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How to Develop a Fall Prevention Strategy

Written by: Michael Fragala, PhD, MBA, RN, WCC, CSPHP, AMS

Patients in long-term facilities and nursing homes deserve the best of care. At the same time, their caretakers also deserve to stay safe in their work environment. One of the best ways to address both concerns is with a fall prevention strategy that mitigates fall risk and keeps both patients and caretakers in injury-free positions.

Medical facilities should be safe places for those suffering from long-term injuries, chronic diseases, or simply advanced age. Yet, studies have shown that long term care residents are three times more likely to fall than their peers and 10 times more likely to sustain significant injuries from those falls. While many simply believe that falls are a part of growing old or suffering from illness, a simple fall prevention strategy in facilities and hospitals can reduce those numbers drastically.

Developing a Fall Prevention Strategy for Your Facility

Many organizations, such as the Center for Disease Control (CDC), have developed tried and true fall prevention strategies outside of a hospital. The Stopping Elderly Accidents, Death, and Injuries (STEADI) initiative focuses on identifying fall risk factors in each patient and intervening to reduce those risks.

Standard strategies to prevent falls include better lighting in commonly used places, grab bars, handrails, ramps instead of stairs, and no-slip lining in danger areas like showers and bathrooms. The CDC recommends “making it personal” by interviewing staff members and providers about their experiences with patient falls. From these stories, identify what could have been done differently to prevent the falls and apply them as necessary.

Not every patient suffers from the same illness, and just as every patient has a specialized treatment plan, they should also have a customized fall prevention strategy. Providers should be able to have a clear understanding of each patient’s risk factors, from medications to previous falls to current symptoms that might affect balance. Furthermore, patients should participate in activities that help strengthen balance and mobility to lessen their fall risk.

Completing Standardized Fall Risk Assessments

Healthcare facilities may vary in their approach to assessing fall risk in each patient. For those in long-term care, assessments may need to be conducted regularly since the status of those in care may change dramatically over the course of a few weeks. Continuous fall risk monitoring will ensure that providers maintain awareness over time, even if the patient is not currently presenting any fall risk.

Patient history is crucial to understanding fall risk. Previous falls indicate that there is a high chance someone will fall again. Disorders, symptoms of a disease or medication, and even simply poor vision can all raise someone’s fall risk significantly.

Adjusting Care Based on Risk Factors

Awareness does not completely mitigate fall risk. In fact, for some patients, fall risk will never completely go away, especially if they have conditions that make it hard for them to stay mobile. However, some steps can be taken to reduce falls so that the patient has a better chance of staying healthy.

These steps may include:

  • Incorporating exercise into a patient’s care routine. These exercises do not have to be strenuous but rather focused on keeping muscles in shape.
  • Monitoring blood pressure and assessing Vitamin D levels.
  • Providing occupational therapy and physical therapy (such as Tai Chi) for those who can recover.
  • Addressing postural hypotension.

Caring for Patients Who Have Fallen

Despite consistent fall prevention strategies, patients may fall regardless. When this event happens, it’s important to address the situation immediately. Medical professionals should examine patients who have fallen in a long-term care facility as soon as possible. Even if the patient doesn’t exhibit symptoms, they still may need to be evaluated for head injuries, internal bruising or bleeding, or more.

Incorporating Best Practices into a Fall Prevention Program

With a fall prevention strategy, providers can help patients stay safe and rehabilitate throughout their stay instead of compounding it by an accidental fall. Make sure to develop your strategy, personalize it for each patient, and adjust care based on the existing factors and fall history.

If you need more help developing a fall prevention strategy tailored to the specific needs of your facility, start by taking our Patient Falls Management Assessment.

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