Preventing Falls and Hospital Readmission
By Improving your Night Time Incontinence Program
In a typical nursing home with 100 beds one can expect between 100 and 200 reported falls annually. Per year the average resident will fall more than once. In this Marcus Evans Webinar from October 2016, industry specialists Teresa Moore and Tony Forbery explore the ways in which a Nighttime incontinence plan should be implemented and its importance.
Sitting on our expert panel is firstly Teresa Moore (pictured below left), a Registered Nurse and licensed Nursing Home Administrator with experience in the senior care industry since 1990. She has worked for Acts Retirement-Life Communities for the past 20 years in multiple positions including Director of Home Health, Director of Nursing, Nursing Home Administrator, Regional Clinical Director, and Director of Quality Education. Teresa is joined by Tony Forsberg (pictured below right), who has previously held positions within SCA Personal Care North America including Product Director, Regional Clinical Director and Territory Manager. Tony is a Wound Care Certified Registered Nurse and holds a BA in Business Administration. He focuses on working closely with customers to ensure the effective development of individualized continence care programs. Over the course of the webinar, the duo discusses facts about falls, how lack of sleep can impact falls and how a nighttime incontinence plan can help. Here are the key points to take from the discussion:
1. Specifics on Falls
It is important to begin by painting a picture about the details surrounding falls. You may ask how big the problem really is, and the answer is that it is a very prominent issue. In over 65s, falls make up 55% of the causes of unintentional deaths, followed distantly by motor vehicles at 14%. The costs of these falls can be extreme, in terms of both money and harm to the injured person. Evidently falls occur more often in nursing homes due to the older generation being more frail, prone to chronic issues and having increased walking problems. Additionally, environmental hazards have more impact on older people, for example getting out of bed on the other side, something that a young healthy person might think as a customary routine change, is enough to cause a fall.
2. The Importance of Sleep
The benefits of sleep are undisputable and not only for the older generation. Sleep protects against strain, reduces energy consumption, allows for the regain of physical neurological and psychological balance and recovery and activation the immune defense system. In the case of residents in care homes, sleep is extremely important because if they don’t sleep they are more likely to wander around at night and perhaps become agitated. Sleeping medicines can make residents groggy and contribute to walking issues, thus making falls more likely.
3. Prevention
The panel enlightens the audience about prevention, and how a nighttime incontinence plan can be of assistance. As Teresa says, “we know that falls will happen despite our best efforts.” Thus, nursing homes have to ensure that they have a rigid falls management program in place. Providing an environment in which there are minimal risks for residents is vital to beginning this process. Often interventions come after a fall, however these can be executed before if an assessment is done early on. Nevertheless, what works for one patient might not work for another. When a resident comes into your care, part of the plan should involve understanding their previous routine to ensure you prevent any abrupt changes that could cause damage.
4. The Nighttime Incontinence Plan
The Nighttime incontinence plan should have several focuses. One of these is the resident toileting program adjustments which includes bowel and bladder diary assessment. This is very important because it illustrates how the resident use the toilet during the night, as this is when the largest amount of urine production occurs, thus allows determination of their program; nighttime falls are a particular concern. Tony says, “it makes sense to have a third party who come in and help provide some education”, so that the staff are aware of the correct product procedures, timetables to adhere to and how to go about individualized care. In terms of product changes, there is also a need for absorbent product feature training. This ensures the correct sized briefs are used during the day and at night to prevent leakages or skin irritation.
5. Benefits of the Plan
So what are the benefits of implementing a regimented nighttime incontinence program? If your staff are educated and know how to use the right product sizes, it can prevent resident leakages during the night, thus reducing firstly laundry costs, and also less night changes giving more focus on other activities. More comfort for residents minimizes the likelihood of them waking up during the night and walking around. Clinically, the skin health of residents will improve if the correct procedures are used and all in all improving their wellbeing.
There are many important factors that must be adhered to, to ensure a fully effective nighttime incontinence program. By individualizing care for each resident, it helps to prevent falls and hospital readmission. Through building and developing the intervention options, staff can determine what is appropriate, thus it is essential to educate them. Because falls are so common, ensuring that the residents are fully rested and not lacking in sleep aids the prevention process, and enhances the wellbeing of themselves and the environment in which they live.
