Preventing patient falls in nursing homes

1.5 million seniors live in U.S. nursing homes and 75 percent of them fall annually. About 1,800 fatal falls occur every year and up to 20 percent cause serious injuries. Falls result in decreased physical functioning and disability and fear of falls leads to depression and social isolation.

How can nursing homes prevent falls?

The Centers for Disease Control and Prevention offers these fall prevention guidelines:

* physical conditioning and rehabilitation using prescribed exercises to improve strength and endurance
* environmental assessments and modifications to improve mobility and safety, such as installing grab bars, lowering bed heights and installing handrails in hallways
* review of prescribed medications to assess their risks and minimize use
* provide patients with hip pads to prevent hip fractures if falls occur
* technological devices such as alarm systems that are activated when patients try to move unassisted

Your staff must understand the proper assessment tools and protective strategies they can take to prevent patient falls.

Psychiatric service test announced by JCAHO

The Joint Commission on Accreditation of Healthcare Organizations recently announced an initiative to test and implement an initial set of core performance measures for hospital-based, inpatient psychiatric services.

The five candidate measures in the set address the following dimensions of in-patient psychiatric care:

* Assessment of potential risks, previous trauma, co-existence of substance abuse and patient strengths
* Restraint use
* Seclusion use
* Patient discharge on multiple antipsychotic medications
* Provision of discharge assessment and aftercare recommendations to responsible community health providers upon discharge

Psychiatric hospitals are now being sought to voluntarily test the measures for a one-year period beginning on January 1, 2007. More than 550 psychiatric hospitals accredited by the Joint Commission are eligible to participate in the test. Participating organizations will be able to substitute the reporting of test measure data for current performance data reporting requirements. Test data from individual hospitals will not be publicly reported.

The Joint Commission will use the measure testing experience to make appropriate refinements to the measures, with a final set of measures becoming available to psychiatric hospitals in the fall of 2008 to meet Joint Commission performance measurement requirements.

Psychiatric hospitals wishing to participate in the testing of the candidate measures should contact Frank Zibrat, associate director, ORYX Implementation, Accreditation Operations, at 630-792-5992 or fzibrat@jcaho.org.