presented by Dedee Culley
Today’s home health nurse cares for a wide variety of patients. Each must be assessed for their rehabilitation potential as well as risk factors affecting compliance and falls/injuries. Given this, knowledge and assessment skills are critical for assessing a patient’s risk for falls in the home and providing education and support to prevent these falls/injuries. This course will enhance the nurse’s ability to assess a patients mental, physical and environmental status. In addition, the nurse will be provided guidance on when and whom to incorporate into the patients care to ensure the best outcomes and prevention of falls. Finally, the nurse will be provided tips and resources to use in educating their patients on prevention of falls in the home.
Dedee Culley is a registered nurse with over 18 years of experience, with the last 10 years being specifically in the home health and hospice areas. She has been a field nurse, case manager, educator and director of operations in agencies. She has also served as a clinical expert analyst for a software vendor, designing and developing EHRs for home health and hospice as well as implementing and providing transitions for them. In addition, she is a legal nurse consultant, COS-C, and holds a certificate for project management. She currently applies her experience and knowledge by providing education and consulting services to agencies across the country in order for them to practice optimal EHR transitions and avoid pitfalls. She is married with four children, three grandchildren, and loves to ride motorcycles and travel with her husband and family. She serves her community in organizations focused on feeding the homeless and those dealing with gynecological cancer.
This chapter will focus on the key mental and physical factors that impact a patient’s rehabilitation potential as well as their risk for falls in the home. Mental capabilities along with the social stigma about falls and falling can have a dramatic effect on how we can better ensure a patient’s safety. The physical factors are often hidden from us unless we use all our senses to determine just how stable our patients are in the home.
This chapter will focus on the environmental factors that can trip up anyone in the home, so we want to ensure everyone’s safety. Environmental factors include both the inside and outside of the patients home as well the vehicles and equipment they utilize. We will learn how best to incorporate these factors into our assessments for the patient’s safety and best outcomes.
Seeing, hearing, smelling and touching are not enough when it comes to assessing for falls. Nurses must be able to use the most appropriate assessment tools that will provide measurable data to the physician and therapy team. This data provides the validation for such added services, a baseline of the patient’s status and measurable outcomes when the treatment has been completed.
Once the assessment is complete and the assessment tools have data indicating the patient is a risk for falls in the home, what’s next? The physician must be notified, and orders received for the appropriate therapy to begin. When the data is provided, this task is made much easier for everyone. This chapter will address the reporting of the results, follow up with therapy and development of the Care Plan with the patient to ensure the best outcomes.
Once the assessment has shown the risk of fall exists and the interdisciplinary team is in place, the nurse is now ready to provide education and guidance on prevention measures the patient and their caregivers can use to further help prevent the risk of falls. This chapter will cover tips, checklists and other tools to support safety in the home environment.