Purpose The catalyst for this quality improvement project (QIP) was an injurious fall in the Cardiology Unit at St Joseph’s Healthcare Hamilton (SJHH). In Canada, seniors account for an estimated 44% of publicly funded healthcare costs.4 The economic cost in managing cardiovascular diseases in Canada is $22.2 billion according to a study carried out by the Public Health Agency of Canada in 2000.4 Of the syncopal episodes that result in falls among older persons, 70% are unwitnessed,5 which make an accurate history from a witness account difficult.6 People who fall due to cardiovascular disease have greater mortality than those who fall from other causes.7 These facts point to a sense of urgency in addressing specific areas of cardiac-related falls and injuries. Admissions for atrial fibrillation have increased by 66% in the past 20 years due to the aging population and an increase in chronic cardiac conditions.1,2 This has significant implications for: morbidity and mortality,3 frequency of older adults visiting Emergency Rooms, and frequency of readmission to hospital due to cardiac-related falls and injuries. Assessment and intervention falls risk, cardiac-related falls, syncope, arrhythmia, older persons Introduction Older patients with chronic cardiac conditions are more vulnerable to falls and the risk of falls and injuries can double with associated cognitive impairment.
It also provided information about the prevalence of cardiac-related risk fall factors that were utilized in the development of this Assessment and Intervention Falls Guide for elderly people. Conclusion The project demonstrated an evidence-informed process that was used to design and implement this assessment tool and a change in nursing practice. The developed Assessment and Intervention Falls Guide was utilized with seven patients in the Cardiology Unit who were admitted with diagnosis of syncope and atrial fibrillation to assess their risk for falls.
Prior to the development of this guide, the charts of six patients were reviewed to assess specific data including age, history of falls, type of injury, cognitive function and underlying medical conditions. Process A review of best practice guidelines, related studies and patients’ profiles from chart audits were utilized to obtain evidence-based information to develop this Assessment and Intervention Falls Guide. Aim The paper describes the process taken to design, develop and implement a practice-change initiative that specifically focuses on cardiac-related falls and injuries. The need to identify the fall risk-related factors that cluster with arrhythmia and syncope is relevant as it will potentially reduce patients’ risk for falls and fall injuries. Cardiovascular conditions, prevalent in older people, are also the frequent cause of potentially harmful fall injuries among this group. The development of an Assessment and Intervention Falls Guide for older hospitalized adults with cardiac conditions The development of an Assessment and Intervention Falls Guide for older hospitalized adults with.īelita, Lydia Ford, Patricia Kirkpatrick, HelenĪbstract Background Older patients with chronic cardiac conditions are more vulnerable to falls and injuries.
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