For Work

Reasons Patients Fall:

1. Position, they were sitting too long, lying on one side too long, they were

getting restless and bored in their present surroundings so they had a

need to move their position.

2. Personal needs/potty

3. Pain, so they were becoming uncomfortable, aching and hurting, so they

needed to move to relieve themselves of the pain.

4. Placement of their personal items, their glasses were out of reach, the

tissue box or telephone, call light button in reach: so it was the placement of a personal item that

they were getting up for that led to them falling.

Interventions:

FOLLOW CARE DIRECTIVES

1. Appropriate activities through out day, allowing pt to walk as much as possible as part of their normal routine (to meals, to the toilet, to an activities), Standing during bingo, standing at table before meals, standing at rails in hallway

2. and 3. Quick Response time to call lights (less than 5 mins, ideally 1-2 minutes), knowing your residence typical bowel and bladder habits and taking them during the time they normally need to go, adhering to timed toileting programs, noticing pre-toileting behaviors such as fidgeting, restlessness. Maintaining ROM programs. Timely pain medication management.

4. a) Adequate lighting and access to overhead light if they are able to use. (http://www.lrc.rpi.edu/programs/solidstate/cr_innovativeSolutions.asp)
   b) Correct height on bed = 90 degrees – never a low/high bed. Return bed height after changing linen.
   c) If you move anything in the room, return it to correct position (lock Wheelchairs, walkers close to/far from resident, return bed side commodes where they belong for that time of day)
   d) Appropriate use of bed transfer bars for mobility

Other Building Strategies:

Consistent Staffing so Nurses and CNA's know their residents

Spreading out Mon-Fri staff (Rehab, Office, Admin...)

Appropriate use of weighted dolls and blankets

Contrasting Toilet Seats (black with white floors), Bright bed comforters, Bright shoes on residence, brightly colored tubing on call lights, glasses and other personal items

Appropriate use of anti-roll back or automatically locking brakes on Wheelchairs