall decision making. I also conducted an exploratory survey on post-fall …

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 …