1. Falls in the elderly (persons aged 65 or older) are a topic of concern; causing disability, decreased quality of life, institutionalization, mortality, and financial burden. Falls are one of the difficult challenge in long term care facilities, studies have indicated that 50% of residents experience a fall over a 12 month period (Haralambous, et al., 2010). There are a number of risk factors involved; age, decreased sensory perception, cognitive impairments, visual impairments, and other comorbidities all contribute to falls (Waldron, Hill & Barker, 2012). Understanding and assessing fall risks is a crucial aspect of reducing falls in long term care facilities. Reducing falls in long term care facilities will require multifactorial interventions as well as staff training and support. Reducing Falls in the Elderly in Long Term Care Facilities Melissa Ippolito, RN State University of New York Institute of Technology Department of Nursing Introduction Methods Abstract Results References Acknowledgements I would like to acknowledge the following for their assistance in making this research possible.  SUNY Cayan Library  Dr. Diane Price  Dr. Kathleen Rourke  My co-workers Conclusion A fall is defined as “an unintentional change in position coming to rest on the ground or onto the next lower surface (bed, chair, bedside mat, etc.)” (Rask, et al., 2007). Falls occur frequently in long term care facilities (nursing homes) and can result in anywhere between no injury to fatal injuries, injuries can be costly. Injuries are not the only complication of falls. Long term care residents suffering from falls can display fear of subsequent falls which may result in decreased participation in activities of daily living, decreased social interaction and subsequently a decrease in quality of life (Rask, et al., 2007). There are multiple risk factors that may lead to falls in the elderly:  Age  Decreased sensory perception  Cognitive impairments  Visual impairments (Waldron, Hill & Barker 2012)  Polypharmacy  Vestibular dysfunction  Movement dysfunction (which includes conditions such as Parkinson’s Diseases)  Other comorbidities (Shwartz, 2013). Reducing falls in long term care facilities is a priority. Studies indicate that 50% of long term care residents experience a fall in a 12 month period and long term care facilities also have a higher incidence of injuries related to falls than elderly living at home (Haralambous, et al., 2010). PICO statement: What interventions are effective in reducing falls in the elderly living in long term care facilities?  Literature search through online databases; CINAHL and MEDLINE was conducted using search words; falls/accidental falls, elderly/aged, and long term care facilities/nursing homes.  Inclusion criteria included ; peer reviewed articles published in the last 10 years.  Working with team at a local nursing home to statistically graph and correlate falls that have occurred in the facility and to further implement a Fall Team that will work to reduce the number of falls in the nursing home.  Using Ernestine Wiedenbach’s conceptual model of nursing called the Helping Art of Clinical Nursing to guide this project; this model of nursing stresses the identification of a resident’s needs through clinical assessment and skill. It is important to identify a resident’s need for help. (retrieved from: http://ww. http://nursing-theory.org/theories-and- models/wiedenbach-the-helping-art-of-clinical-nursing.php). Helping Art of Clinical Nursing Reducing falls will require multiple strategies in order to produce effective clinical practices to reduce falls in long term care facilities. A team approach is necessary as well as administrative support when implementing any strategies. Strategies that may help reduce falls include;  Comprehensive Fall Risk Assessment tool and intervention guidelines  Environmental assessments  Adaptive equipment assessments  Risk factor reduction  Injury prevention in high risk residents  Post fall re-assessment (Emeric, et al., 2006)  Medication review; decrease or eliminate psychotropic medications, possible vitamin D supplementation  Continence management  Staff education (Haralambous, 2010) Research studies have been inconclusive in indicating whether fall reduction approaches have been successful in reducing falls. The fall risk team at the nursing home will discuss the approaches they wish to implement in attempts to reduce falls and then track data monthly, indicating when and what interventions were initiated. This monthly data will be compared to data that has been compiled from 2012, 2013 and the current data obtained from 2014 thus far. Emeric, C., Schenck, A., Gorospe, J., McArdle, J., Dobson, L., DePorter, C., and McConnell, E. (2006). Translating evidenced-based falls prevention into clinical practice in nursing facilities: Reslts and lessons from a quality improvement collaborative. Journal of the American Geriatrics Society. 1414-1418. doi: 10.1111/j.1532-5415.2006.00853.x Haralambous, B., Haines, T., Hill, K., Nitz, J., and Robinson, A. (2010). A protocol for an individualized, facilitated and sustainable approach to implementing current evidence in preventing falls in residential aged care facilities. BMC Geriatrics. Retrieved from: http://www.biomedcentral.com/1471-2318/10/18http://www.biomedcentral.com/1471-2318/10/18 Jensen, J., Lundin-Olsson, L., Nyberg, L., and Gustafson, Y. (2002). Fall and injury prevention in older people living in residential care facilities. Annals of Internal Medicine. 136:733- 741 Rask, K., Parmelee, P., Taylor, J., Green, D., Brown, H., Hawley, J., Schild, L., Strothers, H., and Ouslander, J. (2007). Implementation and evaluation of a nursing home fall management program. Journal of the American Geriatrics Society. 342-349. doi:10.1111/j.1532-5415.2007.01083.x Schwartz, S. (2013). Factors leading to falls in elderly patients with hip fractures. Topics in Geriatric Rehabilitation. 277-280. doi:10.1097/TGR.0b013e3182940ce2 Waldron, N., Hill, A., and Barker, A. (2012). Falls prevention in older adults: assessment and management. Australian Family Physician. 930-935 http://ww. http://nursing-theory.org/theories-and-models/wiedenbach-the-helping-art-of-clinical- nursing.php