The importance of fall prevention in occupational therapy.
March 10, 2021
Falls during therapy and injuries in a whirlpool or on equipment is a common allegation in claims/lawsuits against Occupational Therapy (OT) practitioners. Falls remain the leading cause of injury and death among older adults, with an estimated total medical cost for fatal and nonfatal fall injuries of $30.9 billion.[i] In 2015, there were 24,190 fatal falls.[ii] The Agency for Healthcare Research and Quality estimates that 700,000 to 1 million hospitalized patients fall each year.[iii] Patients in long-term care facilities are also at very high risk of falls. Approximately half of the 1.6 million nursing home residents in the United States fall each year, and a 2014 report by the Office of the Inspector General found that nearly 10% of Medicare skilled nursing facility residents experienced a fall resulting in significant injury.[iv] Research shows that close to one-third of falls can be prevented.[v] Fall prevention involves managing a patient's underlying fall risk factors and optimizing the physical design and environment.
According to the Joint Commission, the most common contributing factors relating to falls include:
- Inadequate assessment
- Communication failures
- Lack of adherence to protocols and safety practices
- Inadequate staff orientation, supervision, staffing levels or skill mix
- Deficiencies in the physical environment
- Lack of leadership[vi]
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[i] Burns, E.R., J. A. Stevens, and R. Lee. 2016. "The direct costs of fatal and non-fatal falls among older adults—United States." Journal of Safety Research 99–103. doi:http://dx.doi.org/10.1016/j.jsr.2016.05.001
[ii] Ibid
[iii] Rand Corporation, Boston University School of Public Health, ECRI Institute. 2018. Preventing Falls in Hospitals: A Toolkit for Improving Quality of Care. Rockville, MD: Agency for Healthcare Research and Quality,. http://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/index.html.
[iv] Levinson, D.R. 2014. Adverse Events in Skilled Nursing Facilities: National Incidence Among Medicare Beneficiaries. Report No. OEI-06-11-00370., Washington, DC: US Department of Health and Human Services, Office of the Inspector General.
[v] Ibid
[vi] The Joint Commission. 2015. Joint Commission Sentinel Event Alert: Preventing falls and fall-related injuries in health care facilities . Oakbrook Terrace, IL: The Joint Commission.
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