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Gathering Baseline Data It is very important to establish a baseline before the implementation of a fall prevention program. Determination of a current baseline for the incidence of falls in a healthcare facility, including any historical trends, is important to evaluate whether the falls prevention attempts are making any difference. Having baseline data and information should support staff buy-in for the fall prevention program. Ongoing data collection will provide concrete feedback on the impact of the interventions in preventing falls (Registered Nurses Association of Ontario [RNAO] 2005). Falls can be measured in different ways; therefore it is important to ensure that a consistent definition for falls is utilized by staff to support accurate data. On admission, the following baseline data should be collected from the patient/resident (RNAO, 2005): · Age; · Sex; · Living arrangements before admission; · Admission diagnostic category; · Medical history (stroke, Parkinson’s disease, cancer, congestive heart failure, osteoporosis or fracture related to a fall); · Cognitive impairment (mini-mental state examination); · Functional dependency. Risk management data will include the following information (RNAO, 2005). · All residents who come to rest inadvertently on the ground or floor or other lower level; · Falls may be observed or unobserved – it is important to collect both but to distinguish between the two; · A history of falling (repeated falls) puts a resident at higher risk and therefore, collecting all falls per resident is important; · It is also important to collect falls with or without injury; · It is also important to distinguish the severity of the fall. There are no standards to this; however, minor injury would include scrapes, bruises; moderate may include gashes, sprains; severe may include fracture, and even death. Outcome Measurements The primary desired outcome for a falls prevention project is to reduce falls among the elderly. The process outcome should include an interdisciplinary approach to fall prevention and management; increased availability of experts in fall prevention and management; and systematic program deployment and evaluation. Desirable patient outcomes would include increased knowledge about falls; increased strength, balance, and mobility; increased functional independence with use of exercise and assistive/adaptive devices as needed; increased confidence in abilities; and reduced severity of fall-related injuries. Evaluation The evaluation component is necessary to determine if the program is satisfactorily achieving what it was designed to achieve (McNamara, 1998). Evaluations produce data that can verify if a program is effective. The evaluation for this program should be outcomes based, in order to identify the benefits to the clients. The clients in this case include the patients or residents, and nursing home staff and administration.
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