Because falls are among the significant adverse events experienced in community settings and health care institutions, scholars and health care practitioners are increasingly relying on educational programs to create awareness and hence enhance safety (Pearson & Coburn, 2011). Older people make up a large and increasing percentage of the population in McLean County, hence the need for Advocate Bromenn Medical Center to target this group of the population in its educational programs on falls prevention because people are increasingly at risk of falling and consequent injuries as they grow older (Lin, Liao, Pu, Chen, & Liu, 2011; United States Census Bureau, 2014).
The overall educational goal for the target population is to illuminate the risk factors associated with community or hospital falls, as it is generally felt that such knowledge will not only substantially reduce the incidences but also assist the elderly to speak about their predicaments.
It has been reported that community-dwelling older people as well as elderly inpatients in hospital settings neither recognize the risk factors associated with falls nor report their falls to community members, nursing professionals, or physicians, with available literature demonstrating that the risk factors for falls only become clear after injuries and disability have occurred (Lin et al., 2011). These authors further report that it is important for the elderly to be educated on the risk factors associated with falls because prior knowledge assists in the prevention of falls and also empowers the elderly to speak about challenges that may be unique to the community or practice settings.
As demonstrated by Lin et al (2011), “the risk factors for falls include co-morbidities, cognitive impairment, neuromuscular impairment, balance and gait disorder, functional decline, higher use of medication, and environmental hazards” (p. 1). Pearson and Coburn (2011) divide the risk factors into two broad categories, namely factors related to the person’s physiology (intrinsic) and factors related to the physical environment in communities or health care settings (extrinsic).
Some of the intrinsic risk factors that older patients need to be educated about include lower extremity weakness, history of falls, gait/balance deficit, use of assistive devices, vision deficit, arthritis, impaired activities of daily living, depression, chronic illness, orthostatic hypotension, postural hypotension, urinary incontinence, mental/cognitive deficit, and medication/polypharmacy (e.g., antidepressants, antipsychotics, benzodiazepine, calcium channel antagonists, diuretics, hypoglycemics, laxatives, and nonsteroidal anti-inflammatory agents). The most important extrinsic risk factors that this group of the population needs to be educated about include lack of grab bars in the bath or toilet, poor lighting, the height of bed or chairs, improper use of assistive devices, poor condition of flooring surfaces, and improper footwear (Lin et al., 2011; Pearson & Coburn, 2011).
Lastly, the rationale for selecting this educational goal is based on the fact that knowledge about the risk factors associated with falls has been positively correlated to a reduction of falls among the elderly. Additionally, knowing the risk factors associated with falls has served to encourage older members to speak up and share their challenges with relevant stakeholders in a bid to reduce fall incidences.
It is reported in the literature that inpatient falls at one critical access health facility in Maine, United States, were substantially decreased over a year through the employment of a multiplicity of approaches, key among them educating caregivers, patients, and their families on the intrinsic and extrinsic risk factors associated with falls (Pearson & Coburn, 2011). Consequently, this educational goal is justified in preventing community-based or institutionalized falls among the elderly.
References
Lin, C.H., Liao, K.C., Pu, S.J., Chen, Y.C., & Liu, M.S. (2011). Associated factors for falls among the community-dwelling older people assessed by annual geriatric health examinations. PLoS ONE, 6(4), 1-5.
Pearson, K.B., & Coburn, A.F. (2011). Evidence-based falls prevention in critical access hospitals. Policy Brief No. 24. Web.
United States Census Bureau. (2014). McLean County, Illinois. Web.