General Medicine
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/30438
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Browsing General Medicine by Author "Hadley, Lesca"
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Item Assessing Fall Risk in the Geriatric Population(2021) Nance, Callie; Hadley, Lesca; Gibson, John; Daley, RebeccaPurpose Falls in the geriatric population are a major cause of morbidity and mortality, and identifying patients at risk of falling can guide physicians in their next steps of preventative management. We implemented the Gait Speed Test into pre-wellness visits at the clinic to identify patients at greater risk of falling. Methods We tested the patients Gait Speed by having them sit in a chair, stand up and walk down a hallway that is marked on the side. When the patient passed the start line we began timing, and we stopped the timer when they walked 4 meters and passed the finish line. The time in seconds was divided by 4 meters, giving the "Gait Speed' which was recorded. Results were discussed at the wellness exam the following week. Results We tested 15 individuals during the month of November, which was 100% of the patients seen for pre-wellness exams. Of these, 5 were considered increased risk for fall (>5s/4m). We were able to counsel the patient on their individual situation and give them exercises to increase their strength and gait speed. Conclusions The Gait Speed Test proved to be a fast and efficient way to determine which patients need more time spent on education about fall prevention. The clinic is going to repeat the test annually to follow along with patients as they increase in age. This will hopefully be able to catch any decline in function in patients before it gets severe.Item Improving Fall Risk Assessment in a Rural Primary Care Clinic(2021) Fischer, Joseph; Qualls, James; Gibson, John; Hadley, LescaPurpose: The Athens Family Medicine clinic serves many elderly patients with a history of falls. The practice does not have any screening tools that assess a patient's risk for future falls. This project aims to see if increasing or diversifying screening services will lead to an increased screening for future fall risks in adults ages 65 and older. Methods: In this project two established fall assessment tools, the 4-Stage Balance Test and a modified Chair Stand test, were used to assess the fall risk of the patients. A "high risk" or "moderate risk" or "no increased risk" determination was assigned based on the assessment findings. Results: There was a total of 52 patients seen in the clinic during the assessment period that were greater than or equal to 65 years old. 40 patients out of the 52 patients had their fall risk assessed; an improvement of 77% compared to prior to the start of the survey. Of the patients surveyed 15 (38%) were found to have no increased fall risk, 9 (22%) had a moderate fall risk, and 16 (40%) had a high fall risk. Conclusions: The project showed that the fall risk screening method used allowed for the majority of eligible patients to be screened during the screening period, showing an increase in screening services in patients ages 65 and older. The next step is to then have a more personalized patient conversation about fall risk and preventing falls for those at increased risk.Item Telehealth Education for Geriatric Populations(2021) Wilder, Alyssa; Jenkins, Joseph; Gibson, John; Hadley, LescaIntroduction The acceptance and use of telehealth by geriatric patients are a result of many factors, including perceived value, attitude, perceived behavior control, and resistance. Technology anxiety is often a large contributor to the negative reception of telehealth by geriatric patients. Will educational handouts lead to increased usage of telehealth services among geriatric patients? Methods Geriatrics patients were informed about the clinics telehealth services and offered two educational handouts about the telehealth service. The handouts were provided to patients over the course of a month as well as given to the medical assistant for reference when speaking to patients over the phone. The electronic health record was used to record the number of visits. Results The table shows that the number of geriatric patients utilizing the telehealth services decreased from 10.3% to 8.7% during the course of the project. Upon further investigation, the number of telehealth visits for the entire clinic had decreased in the month of August. This appears to be correlated with the declining number of COVID-19 cases in Port Lavaca during this time frame. Conclusions Though the number of telehealth visits decreased, patients felt more informed about what to expect. The medical assistant used the handouts to determine which patients could use the service. For this project the intent was to provide physical handouts could refer to after an in-person visit. Moving forward, it would be beneficial to add the flyers or other instructions to the patient portal, for easy access to all patients.