• Define the key terms listed in this chapter. • Identify the causes and risk factors for falls. • Describe the safety measures that prevent falls. • Explain how to use bed rails safely. • Explain the purpose of hand rails and grab bars. • Explain how to use wheel locks safely. • Describe how to use transfer/gait belts. • Explain how to help the person who is falling. • Perform the procedures described in this chapter. • Explain how to promote PRIDE in the person, the family, and yourself. See Focus on Surveys: Assisting With Fall Prevention. • In patient and resident rooms and in bathrooms. • Within the first 72 hours of admission to a hospital or nursing center. • During the night and after meals. • During shift changes. Staff are busy going off and coming on duty. Confusion can occur about who gives care and answers call lights. The accident risk factors described in Chapter 9 can lead to falls. The problems listed in Box 10-1 increase a person’s risk of falling. Agencies have fall prevention programs. The measures listed in Box 10-2, p. 116 are part of such programs and the person’s care plan. The care plan also lists measures for the person’s risk factors. Box 10-2 Safety Measures to Prevent Falls • Eyeglasses and hearing aids are worn as needed. Reading glasses are not worn when up and about. • Tasks are explained before and while performing them. • Help is given with elimination needs. Assist the person to the bathroom. Or provide the bedpan, urinal, or commode. • The bedpan, urinal, or commode is kept within easy reach if the person can use the device without help. • A warm drink, soft lights, or a back massage is used to calm the person who is agitated. • Barriers are used to prevent wandering (Fig. 10-1). • The person is properly positioned when in bed, a chair, or a wheelchair. Use pillows, wedge pads, seats, or other positioning devices as the nurse and care plan direct (Chapter 13). • Correct procedures and equipment are used for transfers (Chapter 14). Follow the care plan. • The person is involved in meaningful activities. • Exercise programs are followed. They help improve balance, strength, walking, and physical function. Bathrooms and Shower/Tub Rooms • Tubs and showers have non-slip surfaces or non-slip bath mats. • Grab bars (safety bars) are in showers (p. 118). They also are by tubs and toilets. • The person uses grab bars in bathrooms and shower/tub rooms. • Shower chairs are used (Chapter 16). • Safety measures for tub baths and showers are followed (Chapter 16). • Carpeting (if used) is wall-to-wall or tacked down. • Scatter, area, and throw rugs are not used. • Floor covers are 1 color. Bold designs can cause dizziness in older persons. • Floors have non-glare, non-slip surfaces. • Non-skid wax is used on hardwood, tiled, or linoleum floors. • Loose floor boards and tiles are reported. So are frayed rugs and carpets. • Floors and stairs are free of clutter, cords, and other items that can cause tripping. • Floors are free of spills. Wipe up spills at once. Put a wet floor sign by the wet area. • Floors are free of excess furniture and equipment. • Electrical and extension cords are out of the way. This includes power strips. • The bed is at the correct height for the person. • The bed is in the lowest horizontal position, except when giving bedside care. The distance from the bed to the floor is reduced if the person falls or gets out of bed. • Bed rails (p. 118) are used according to the care plan. • A mattress, special mat, or floor cushion is placed on the floor beside the bed (Fig. 10-2). This reduces the chance of injury if the person falls or gets out of bed. • Wheelchairs, walkers, canes, and crutches fit properly. They are in good repair. Another person’s equipment is not used. • Crutches, canes, and walkers have non-skid tips. • Wheelchair and stretcher safety is followed (Chapter 9). • Wheel locks on beds (p. 119), wheelchairs, and stretchers are in working order. • Bed and wheelchair or stretcher wheels are locked for transfers. • Linens are checked for sharp objects and for the person’s property (dentures, eyeglasses, hearing aids, and so on). • Non-skid footwear is worn. Socks, bedroom slippers, and long shoelaces are avoided. • Shoes fit well. They should not slip up and down on the person’s feet. All shoelaces and straps are fastened. • Clothing fits properly. Clothing is not loose. It does not drag on the floor. Belts are tied or secured in place. • The person is taught how to use the call light (Chapter 15). • The call light is always within the person’s reach. This includes when sitting in the chair, on the commode, and in the bathroom and shower/tub room. • The person is asked to call for assistance when help is needed. • Call lights are answered promptly. The person may need help right away. He or she may not wait for help. • Bed, chair, door, floor mat, and belt alarms are used. They sense when the person tries to get up, get out of bed, or open a door (Fig. 10-3).
Assisting With Fall Prevention
Causes and Risk Factors for Falls
Fall Prevention
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