Using Information Technology to Assist in Redesign of a Fall Prevention Program

Browne, Jennifer Allan; Covington, Barbara; Davila, Yvonne C.

doi:10.1097/00001786-200407000-00008

Cited by 23 publications

(16 citation statements)

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“…To our knowledge, there is no previous literature analyzing the effect of an EMR-based intervention on polypharmacy reduction or fall risk modification in the elderly; however, recent work has examined the use of informatics to enhance care delivery to the elderly. Browne et al trialed an inpatient adult falls program using the EMR to increase the accuracy of fall risk assessments 29 . In addition, Nebecker et al recently described multiple ways in which informatics can be used to assist in the management of geriatric patients, including enhanced interdisciplinary communication and decision support 30 .…”

Section: Discussionmentioning

confidence: 99%

An Electronic Medical Record (EMR)-Based Intervention to Reduce Polypharmacy and Falls in an Ambulatory Rural Elderly Population

2008

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BACKGROUND: Falls are the leading cause of injuryrelated deaths in the aging population. Electronic medical record (EMR) systems can identify at-risk patients and enable interventions to decrease risk factors for falls. OBJECTIVE:The objectives of this study were to evaluate an EMR-based intervention to reduce overall medication use, psychoactive medication use, and occurrence of falls in an ambulatory elderly population at risk for falls. DESIGN:Prospective, randomized by clinic site. PATIENTS/PARTICIPANTS:Six-hundred twenty community-dwelling patients over 70 at risk for falls based on age and medication use. INTERVENTIONS:A standardized medication review was conducted and recommendations made to the primary physician via the EMR. MEASUREMENTS AND MAIN RESULTS:Patients were contacted to obtain self reports of falls at 3-month intervals over the 15-month period of study. Fall-related diagnoses and medication data were collected through the EMR. A combination of descriptive analyses and multivariate regression models were used to evaluate differences between the 2 groups, adjusting for baseline medication patterns and comorbidities. Although the intervention did not reduce the total number of medications, there was a significant negative relationship between the intervention and the total number of medications started during the intervention period (p <.01, regression estimate −0.199) and the total number of psychoactive medications (p<.05, regression estimate −0.204.) The impact on falls was mixed; with the intervention group 0.38 times as likely to have had 1 or more fall-related diagnosis (p<.01); when data on self-reported falls was included, a nonsignificant reduction in fall risk was seen. CONCLUSIONS:The current study suggests that using an EMR to assess medication use in the elderly may reduce the use of psychoactive medications and falls in a community-dwelling elderly population.

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Section: Discussionmentioning

confidence: 99%

An Electronic Medical Record (EMR)-Based Intervention to Reduce Polypharmacy and Falls in an Ambulatory Rural Elderly Population

2008

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“…의료진은 낙상 관련 손상을 예방하기 위해 환자 중심적 접근 방식을 통해 (Poe, Cvach, Gartrell, Radizik, & Joy, 2005), 환자의 낙상 위험을 증가시킬 수 있는 시력장애, 통증, 수면 장애 등과 같은 내적 요인 및 다양한 환경적 위험 등의 낙상 위험 요인 (Hur & Kim, 2009)을 사정하여 적절한 중재를 제공하여야 한다 (Kim & Suh, 2002). (Browne, Covington, & Davila, 2004;Oliver et al, 2004), 그 중 낙상 위험도 평가 도구로 Morse Fall Scale (MFS) (Morse, Morse, & Tylko, 1989)이 많이 사용되고 있다. 그러나 국내에서는 노 인 대상의 낙상 위험 요인 관련 연구 (Hur & Kim, 2009;Shin, 2011), 의료기관 내 특정 영역의 낙상 관련 연구 (Beack, 2011) 및 낙상 위험 사정 도구에 대한 연구 Park, Cho, Kim, & Kim, 2011 …”

Section: 및 독립성 상실을 초래하고 때때로 사망에까지 이를 수 있는 것으로 영국의 국가환자안전기구(National unclassified

Fall Risk Factors and Fall Risk Assessment of Inpatients

Kim

Choi-Kwon

2013

Korean J Adult Nurs

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Purpose:The purpose of this study was to identify the fall risk factors and to evaluate the effectiveness of the Morse Fall Scale(MFS) as an assessment tool among hospitalized inpatients. Methods: The medical records of a total of 294 patients who admitted to hospital from January 1 to December 31, 2010 were reviewed. One hundred forth seven patients who had experienced fall were matched with 147 patients who have never experienced fall. The fall information was obtained from electronic medical records and fall reports. Results: There were significant differences in visual disturbances, pain, emotional disturbances, sleep disorder, urination problems and elimination disorder at admission between fallers and non-fallers. Patients who had higher MFS scores at admission were more likely to fall as compared to the patients with lower MFS scores. When falls did occur, these occurred within five days following admission, in the patient room, among patients with alert mental status, and among patients who were ambulant with some assistance. Conclusion: The findings of this study support the need of using risk assessment tool for predicting risk for falls. This finding can be used as a useful resource to develop nursing intervention strategies for fall prevention at the hospital.

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“…Over 15 scales attempt to identify patients at risk of falling. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] The majority of these tools have not been validated, include only 1 population, or lack adequate sensitivity or specificity for clinical use. Three of these fall risk tools have been validated in multiple studies across the populations.…”

Section: Risk Stratificationmentioning

confidence: 99%

“…8,16,17,[27][28][29][30][42][43][44][45][46][47][48] Medications including benzodiazepines, anticonvulsants, antihypertensives, antidepressants, and sleep aids have also been targeted as high-risk medications. 8,[26][27][28][31][32][33][34][35]42,[49][50][51][52][53][54][55][56] Two additional risk factors that are often mentioned are male sex and poor functioning or inability to independently perform activities of daily living. 13,15,19,24,27,35,56,57 …”

Section: Risk Stratificationmentioning

confidence: 99%

Inpatient Falls

Cumbler

Simpson

Rosenthal

et al. 2013

The Neurohospitalist

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In this 2 part series, analysis of the risk stratification tools that are available, definition for the scope of the problem, and potential solutions through a review of the literature are presented. A systematic review was used to identify articles for risk stratification and interventions. Three risk stratification systems are discussed, St Thomas's Risk Assessment Tool in Falling Elderly Inpatients, Morse Fall Scale, and the Hendrich Fall Risk Model. Of these scoring systems, the Hendrich Fall Risk Model is the easiest to use and score. Predominantly, multifactorial interventions are used to prevent patient falls. Education and rehabilitation are common themes in studies with statistically significant results. The second article presents a guide to implementing a quality improvement project around hospital falls. A 10-step approach to Plan-Do-Study-Act (PDSA) cycles is described. Specific examples of problems and analysis are easily applicable to any institution. Furthermore, the sustainability of interventions and targeting new areas for improvement is discussed. Although specific to falls in the hospitalized patient, the goal is to present a stepwise approach which is broadly applicable to other areas requiring quality improvement.

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Using Information Technology to Assist in Redesign of a Fall Prevention Program

Cited by 23 publications

References 1 publication

An Electronic Medical Record (EMR)-Based Intervention to Reduce Polypharmacy and Falls in an Ambulatory Rural Elderly Population

An Electronic Medical Record (EMR)-Based Intervention to Reduce Polypharmacy and Falls in an Ambulatory Rural Elderly Population

Fall Risk Factors and Fall Risk Assessment of Inpatients

Inpatient Falls

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