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Fall Prevention in Nursing Homes

Nursing home residents are one of the most at-risk populations for injuries and deaths resulting from falls. Facilities with 100 beds average as many as 100 to 200 falls per year. The falls result in broken bones, reduced mobility and, in some cases, death.

  1. The Cause of Falls

    • Knowing the most common causes of falls is essential in preventing them. Elderly residents are at higher risk by virtue of their advanced age and frail health, their increased use of prescription drugs (sedatives, for example) and mobility issues caused by medical conditions such as foot or neurological problems.

    Moving Is the Point of Highest Risk for Patients

    • Any time a patient changes position, the risk of falls increases. Going from a wheelchair into the bed, getting on and off the commode and just moving from a chair to a standing position all pose a risk. Thirty to 60 minutes after medications are given, patients are apt to be more unsteady on their feet as well.

    Environmental Causes of Falls

    • Shoes that fit poorly, wet floors, poorly lit areas in the facility, beds that are too high, and canes and walkers that are not the right size or are in poor condition are also a source of falling problems.

    Preventing Falls With Staff Awareness

    • Staff members should be trained to report patients who seem over medicated or dangerously unsteady on their feet to their doctors. Some residents may be able to use fewer medications or smaller doses. If that isn't feasible, they can be given hip pads to help to reduce the incidence of fractures. Exercise programs will help with motor skills such as balance and muscle strength as well.

    Changes in the Environment Will Also Help

    • Bathrooms should have raised seats and grab bars. Beds should be kept low to help patients get in and out of beds more safely. Hallways and public spaces should have good lighting and safety handrails. Patient rooms should be kept free of excessive clutter so that there is always a clear area to walk around in.

    Patient Care Adds to Patient Safety

    • Patients should be assessed every three months to see whether they are at high risk for falls. Those who are should be charted as such and staff should be alerted to this. Nursing home residents should have routine eye exams to make sure that they are seeing as well as they are able to. Checking the patients' feet will help them to walk more steadily. They also need to have nonslip shoes that fit their feet correctly.

    Speed Helps

    • Answering a patient call quickly is of vital importance because when patients are kept waiting, they often get up alone when they shouldn't. Likewise, patients who can't easily control their bowels or bladder must be answered quickly. When accidents occur, the floors are slippery right at the patient's feet so that even sitting back down is dangerous.

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