People living in nursing homes CAN experience fewer falls. To do so calls for strong education FOR ALL to learn the simple, doable, no cost, individualized and proactive practices that can reduce falls when intentionally implemented while also individualizing care and supporting resident-directed living. Typical fall reduction strategies continue to be only clinical and generic focusing on the old-style overly-medical “interventions” instead of the person. Falls harm people and yet can be prevented.

All team members, community wide, learn during a monthly webinar. Then the team discusses the intricacies of each home’s culture, particular individuals’ situations, and plan accordingly. As falls do not belong to nursing, we gain more traction when it is the wider team to prevent falls. Teams agree to the big goal of seeking to see falls decrease every single month and … ZERO falls per month as the goal!

Edu-Catering taught workshops regarding proactive practices in Colorado under a CMP grant state-wide in 2018. Then was awarded a 3-year CMP grant in the state of Florida to implement these simple practices directly with whole communities. Data is very positive and below also Final Report 3-Year FL CMP Grant Project is available at this website: https://ahca.myflorida.com/MCHQ/Health_Facility_Regulation/Long_Term_Care/DOCs/CMP_Docs/GFA068_Final_Project_Report.pdf.

Proactive Practices that Reduce Falls Curriculum:

1. Moving from the same old “interventions” to Proactive Practices to Prevent Falls
2. Proactive Practice: Anticipating Needs, particularly bathroom, by All 
3. Proactive Practice: Proactively checking in with residents by All  
4. Proactive Practice: Increased Individualized Movement by All
5. Proactive Practice: Meaningful Engagement by All 
6. Lots More Proactive Practices to Reduce Falls: Lavender, Music, Consistent Team
7. Proactive Practices: Honoring Sleep/Natural Awakening and Open Dining Times 
8. Proactive Practice: Identifying Highest Practicable Level of Well-being – as required by CMS regulations 
9. Proactive Practice: Enhancing Well-being – now part of CMS requirements 
10. Proactive Practice: Using the Environment to our Advantage to Prevent Falls
11. Individualizing Care Plans to include Proactive Practices to Prevent Falls
12. End of Year, Successes, Lessons Learned, Strategies for Sustainability

If a home still uses bed/chair alarms, we must begin with 1) The Harms of Alarms, and 2) How Alarms can be Deficient at 7 CMS Regulations.

If your home or organization wants to reduce falls, education can be catered to meet your needs from shorter to longer, live to recorded videos expressly for your community/organization.

Edu-Catering Falls Reduction Projects and Data

Proactive Practices to Prevent Falls Florida 3 Year Florida Project

Year 1- April 2019 – March 2020

People living in 6 of 10 FL nursing homes experienced fewer falls 2019/2020. Ten Florida Nursing Homes took part in monthly education on proactive practices to prevent falls, coaching calls and implemented practices learned for 12 months from April 2019 – March 2020.  It was also a focus at the time to learn how to replace bed and chair alarms with better practices to prevent falls. In six of these ten homes falls decreased.

These numbers represent total number of falls during the first month of the project and total number of falls during the last month of the project:

1. Courtney Springs 18 to 6
2. Healthcare at Brentwood 21 to 14
3. Regents Park 42 to 28
4. Signature Chautauqua 37 to 16
5. Signature Peninsula 23 to 16
6. Sunset Lake 31 to 10

Regarding the other four: one home began with 8 and ended with 8 falls; two homes experienced an increased number of falls and one home did get from 31 to 17 at one point but had 33 in last month.

Year 2 – Aug. 2020- July 2021

People living in 8 of 14 FL nursing homes experienced fewer falls 2020/2021.

Fourteen Florida Nursing Homes took part in monthly education on proactive practices to prevent falls and monthly coaching calls and implemented practices learned for 12 months from Aug. 2020 – July 2021.

Of 14 homes, 8 experienced a decreased average number of falls per month; 2 remained the same and 4 increased due to covid and staffing challenges.

Average Falls/Month pre-project Aug. 2019-July 2020 and post project Aug. 2020-July 2021

1. Marshall 26 to 18
2. Orange Park 22 to 18
3. San Jose 26 to 16
4. Tallahassee 14 to 10
5. Lake Mary 36 to 34
6. Oaktree 10 to 8
7. Pensacola 14 to 13
8. Governor’s Creek 13 to 12

Two homes’ fall averages remained the same and 4 homes’ averages increased. These teams were less able to implement practices as a result of being hit harder with covid and resulting staffing challenges.

Year 3 – April 2021 – July 2022

Fifteen homes signed up and although times were very difficult due to staffing challenges because of COVID-19 aftermath, no home dropped out. What follows are some good outcomes even though there were challenges.

Three homes saw average number of falls decrease:

1. Orchid Cove of Naples 11.25 to 8.83 falls per month.
2. Orchid Cove of Stuart slightly 20 to 18 falls per month.
3. Orchid Cove of Venice 13.6 to 11.07 falls per month.

With COVID-19 and loss of staff and having to use agency staff, this took a toll on total falls. It is true when you see a stable team work together and implement proactive practices, falls decrease.  This was stated by many in this project month after month: if falls were increased you would hear, “Well we have 50% agency in the building.” Or if falls decreased, teams would say, “We have stable staff again and/or we have really focused on these simple techniques and using them and reducing falls.”

A Self-Assessment tally of Proactive Practices to Prevent Falls was developed for this 3^rd year. There were 28 practices. Some homes never submitted pre and/or post assessments and the most notable homes with improvement were:

• Anchor Care 0 to 22 proactive practices.
• Balanced 0 to 20 proactive practices.
• Orchid Cove of Venice 1 to 22 proactive practices.

Of the 12 months of the project, the number of times/months falls decreased was tracked:

• 8 months falls decreased at Orchid Cove of New Port Richey
• 7 months falls decreased at Orchid Cove of LaBelle
• 6 months falls decreased at 4 homes Orchid Cove of Dade City, Orchid Cove of Daytona, Orchid Cove of Naples, Orchid Cove of Oldsmar

Of the 12 months of the project, the number of times a resident fell, and it resulted in a major injury such as a fracture was also tracked:

• One home, Orchid Cove of Dade City experienced ZERO major injuries from falls.
• Three homes, Orchid Cove of Kissimmee, Orchid Cove of Longwood, and Orchid Cove of Oldsmar only experienced only 1.
• Two homes, Orchid Cove of Venice and Orchid Cove of Daytona, experienced only 2.

Stay tuned as Edu-Catering is conducting another 3-year CMP reinvestment project Proactive Practices to Prevent Falls under contract with the State of Florida, Agency for Health Care Administration from 8/2024 to 7/2027 with 10 nursing homes per year. At the end of the second month, 5 homes had fewer falls and in 3 of them falls reduced by half!

This education can be catered to providers, ombudsmen, surveyors, membership organizations, and more to meet your needs from shorter to longer learning opportunities, live to recorded videos expressly for your team.

Let’s all work to get falls to ZERO!

Carmen Bowman, 303-981-7228, carmen@edu-catering.com