Increase Fall in Nursing Home

Fall Prevention

All Staff

Falls in the Nursing Home

There has been an increase in falls in the nursing home. A number of things can cause residents to fall (Patient falls: How to prevent them). Illnesses, such as dementia among others, can cause residents to be confused. Confusion with residents requires continual monitoring in keeping the resident safe. Muscle weakness and instability cause falls when residents are confused, or when the resident insists on doing things themselves and maintaining their own independence in spite of the weakness or instability issues. Medications can also cause confusion. Sedatives and anti-anxiety medications are a particular concern in causing confusion. Medications can also cause drowsiness that can cause falls if patients are not put to bed when the medications are given.

Environmental factors also play a role in falls. Wet floors, poor lighting, incorrect bed height, improperly fitted shoes, unmaintained wheel chairs, or items on the floor that cause obstructions all can cause falls for residents. Poor foot care can be a factor if toe nails, corns, etc. are not properly cared for. Some shoes have soles that cause skids on certain floors. Improper use of walking aids can also be factors in fall incidences.

According to the CDC (Falls in Nursing Homes), nursing home staff have abilities to prevent falls when properly trained in fall prevention strategies. Risk factors should be addressed and underlying medical conditions should be treated. Reviewing prescribed medication can determine when medications should be given with the patient in bed. For residents that are coherent, safety teaching goes a long way in enabling the resident to practice safety at all times.

Call lights should be answered immediately. Residents with limited mobility, but coherent, need assistance for restroom needs, but will not usually wait when staff takes too long to assist them. Some residents require raised toilet seats because of limitations in sitting too low. Beds should be adjusted properly to enable ease of the resident when getting up and down. Residents who are confused need their beds to be all the way down, preferable with a mattress at the bedside, to soften the fall if they try to get up without calling for help. The use of bedrails needs precautionary measures because confused residents may crawl over them, causing more injury from a higher fall. The use of bed and chair alarms can also be used to alert staff when a resident is getting up, especially a confused resident.

Staff rounding on a continual basis is especially important to monitor residents under fall precaution standards. Staff can monitor when residents are using walking aids improperly and work with residents to ensure the proper use for safety. Rounding can also monitor confused residents and prevent accidents that can cause injury. It can also assist residents who insist on maintaining their own independence, even though they have limitations that prevent them from being totally independent. Residents with mobility issues should always be walked and exercised by a staff member with the use of a gait belt for safety from falling.