Falls And Trauma Case Study

Falls and trauma is one out of the few complications in the United States that are no longer paid for by healthcare. This complication occurs mostly among the elderly population and is the common cause of injuries and fatalities. Falls and trauma can be eliminated using different prevention measures. Per the assignment instructions, this paper presents the cost of treatment, nursing measures to prevent complications and impact of non- reimbursement.

Cost of Treatment
According to Centers for Disease Control and Prevention (CDC), each year, millions of adults aged 65 and older fall. The outcome linked to falls, resulted in hip fractures, head traumas and early death (“Falls Among Older”, 2015). The CDC reports the total lifetime

medical costs of unintentional nonfatal fall injuries in people 65 years and older which were treated in emergency departments and hospitalized by sex (“Falls Among Older”, 2015). This report shows that cost of women surpassed the cost of men treated in the hospital. Medical costs for falls treated in emergency department (ED) in 2005 in people 65 years and older totaled $6.3 billion- 451 million for patients who were treated and released and 5.8 billion for patients who were subsequently hospitalized (“Falls Among Older”, 2015). Since 2008, the Centers for Medicare and Medicaid Services do no pay hospitals for the extra care associated with an inpatient fall and the trauma associated with it (“Falls Among Older”, 2015). In 2013, the direct medical costs of falls, adjusted for inflation, were $34 billion (Butcher, 2013). With these reports we can see an increase in costs and falls in people 65 years and older throughout the years. The mission of nurses is to ensure patient safety. Let it be our mission to provide exceptional outcomes for patients through safe, quality and caring services.
Nursing Measures to Prevent Complication
Nobody can prevent every fall.

As nurses we are taught to address infections and diseases by adopting evidence based protocols, but in regards to fall and the associated trauma there are no evidence- based bundle of practices to prevent it from occurring. Taking prevention measures does not always constitute whether the patient remains free from falls, but is used as a preliminary measure. As nurses, we are the patient’s advocates so we must intervene to provide optimal care. As a medical surgical unit, important unit measures that should be followed are: upon admission, screen patients for probable indicators of fall risk. Implement a fall risk assessment on each patient, regardless of negative screening. Following admission, periodic risk assessment should be done at each shift change and change in status of the patient. By completing the necessary assessments and obtaining subjective and objective data, helps nurses monitor the patients closely and help tailor prevention intervention based on the characteristics and needs of the

patients.
On the unit, patients are categorized by yellow arm-bands as high fall risk, which makes them easily identifiable. Hourly rounding on these patients significantly reduces devastating consequences. Other interventions pertinent to the care of such patients include, explaining the fall risk to each patient, demonstrating to the patient on how to use the call light, maintain patient mobility, regularly assess mental status, implement a bathroom schedule, and fall proof the hospital room (“CMS Rules”, 2010). Nurses can evaluate the interventions by obtaining feedback from the patients as well as observing if the intervention worked and prevented them from furthering harming themselves. Nurses are held accountable and responsible for patient safety.
Impact of Non-reimbursement
With Medicaid no longer covering category 1- falls and trauma, the hospital has suffered a major reimbursement loss.

With Medicare being eliminated, mounting economic pressure has risen flooding the minds of individuals with the quality and cost of health care. Medicare covers more than 39 million Americans, and patient’s ages 65 and older account for nearly 14 million discharges from short stay hospitals annually (Kurtzman & Buerhaus, 2008). CMS calculates 490,000 claims could be paid at a lower rate under the new rule, CMS-1533-FC (Kurtzman & Buerhaus, 2008). Its estimated that Medicare will save 20 million annually in direct payments, but the impact on U.S health care costs and reimbursement is likely to be much greater (Kurtzman & Buerhaus, 2008). There is a positive correlation with non-reimbursement proven lower rates of complication and high quality nursing care. With non-reimbursement the hospitals continue to face challenges, but the positive outcomes outweigh the negative benefits to the hospital. There are strategies to address clinical complications and implementing it is an incentive to improve quality

efforts.