What preventative strategies you can implement for your patient in order to prevent falls?
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“Prevent residents from falling” is one of the National Patient Safety Goals for nursing care centers. Patient falls, whether in the nursing care center, home, or hospital, are very common and can cause serious injury and death. Older adults have the highest risk of falling. Each year, 3 million older people are treated in emergency departments for fall injuries, and over 800,000 patients a year are hospitalized because of a head injury or hip fracture resulting from a fall. Many older adults who fall, even if they’re not injured, become afraid of falling. This fear may cause them to limit their everyday activities. However, when a person is less active, they become weaker, which further increases their chances of falling.[1] Many conditions contribute to patient falls, including the following:[2]
Most falls are caused by a combination of risk factors. The more risk factors a person has, the greater their chances of falling. Many risk factors can be changed or modified to help prevent falls. The Centers for Disease Control has developed a program called “STEADI – Stopping Elderly Accidents, Deaths & Injuries” to help reduce the risk of older adults from falling at home. Three screening questions to determine risk for falls are as follows:
If the individual answers “Yes” to any of these questions, further assessment of risk factors is performed.[3] Read more about the CDC’s STEADI initiative at STEADI – Stopping
Elderly Accidents, Deaths & Injuries. Fall Assessment ToolsBy virtue of being ill, all hospitalized patients are at risk for falls, but some patients are at higher risk than others. Assessment is an ongoing process with the goal of identifying a patient’s specific risk factors and implementing interventions in their care plan to decrease their risk of falling. Commonly used fall assessment tools used to identify patients at high risk for falls are the Morse Fall Scale and the Hendrich II Fall Risk Model. Read more about these fall risk assessment tools using the hyperlinks provided below. Key risk factors for falls in hospitalized patients are as follows:[4]
View common fall risk assessment tools using the following hyperlinks:
Interventions to Prevent FallsUniversal fall precautions are established for all patients to reduce their risk for falling. In addition to universal fall precautions, a care plan is created based on the patient’s fall risk assessment findings to address their specific risks and needs. Universal Fall PrecautionsFalls are the most commonly reported patient safety incidents in the acute care setting. Hospitals pose an inherent fall risk due to the unfamiliarity of the environment and various hazards in the hospital room that pose a risk. During inpatient care, nurses assess their patients’ risk for falling during every shift and implement interventions to reduce the risk of falling. Universal fall precautions have been developed that apply to all patients all the time. Universal fall precautions are called “universal” because they apply to all patients, regardless of fall risk, and revolve around keeping the patient’s environment safe and comfortable.[8] include the following:
Interventions Based on Risk FactorsPatients at elevated risk for falling require multiple, individualized interventions, in addition to universal fall precautions. There are many interventions available to prevent falls and fall-related injuries based on the patient’s specific risk factors. See Table 5.6a for interventions categorized by risk factor.[11] Table 5.6a Interventions Based on Fall Risk Factors
Scheduled Hourly Roundingare scheduled hourly visits to each patient’s room to integrate fall prevention activities with the rest of a patient’s care. Scheduled hourly rounds have been found to greatly decrease the incidence of falls. See below for a list of activities to complete during hourly rounds. These activities can be completed by unlicensed assistive personnel, nurses, or nurse managers.[12] Hourly Rounding Protocol.[13]
Medications Causing Elevated Risk for FallsEvaluate medication-related fall risk for patients on admission and at regular intervals thereafter. Add up the point value (risk level) in Table 5.6b for every medication the patient is taking. If the patient is taking more than one medication in a particular risk category, the score should be calculated by (risk level score) x (number of medications in that risk level category). For a patient at risk, a pharmacist should review the patient’s list of medications and determine if medications may be tapered, discontinued, or changed to a safer alternative.[14] Table 5.6b Medications Causing High Risk for Falls[15]
View tools used to assess delirium and confusion in the Delirium Evaluation Bundle shared by the Agency for Healthcare Research and Quality. What strategies can be implemented in the prevention of falls?Steps to take to prevent falls. Stay physically active. ... . Try balance and strength training exercises. ... . Fall-proof your home. ... . Have your eyes and hearing tested. ... . Find out about the side effects of any medicines you take. ... . Get enough sleep. ... . Avoid or limit alcohol. ... . Stand up slowly.. What are three interventions to prevent falls in patients?Interventions to Prevent Falls. Familiarize the patient with the environment.. Have the patient demonstrate call light use.. Maintain the call light within reach. ... . Keep the patient's personal possessions within safe reach.. Have sturdy handrails in patient bathrooms, rooms, and hallways.. |