Paper on Falls Among the Elderly: A Comprehensive Analysis of Global Impact, Standard Care, and Human Factors

Introduction

Falls are shared among the external causes of accidental injury. According to the World Health Organization, falls are defined as “inadvertently coming to rest on the ground, floor or other lower level, excluding intentional change in position to rest in furniture, wall or other objects” (Burns, & Kakara, 2018). Amongst the elderly population, falls are one of the critical causes of illness and death. Nearly one-third of adults aged 65 years old suffer from one or more annually, and this ratio surpasses 40% amongst those older adults aged 85 and above. Falls lead to psychological disorders entailing social withdrawal, the loss of self-confidence in an individual ability to conduct daily activities, and depression (Houry, Florence, Baldwin, Stevens, & McClure, 2016). Severe fall injuries become infuriating factors to health-related quality of life (HRQQL) amongst the aged population by reducing mobility limitations, compelling admission to nursing homes, and increasing healthcare expenditure. Bown et al. (2019) assert that although mild and significant injuries are well-acknowledged consequences of falling, fear of losing (FOF) is more dominant in the aged population.

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The curbing of falls is of vital significance because they provoke substantial morbidity, mortality, and suffering for the aged population and their families and social costs due to hospital and nursing home admissions. Some fall prevention measures are highly routinized as other parts must be tailored to a patient's particular risk profile. Similarly, no matter the knowledge of a clinician, it is difficult to handle all falls. Therefore, fall prevention requires the effort and engagement of a certain number of specialists inclusive of a patient's care team. Thus, to accomplish fall prevention, a comprehensive, organized culture, and operational ethics that foresee teamwork and information flow are required. However, fall prevention practices need to be checked with other consideration factors such as minimizing a patient's restraints and mobility to provide care to the patient. Hence, the urge to focus on an improved fall management system to realize the need for changes.

Why Change is Essential

Falls Globally

Ausloos, Brugha, and Collaborators (2018) claim that the Global Burden of Fall in 2017 stands at position 18, the leading cause of age-standardized rates of disability-adjusted life years. Outranking conditions such as asthma, chronic kidney disease, and Alzheimer's disease (Collaborators, 2018). On top of that, falls have been recognized as the second leading cause of death due to unplanned injuries, after road injuries and outranking causes such as drowning and interpersonal violence

Fall in the United States

For instance, Jia, LuJbetkin, DeMichele, Stark, Zack, and Thompson (2019) state that approximated that between 70,000 to 10000 individuals fall annually in the United States. 30% to 35% of those patients sustain an injury because of a fall, and about 11,000 falls are fatal. Besides, 2-6 injuries can lead to an increase in hospital stays with an average cost of$14,056 per patient (Jia, LuJbetkin, DeMichele, Stark, Zack, and Thompson .2019)

Fall in Canada

Fall in Canada is a national public health concern. In 2017, 183,249 Canadians visited the emergency department for a fall, amounting to about a quarter (28%) of fall visits from Canadians of all ages (653,766 trips) ( Pirrie, Saini, Angeles, Marzanek, Parascandalo, & Agarwal, 2020). Falls were the primary cause of injury-associated hospitalization for aged Canadians with 73,190 hospitalizations in 2008 and 2009, equivalent to 85% of injury-related hospitalizations for that age cohort (Rao, Zeng, Zhang, Zong, An, Ng, & Xiang, 2019). The minimum length of stay in the hospital for older Canadians admitted for falls was estimated to be 22 days. Fall is the leading cause of mortality among the aged population of Canadian

Standard Care

Bae (2016) points out that in 2008, the Center for Medicare and Medicaid Services (Center for Medicare and Medicaid Services) recognized falls as hospital-developed conditions. The problem occurs due to admission, for instance, falls, urinary tract infections, and pneumonia, and no longer covers care costs due to an inpatient fall. Moreover, the Joint Commission needs recognized hospitals to carry out fall-risk evaluations for admitted patients. The purpose of the standard is to identify patients at risk for falls so that prevention initiatives can be executed. Many health facilities also gather information on falls to participate in the National Database for Nursing Quality Indicators to manage the status quality advancement program (Moncada, & Mire, 2017). Consequently, these measures have stimulated interest in enhancing fall rates

Relationship between Standard Care and Governance

Ensuring patient safety in connection to falls needs sound governance structures and fall prevention systems. Health services organizations will require certifying that

• fall risk is screened and documented
• fall risk is evaluated if needed and documented
• suitable multifactorial approaches are present and applied
• falls are recorded and examined to ensure that falls and the harm experienced from them are reduced. Furthermore, health service organizations will be required to notify patients and caregivers about fall risks present strategies and engage them in establishing a suitable fall prevention plan.

Hence, a range of professionals share the mandate for developing and maintaining falls prevention governance. Systems comprise health service managers, health services executives and owners, educators, clinicians, and individuals with policy and quality enhancement tasks. It is recommended that the fall prevention system be established, taking into account the local condition (Bismark, Walter, & Studdert, 2013). Attention needs to be given to each health services organization's tasks and resources, and each clinical setting within a health service organization, during the execution process. Facilities may require extra resources such as personnel, equipment, education, and training to guarantee patients approximately screened risk evaluated and appropriate risk reduction strategies.

Regardless of whether the system is established on a statewide, national, or local level, health services organizations may desire to develop local project teams to manage, pan, and coordinate the execution and assessment of fall prevention systems. Project teams should comprise representation from across the scope of health professionals accountable for fall prevention. Similarly, engaging patients, caregivers, and families as partners brings advantages of enhanced services and higher satisfaction.

Assessment of the new systems is vital to develop efficacy and define the transformation required to maximize performance. Ongoing observation of fall prevention systems is also essential to track changes over time to ensure that the system continues to function effectively and recognize enhancement (Jamali, Hallal & Abdallah, 2010). Data produced from evaluating fall prevention systems should be communicated to the health workers. They may assist in informing health professionals of sections that require advancement and inspire them to change practice and enhance activities. These feedback processes also support accountability and transparency.

According to Mulyadi, Anwar, and, Ikbal (2012), an essential part of apprising systems for fall prevention includes frontline clinical to seek information on any challenge to use the system. Besides, appraising patients, caregivers, and family perceptions and encounters offers essential information on the personal elements of care, notes regions requiring enhancements, and provides solutions to system challenges. Health services executives are accountable for ensuring that fall prevention systems are established, executed, and function as planned within a health service organization. Generally, the health service organization's clinical governance model gives the mechanism for all this to happen.

Van Zwanenberg and Harrison (2018) suggest that health service executives require selecting appropriate individuals, and committees, and forming a clinical governance model, motivating the fall prevention system to be established, observed, and enhanced continuously. The framework may entail one or more relevant committees such as the safety and quality committee to analyze all the fall prevention system elements.

The human factor of Health that causes fall

Situation awareness

To continuously monitor the activities taking place in a patient's environment, situation awareness is carried. According to HIgha (2018), psychologists regard the act as paying attention or instead evaluation of perception. Situation awareness enhances configuring what is going on and predicting what shall happen in the rear proceeding. Situation awareness analysis bolsters a way of gaining diplomatic skills in dealing with a particular issue. When a person is faced with a high quittance of situation awareness, it develops psychological disorders, which eventually lead to falls.

The increased concern in attention skills and abilities in the job environment is, in a way, driven by the developed technology, mainly the computerized controlling systems and other mechanical and technological developments. Similarly, in most workplaces, the employees or the workers must possess an excellent mental diagram analyzing the ensued task and the possible dangers surrounding them.

In addition, situation awareness is a predecessor of decision stand fold in spirited settings when a given assessment is done to measure the necessity of action taking. Therefore, situation awareness breakdown is currently linked with car and industrial accidents in many work settings. A comprehensive situation awareness leads to a team-level build-up, hence a related understanding of the activities. The value is a core factor for a well-up performance.

Gluyas and Harris (2016) urge that good situation awareness is essential in all healthcare zones, particularly in acute medicine when changes to the patient's situation have to be done immediately. Surgeons place considerable consideration on situation awareness, particularly what they call anticipation thinking ahead of the action about to be performed. Situation awareness and concentration are weakened by fatigue and stress and can be influenced by disruptions and distractions.

Fatigue

When the body is overworked, it develops and accumulates a range of mental, social, and physical disorders. Sleeping and having a rest from the daily choirs is essential for the development and maintenance of a well-functioning body system. Lack of sleep leads to fatigue or tiredness. Crowe, Jordan, Gillon, McCall, Frampton, and Jamieson (2017) suggested that fatigue reduces body energy and interferes with the outlined daily partakes. On average, a normal human being should sleep for about eight hours per day for the body's systems to function well, a failure to which a person develops pathological levels of sleepiness. However, there is a specific and individual sleep level that varies from one person to another. The disparity is caused by various factors such as the internal body clock or energy and an individual's daily activities.

It should be noted that fatigue interferes with the effectiveness and productivity of the workers in the workplace. Similarly, the safety of workers in the workplace is a function of fatigue level. For instance, many industrial and road accidents have been associated with fatigued workers.