Quality Assurance

One of the major health care challenges, both in the hospitals or nursing homes have always remained falls among elderly patients, especially in patients with dementia or Alzheimer's. Some of them are preventable, some are not. Nursing homes and hospitals are spending a huge amount of money on prevention or post fall care every year. Fall is one of the quality indicators assessment used by the Department of Public Health to evaluate nursing homes.

I work for Kindred care and they pay a lot of attention to falls. The administration established a fall management team which sits on Tuesdays every week to review every fall and formulate preventive care plan as a standard quality control measure. The management team on a regular basis evaluates every intervention and may also make adjustments based on particular incident. At my job we have a quality assurance standard chart which enables nursing staff to identify cause of action after each fall. Many times the fall management team can also evaluate overall falls in the entire nursing home to identify pattern to study trends to enable them. Marquis and Houston points out, " Outcome audits determine what results, if any, followed from specific nursing interventions for patients." (2006, page 608)

In one fall project, the fall management team studied every fall in the nursing home and identified every fall first by the shift in which the fall occurred. Then identified which shift had more prevalence of falls and narrowed down to which unit and staff assigned to this patient. The result was that some nurses had more falls occurrence in their units than others. As a follow up, in-services and disciplinary actions were given out and the number of falls went down by 50 %.