Hcs420 current issues paper

Hcs420 current issues paper

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  Running head: Falls1 Current Issues Presentation: Falls Alexandria Amici HCS 420.01: Current Issues in Healthcare Science Professor Durant 4/25/2017
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  Falls 2 Falls areof vital importance when it comes to the health of those currently in our geriatric population. They have serious effects on our individual as a whole, their family, and our society. “Falls are the leading cause of injury-related visits to emergency departments in the United States and the primary etiology of accidental deaths in persons over the age of 65 years. The mortality rate for falls increases dramatically with age in both sexes and in all racial and ethnic groups, with falls accounting for 70 percent of accidental deaths in persons 75 years of age and older”(Fuller 2000). Unfortunately as patients get older, the chance of falls increases due to decrease in overall function of individual. “Annually, falls among older adults are responsible for more than 25,000 deaths, 2.5 million emergency department visits, and more than 700,000 hospitalizations” (Fuller 2000). Chance of falls only increase as the patient gets older. The family and patient have specific needs that we must account to. There are interventions in place to assist in health promotion and fall prevention. There are also state legislatures in place that have helped those who have fallen and any programs assisting those individuals. The geriatric population has enough trouble without adding falls to the top of their problems. Falls need to be addressed constantly as those who have fallen have an increased chance of morbidity due to falls. Falls were an issue in the past but have only increased as the years progressed. “It is projected that more than 340,000 hip fractures will occur in the year 2000, and this incidence is expected to double by the middle of the 21st century” (Stevens 2016). Through history, death from falls is shown to increase. “From 1992 through 1995, 147 million injury-related visits were made to emergency departments in the United States” (Stevens 2016). The fact that records of falls is increasing is a very big issue because of the impacts falling can coincide with. They believe the increase in fall death is because of lack of reporting falls. If the cause of a fall is not
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  Falls 3 reported, thenthe underlying issue may never be solved which shows a more heavily increased chance of falling in the future. Treatment is a huge need when it comes to getting the patient back to their current baseline of function. After a fall, it is difficult to get back from this or even improve function from their previous level. Patients are also not receiving follow ups after falls which result in an increased death rate because the problem was not fixed. The fall could have also impacted their health physically and it was unknown. Those injuries may cause future problems. “The recent rise in the death rate from falls of older Americans during 1999–2007 was primarily due to the previously unreported dramatic nearly sevenfold increase in mortality from the subset other falls on the same level” (Fuller 2000). A fall impacts the overall quality of life in these patients. The victim of a fall is heavily impacted by the result of the accident. “Falls involving a hip fracture lead to 10-15% reduction in life expectancy” (The Trustees of Indiana University 2004). The patient can be impacted by other injuries and even death. Many physical injuries are also a result of falls. “20-30% of those who fall suffer moderate to severe physical injuries including breaks, cuts, and bruising” (The Trustees of Indiana University 2004). Along with physical injuries, there can be mental problems as well. The individual is more likely to worry about falls in the future. They may also become depressed and isolate themselves. The decrease in overall confidence and self esteem will often lead to another fall. The decreased confidence causes decreased mobility and they will fall again. “The elderly are hospitalized five times more often for fall-related injuries than any other injury” (The Trustees of Indiana University 2004). Family is heavily affected by the falling incident of a loved one. Falls are the leading cause of putting that family member in a skilled health facility. This can cause financial burden on the family. The family also experiences emotional worry that this person will fall again or even die.
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  Falls 4 The healthcare system and society is also impacted by falls. Falls affect the cost and availability of health services.”Falls lead to increased use of emergency room resources, increased costs from hospital admissions and extended stays”( The Trustees of Indiana University 2004)Falls cost Americans about $100 billion every year which is a huge financial issue to our health care system and society. These impacts cause the family and patient to have specific needs for the future. A patient has many needs after a fall may occur. Occupational therapy can be used to prevent a future fall and help maintain safety and health. Physical therapy can be used to rehabilitate an injury. Counseling can help an emotionally traumatized patient. Any sort of money management can be used to help the family also. Preventative measures can be used to help with falls. Different interventions include a home safety checklist and an assessment that evaluates falls. The home safety checklist includes appropriate changes, such as “removal of hazards, selection of safer furniture (correct height, more stability) and installation of structures such as grab bars in bathrooms or handrails on stairs”(Woodhouse 2013). When used properly the assessment is very effective in preventing falls. If there is a problem with gait, which is the pattern of walking or ambulation an individual has, one can do gait training, use an assistive device like a cane, or balance strengthening. If medications are the cause, they can be given education about the drugs they are on, different treatment of diagnoses needing medication, or discontinuation or restriction of medications (Woodhouse 2013). If there is impairment in strength, strength interventions and exercises can be used. A patient can do three sets of 10 repetitions of arm lifts using a weight and increasing the weight as the weeks progress. To help prevent falls we can also eliminate environmental hazards, provide follow ups, involve family.
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  Falls 5 There area lot of teaching strategies that can be used to help with the issue of falls for services and families involved. There is the timed Up and Go Test, One leg balance test, and balance and gait testing. Balance and gait testing involves functional balance measures that are quantifiable and correlate well with the ability of older adults to ambulate safely in their environment. The one leg balance they stand on their leg for five seconds which measures strength. The up and go test helps evaluate gait by having patients walk a distance and evaluate their ability to do so (Fuller 2000). The tests can also be used to measure changes in mobility after interventions have been applied(Fuller 2000).There is also a mnemonic for physical signs to look for after a fall is experiences to watch for further damage. The mnemonic is called I HATE FALLING: A Mnemonic for Key Physical Findings in the Elderly Patient Who Falls or Nearly Falls. It stands for I-Inflammation of joints (or joint deformity),H-Hypotension (orthostatic blood pressure changes, A-Auditory and visual abnormalitie,T-Tremor (Parkinson's disease or other causes of tremor),E-Equilibrium (balance) problem, F-Foot problems, A-Arrhythmia, heart block or valvular disease, L-Leg-length discrepancy-Lack of conditioning (generalized weakness),I- Illness-Nutrition (poor; weight loss), and G-Gait disturbance(Fuller 2000). With the use of these strategies and interventions the chances of falls help decrease in homes and facilities. Common causes of falls involve the physical deficits someone may have like a decrease in their function, their medications being administered wrong, patient history, and the environment in the home such as tripping hazards. These are all barriers for preventing falls. The interventions could not work if there is no follow up to the patient or the family does not listen to physician’s orders. Services and political action has been taken to ensure more safety concerns in the area of falls. The National conference of State Legislatures has taken action towards preventing falls and maintaining a safe environment for those who are impacted by these accidents. The CDC has
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  Falls 6 developed afall prevention tool kit called STEADI (Stopping Elderly Accidents Deaths and Injuries). This tool helps them reduce falls by implementing the American Geriatrics Society’s clinical guideline for fall prevention (National Conference of State Legislatures 2016).States have also taken action towards helping those with falls and preventing them. The list of states who have created legislatures are California, Connecticut, Florida, Hawaii, Maine, Minnesota, Massachusetts, New Mexico, New Jersey, Oregon, and Texas. For example, California created the “Cal. Health and Safety Code §125704 (California Osteoporosis Prevention and Education Act) this requires the department of health services to develop effective protocols for the prevention of falls and fractures and establish these protocols in community practice to improve the prevention and management of osteoporosis”(National Conference of State Legislatures 2016). Even with these actions taking place, falls are still a huge issue to focus on today. Falls are an important issue to be addressed in today’s society. They are a big reason for mortality rates in the most recent years. There are interventions in place to help with this issue. A patient and family are heavily impacted by the problem of a fall and have many needs after a fall occurs. Fall deaths have increased over the years. Political action has been taken to help stop deaths occurred by falls. There are many educational opportunities and fall preventions that can be used to help maintain the health of those in the geriatric population.
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  Falls 7 References (2016, January).ELDERLY FALLS PREVENTION LEGISLATION AND STATUTES. National Conference of State Legislatures. Retrieved from http://www.ncsl.org/research/health/elderly-falls-prevention-legislation-and-statutes.aspx Falls: How Big is the Problem? (2004). The Trustees of Indiana University. Retrieved from http://www.indiana.edu/~bioofag/module2/kw_unit3_HAA2/falls/content/01_03_impact. htm Fuller, G. (2000, April 1). Falls in the Elderly. American Family Physician. Retrieved from http://www.aafp.org/afp/2000/0401/p2159.html Stevens, J. (2016, October). Older Adult Falls. Center for Disease Control and Prevention. Retrieved from https://www.cdc.gov/homeandrecreationalsafety/falls/index.html Woodhouse, K. (2013). 10 Topics in Reducing Harm from Falls. Retrieved from http://www.hqsc.govt.nz/assets/Falls/10-Topics/topic1-falls-in-older-people-15-April- 2014.pdf