Falls Prevention

Falls Prevention




We are going to go ahead and get started now that you guys can see everything. Oh, and just to everybody know that this is recorded so you can go back and see all of the resources and if you have not seen the videos that we are going to talk about today, I have included the link so you can see that also. So this should be on the website in the next week so you can see reporting of those if want to share it with someone else or review it. So getting started here, I just want to let you know who is in the room today, we have Ellyn and Ellyn has so graciously set up Zoom. She is very good at all of our technology and I appreciate her. We also have Luke. Luke can you say hi to everybody, let them know who you are because some people do not even know who Luke is.

Yes, hi everyone. My name is Luke Neitzel I am a HIIN program specialist.

And next we have Kolton. Kolton just started yesterday, so Kolton, now you go ahead and introduce yourself.

My name is Kolton Hewlett. I am the HIIN program specialist also.

Just for you guys know, Ellyn has been our master data person and we have hired someone new to help her out because she has been with the programs from 2012, Ellyn? So she is kind of an incharge of MPH, she has been in charge of data, she has been in charge of communications. I know I am leaving out events. She has been in charge of our website. She has done our toolkit. I could take a whole hour to try to say what Ellyn is doing, but Ellyn do you want to just give a little update, because Ellyn is now the director of our data team and I am sure that she is expected to have more help on board so we can give you guys more resources.

Thank you Jennifer. Good morning everyone. Again, my name is Ellyn. I am the data director for informatics here. So, you will be seeing some new resources for the HIIN program, that is HIIN, the Hospital Improvement Innovation Networks, the new HIIN. There will be some different data needs in regard to reporting and collection, not too many, but you will see those changes reflected in the toolkit as well as measurement documents and we will keep you guys up-to-date on anything falls related as we get information from CMS. So you can reach out to me at any point or Jennifer and she can report that on if you have any data specific questions.

Thanks Ellyn. Okay, so we do have a roomful and if you guys join us for our HIIN calls on Friday that is new, and that is a great time to get a lot of information, we do have all our resources together, so everybody can comment and ask questions. So let us go ahead and get started with this falls prevention community of practice

Introductions: We just did introductions. You guys can introduce yourself in the chat box so people know who is on the call, so you can kind of see who also is on the call right now. Instead of me reading through the names, you guys just kind of can do that as I am talking and as we are watching these videos.

And make sure when you are chatting to say to everyone so that when you are communicating be sure you keep an open line of communication with participants on the call.

Okay, so I just plotted what is kind of important. We started this community practice back in January and for some of you that are just joining I wanted to review today what is the community of practice. When we started this I think a lot of people were questioning like what do we do, do we just listen, do we get some ideas, yes. So what we are doing is we are bringing a group of people together who share common interests and purpose, a network of professionals with shared skills are working together developing on such skills. Another thing, I could be called as a collaborate building shared experience and knowledge. So this is basically an opportunity to work together to drive falls prevention with better understanding and when we think about that Iowa does have an ageing population and we do have a area that we really need to work on which is falls. When we look at that what we have done throughout this community of practice I know that another times we have this thing people on the call, we have been tracking who is on the call and then looking at the improvement and we have seen a nice big improvement. I think for the group that has been on the call we have seen 14% or 15% improvement and overall Iowa we have seen 8% improvement which we think about that that is including that group that has improved 15%. So I really feel like we are bending the scale. So congratulations everyone on, number one, sharing and number two taking just a little piece of maybe what you learned on these calls and implementing between your practice participation, so I kind of get this a little bit because it is saying that we are promoting and sharing and it is kind of hard today because we are doing this via chat box, but learning to use will be wonderful I think once we get it going and I promise next time everybody will be able to speak. So want to share prevention resources, we want to share experiences, and I know the last few ones that we have been looking at. We have been giving you some information, we will move back to having some hospitals share here in the near future. If you are just starting to join a falls community practice, note that you can get on our website under PFP resources and under area resources you can find recordings, under that we have all of our falls community of practice and HAI community of practice recordings up-to-date. You can go back and see if you can get the information if you are not on the initial call and I encourage you to do so because like I said we did get 15% improvement from that group that is on.

Today, what we are going do is we are going to share some videos from the Iowa Falls Prevention Coalition. If you have not heard of them, I have included a link here to show what their vision is. Older Iowans will have fewer falls from fall-related injuries maximizing their independence and quality of life and their mission to foster collaboration amongst state community and healthcare partners to reduce falls by building awareness and providing education about falls prevention. So when we look at this, this is right and probably with our vision and our mission because it is not only what we are doing for our patients in the hospitals, but let us prevent the future falls because as we can screen patients as they come into the hospital and/or the clinic know that we can also make a difference as they go back into their homes. So the videos that are available are fall prevention overview, medication and falls, vision and falling, in-home fall hazards, outside-the-home fall hazards, exercise and balance. The plan for today’s webinar is we are going to view these videos and then what I wanted to do is have a little bit of discussion about how we can use this, but this is mostly I want you to see these videos because I am sure that somebody in your facility if not you will want to use at least one of these videos. So I am going to go ahead and play the videos and then hopefully if you guys can give me a key that you can see it and hear it, that would be wonderful.

Let me just look back, so I can get the volume up. Can everybody hear that?

Okay, we are working to get thoseconversed.

Okay, can you just mention within the chat box if you can hear a little bit better now?

Okay, can everybody hear me now? I am going to bring the phone closer to the computer, and again I apologize for this. Hopefully nobody got dizzy with that one.

Is that better?

The leading cause of injury hospitalizations and emergency visits in Iowa, one out of three adult age 65 to 79 will fall every year and one out of two adult age 80 and older will fall every year. Falls are not caused by just one issue. INAUDIBLE 10:16 to prevent falls include exercise to improve your balance and strength, review prescriptions especially new ones and all over-the-counter medications with your pharmacist, have your eyes checked by an eye doctor once a year, address fall hazards inside your home and to be aware of fall hazards outside of your home. Talk to your doctor and family about falls. The prevention of falls is vital to maintaining your personal independence. If you fall you may begin to limit your activities to become more sedative. This will lead to the loss of physical strength and increase your risk of falling again. Also, make certain you consult with the same healthcare providers, so they are familiar with your medical history. This healthcare team can more easily detect patterns in your health and recommend lifestyle changes to prevent future falls, be proactive and prevent fall. For more information on fall prevention go to lifelonglinks.org. Okay everyone if somebody can put in the chat box we can just start a discussion here. We can start a discussion on how we think we could use these videos. So, some ideas that I had if anybody has TV or they have on their website some education that would be a great place to put it. Does anybody have any other ideas. I think its great that the Iowa Falls Prevention Coalition did make these videos available for everybody to utilize on both inside their hospital and on their website. Can everybody still hear me. Okay so yes everybody can still hear me and do you guys think that you could hear the videos well enough for us to continue to watch them because there are six of them and I do think that they are really nice. We are going to go on with medication management vision which I think that both of those we should talk about individually on different webinars I think those are some good ones in home fall hazards and then outside the home fall hazards which would when they are coming up I think that’s really important so if somebody could just give me any answer, do you think its okay, can you hear well enough that we can continue to watch these videos. Okay, perfect. We are going to continue on with the medication management and what I would be doing is I would be thinking of ways that we can use these videos like I said inside your hospital also using them as resources for patients maybe to give to our clinic doctors or other people that may be using these too so I may go ahead and start the medication management on. Every hour, 24 hours a day, seven days a week, a senior citizen who is transported by ambulance to a hospital because of a fall injury, people 65 and older, falls are the leading cause of injury deaths in Iowa and a leading cause of injury hospitalization in emergency visit in Iowa. One of three adult age 65 to 79 will fall every year and one out of two adult age 80 and older will fall every year. Prescription medicines can make you feel lightheaded and affect your balance which can lead to a fall. First, if you take more than four prescriptions you are at an even greater risk for fall. Many over-the-counter medications are allergies cold and flu and even sleep aids when taken with your prescriptions, they cause dizziness, drowsiness, or confusion that can cause a fall. Make an appointment with your pharmacist to review your prescription including over-the-counter medication and supplement. Drug interactions are very complex and interactions with various medications can pose a risk for a fall so its important for the pharmacist to have a complete list of all of your medications including over-the-counter items, vitamins, herbal supplements and any samples received from the physician so restore and talk to your pharmacist about your complete risk so that the pharmacist will make a full assessment of your potential risk. When you have a relationship with one pharmacy store, that they have your complete medication list. When you refill a new prescription, they can check it for drug interactions with all the medications you already received when you need recommendations for an over-the-counter items, they will make a statement and recommendation. What they hear, go ahead and ask the pharmacist for a comprehensive medication review to ensure that all of your medications you are working together well in system. The pharmacist is required to counsel you on any new prescription so take the time to listen and ask questions about your new medication and make sure that you fully understand what medications is being used for it, how to take it, potential side effects that you may be expecting to monitor for with the medication and what to do if you experience those side effects. Your body INAUDIBLE 16:05 eliminates medicines via your liver and your kidney. Kidney process is slow as you age therefore you can become more sensitive to medications and more at risk for adverse effects like drowsiness and dizziness. There are several medications that can interact with each other to increase the risk for adverse reaction such as falls so the pharmacist will either counsel you if the risk is small or the adverse effects may be mild but if the pharmacist’s concern is great, the pharmacist can call the prescriber and recommend a safer alternative. A close attention to all of your medications, understand how they interact and how they make you feel, talk with your pharmacist regularly to review your prescriptions and over-the-counter medications, be proactive to prevent fall. For more information on fall prevention, go to lifelonglinks.org. Okay what does everybody think about video. We can have some comments in the chat box. How do you think you could use that at your facility, when do you think you could show that to patients or families for that matter. I was thinking that a great time to use that would be at discharge or you know when you are talking about discharge someone is coming in to get a better idea what their medications are just INAUDIBLE 17:50 that is thus going a lot of times when people are in the hospital, their family members are present and that’s a good time to start some discussion prior to discharge of course, so as soon as you can start showing these videos it would start some discussions and may be if they wanted to set up a time to have review with their pharmacist they could post that for after discharge knowing they may go home in three days and also this would educate the family to know you know maybe they feel helpless and they don’t know how to help their family members but I think that it’s a good conversation starter and it is a really quick video. We have a comment, it says I think it would be good on the website for the public to access. Also if we are going to talk to seniors at the senior center also using at discharge is also good. Okay, hopefully you guys are getting some good ideas for other things too because this may not just be a video that you utilize just by showing the videos but may be some good conversation starters otherwise. So, we are going to go ahead and show the vision. Every hour, 24 hours a day, seven days a week a senior citizen is transported by ambulance to a hospital because of a fall injury, for people 65 and older falls are the leading cause of injury deaths in Iowa and the leading cause of injury hospitalizations and emergency visits in Iowa. One out of three adult age 65 to 79 will fall every year and one out of two adult age 80 and older will fall every year. Maintaining good vision plays a strong role in fall prevention. If you have vision impairment, you are twice as likely to experience multiple falls as other disease like glaucoma, cataracts, macular degeneration, and other vision conditions impact visual defect including contrast sensitivity and depth perception.

Stairs in bathrooms can be hazardous if your sight is impaired. At your annual eye exam, optometrist could diagnose or treat many eye diseases early in the disease progression. If your eye had issues where you do not really know you cannot see things this clearly, your vision is a little blurred, there is glare effect, all those things can be part of change in INAUDIBLE 20:25, I will leave the issues with balance and disability so that can need to falling or having issues with getting around just in your own home, so having your eyes dilated every year by your local optometrist, your ophthalmologist will help and just understand if there is any eye health condition that you can either avoid or help prevent. The major vision issues that seniors are macular degeneration, cataract, glaucoma, diabetes and stroke, all those affect their central vision to peripheral vision which all have background mobility or balance stability. There is actually study that has been done to show that early cataract surgery can reduce your chance of falling by about 35-40% which is very significant. Medications are another big one as well with certain medications like diabetic medications, high blood pressure medications or even simple ones as antihistamine for kind of allergy related issues, they can cause your eyes to dry out, it cause you issues to focusing and other ways that you may just not be aware of that you should definitely speak out to your eye care provider to talk to them about the certain side effects with your current medications because your vision becomes affected, then it is going to increase your chance of falling. There are also eye conditions that you cannot correct with glasses, so it is very important that you talk with your eye care provider about what options do exist. Certain things such as putting bright tape on the buttons of your microwave or even on the edges of carpet or step just to help make it more noticeable for you if you do not have any constant trip or falls INAUDIBLE 21:58 to the hospital. As an optometrist, I also noticed many individuals wearing not properly. There is different types of glasses out there like bifocals or reading glasses that most senior individuals do have. The biggest problem is getting up and walking around and reading glasses. If you do not take your reading glasses often to move around, everything will now be blurry for where you are walking so it can increase your chance of falling, so make sure you are talking with your eye care provider about the ways to wear your glasses. Be aware of your vision changes, understand it can play a key role in preventing fall factors such as poor depth perception, limited sight vision, extreme sensitivity to light and glare can affect your safety, maintaining a vision helps with balance and safety, be proactive to prevent a fall, for more information on fall prevention go to lifelonglinks.org.