First and foremost, falls are dangerous to your patients and can be detrimental to their health. Multiple injuries can be caused by falls, especially in the elderly. Everything from bumps and bruises to broken hips and head bleeds. Head bleeds are an especially high risk for those on anticoagulation therapy for atrial fibrillation or other reasons, which is a significant portion of the elderly population, including many hospitalized patients. Falls in hospitals, long-term care, or rehabilitation facilities can be costly to the patient’s insurance or may become a financial burden to the facilities. Many times, if a fall is found to have been preventable, the care for the fall and any subsequent follow-up care costs can be denied for reimbursement by Medicaid as it would be considered a hospital-acquired condition.
Why people fall
Multiple factors play a role in why people fall, here are a few of the most common.
Generalized weakness
When patients are already ill, especially the elderly population, it doesn’t take long for them to develop generalized weakness. Early intervention with physical and occupational therapy is a huge part of helping prevent falls. Get your patients up and moving if possible!
Medication side effects
Many people take medications that can play a role in causing falls, such as blood pressure medications, antidepressants, antiarrhythmic medications and sedatives. Know your patients’ medications; and review them with the patient, family and provider to ensure they know what they are taking and the side effects to help prevent falls. For example, ensure they check blood pressure before taking a blood pressure medication and review sleeping pill safety.
Cognitive issues or delirium
This may be one of the most difficult issues to deal with. Try your best to find the cause of the delirium if it is unknown and work with the patient to keep them safe. Get creative and find things to distract these patients. Music, magazines, tasks and crafts often help keep patients busy. Keeping these patients in view of nursing stations and frequently checking on them will also help keep them safe.
Issues with toileting
Many patients feel the need to rush to the bathroom before having an incontinent episode and in that rush they may fall. Scheduled toileting and frequent patient checks can help prevent these falls that occur in the bathroom.
General fall precautions
Orient patients to their surroundings.
Ensure they always have basic needed items near them, drink, phone, tv remote, call bell, books/magazines, tissues etc.
Make sure their chair or bed is in a low and safe position and the brakes, are locked, if applicable.
Remove clutter and keep the room layout consistent. Area rugs and extension cords are a tripping hazard.
For independent patients with assistive devices, ensure they are near and in good condition and the patient knows how to use them.
Proper footwear is imperative, non-slip shoes, socks or slippers that fit appropriately.
Following these simple guidelines and knowing your facility-specific policies on patient safety will help you prevent your patients from falling and keep them safe.