Fall Prevention

Falls are one of the most common causes of injury for older adults and patients in care. Watch closely for anyone who:

• Has fallen before
• Is weak, unsteady or uses a cane or walker
• Takes medicines that cause drowsiness, dizziness or low blood pressure, such as sleep aids, pain medicines and blood pressure pills
• Is confused, or more confused than usual
• Needs to get to the bathroom often or in a hurry
• Has poor eyesight

Risk changes. A new medicine, an infection or a hospital stay can raise it overnight, so check again whenever the patient changes.

Small changes prevent most falls:

• Keep the bed low and its wheels locked
• Keep the call light, phone, glasses and walker within reach
• Clear the path: cords, throw rugs, clutter
• Turn on a night light between the bed and the bathroom
• Wipe spills right away
• Make sure the patient wears non-slip footwear

In the home, point out loose rugs, poor lighting and missing grab bars to the patient and family, and note them in the visit record.

Before any move, check the care plan for how much help the patient needs and what equipment to use.

• Tell the patient what you are about to do
• Lock bed and wheelchair brakes
• Have the patient sit at the edge of the bed for a moment before standing, to avoid dizziness
• Use a gait belt when the plan calls for one
• Stay on the patient's weaker side when walking
• Get help when you need it. Never attempt a transfer the plan says needs two people by yourself.

If a patient falls:

1. Stay with the patient and call for help
2. Do not lift the patient right away. Check for pain, injury, bleeding, and any change in alertness
3. If you suspect a head, neck, back or hip injury, keep the patient still and follow emergency procedures
4. Get the nurse or supervisor to assess before the patient is moved
5. Report the fall on the incident report the same shift, even when there is no visible injury
6. Watch the patient closely afterward. Some injuries, such as bleeding in the head, show up hours later