Cost Reduction
Transcript: A combination of multiple intervention strategies already being implemented on the unit and providing further education to nurses and patients targeted to each patient’s individual needs would appear to have the most effect. Implementing general fall reduction strategies General fall risk assessment, using wristbands Educating patient to call for help before getting up Bed rails up with bed lowered, call bell in reach, bed alarms, chair alarms Re-educating nurses about fall-risk patients periodically Providing one hour, paid educational sessions for staff about falls off schedule, over the course of one month More detailed assessments that further determine cause of each patient’s previous falls or fall risk Teaching nurses to educate patients or their families on their individual risk factor relating to falls Timeline How do Falls affect patients? Paola Aguirre, Cynthia Gonzalez, Vivian Madinya, Andrea Matchanickal, Jessica Opio, Moises Ruiz, Sean Patrick Russell, Dharitza Sanchez Defining the Problem Ang, E., Mordiffi, S. Z., & Wong, H. B. (2011). Evaluating the use of a targeted multiple intervention strategy in reducing patient falls in an acute care hospital: a randomized controlled trial. Journal of Advanced Nursing, 67(9), 1984-1992 9p. doi:10.1111/j.1365-2648.2011.05646.x Boyé, N. D., Van Lieshout, E. M., Van Beeck, E. F., Hartholt, K. A., Van Der Cammen, T. J., & Patka, P. (2013). The impact of falls in the elderly. Trauma, 15(1), 29-35 7p. Johnson. L., Kelly. L., Siric. A., Tran. D., Overs. B. Improving falls risk screening and prevention using an e-learning approach. (2015). Journal of Nursing Management, 23(7), 910-919 10p. doi:10.1111/jonm.12234 Kumar, S. (2011). What finance needs to know about using technology to improve value. Hfm (Healthcare Financial Management), 65(1), 90-95 6p. Morello. R., Barker. A., Watts. J., Haines. T., Zavarsek. S., Hill. K., Brand. C., Sherrington. C., Wolfe. R., Bohensky. M., and Stoelwinder. J. The Extra Resource Burden of In-Hospital Falls: A Cost of Falls Study. (2015). Medical Journal of Australia, 203(9), 367.e1-367.e8 8p. doi:10.5694/mja15.00296 Sahota, O., Drummond, A., Kendrick, D., Grainge, M. J., Vass, C., Sach, T., & ... Avis, M. (2014). REFINE (REducing Falls in In-patieNt Elderly) using bed and bedside chair pressure sensors linked to radio-pagers in acute hospital care: a randomised controlled trial. Age & Ageing, 43(2), 247-253 Vieira, E. R., Berean, C., Paches, D., Caveny, P., Yuen, D., Ballash, L., & Freund-Heritage, R. (2013). Reducing falls among geriatric rehabilitation patients: a controlled clinical trial. Clinical Rehabilitation, 27(4), 325-335 11p. doi:10.1177/0269215512456308 Literature Review (Morello et al., 2015) (Boye et al., 2013) (Ang et al., 2011; Vieira et al., 2013) (Sahota et al., 2014) Budgeting ROI, Profitability, and Outcomes Why are Falls considered a Problem? Literature Review According to the literature, falls is the leading cause of injury and death by injury in adults over the age of 65 years higher hospitalization costs because of surgical intervention, admission to a nursing home, and decreased overall functional ability. Patients who experience an in-hospital fall have significantly longer hospital stays and higher costs. A study held in England estimated that falls comprised about 40% of all reported patient incidents among older adult patients. A study held in Australia hospital-related costs for fallers were reported to be double those for non-fallers. Falls in hospitals are a major problem and contribute to substantial healthcare burden resulting in: Physical and psychological morbidity for patients Large healthcare costs Treating injuries Increased hospital stay Complaints Litigation Goals and Objectives References The Price to Pay for Falls Medical/Surgical Geriatric Unit 40 beds unit Average Daily patient census of 40 patients Average length of stay is 2.6 additional days Currently 25 full-time RNs on staff RNs hourly wage of $25/hr Reduce the amount of money hospitals spend on falls. Reduce the hospital’s liability on fall incidents. Decrease falls in the elderly by implementing teaching on precautions and tools. Raise nursing performance and increase hospital scores. (Sahota et al., 2014) A study conducted in a 400 bed hospital showed an additional length of stay resulting in a little over $1000 per fall incident. By implementing strategies and interventions to reduce falls , the hospital could have saved $45,000. Falls prevention by nursing staff and structured multifactorial interventions were recommended as potentially effective fall prevention strategies in hospital settings E-learning education program within two hospitals between February 2010 and December 2011. “Education in combination with the regular use of audit and observation of patients and nurses support improvements in falls prevention strategies”. Number of patients aged 65 years or older will double by 2050 1 in 3 patients aged 65 years or