WHAT IS A FALL “A fall is an uncontrolled and undirected occurrence in which the patient comes to rest on the floor”
FALLS FACTS Those in residential care are at twice the risk of those living in their own home.
Most common location of falls is in the resident’s bedroom, bathroom and passageways
The majority of falls are the result of stumbling, tripping or slipping.
CONSEQUENCES OF FALLS Injuries – skin tears, fractures of hip, skull, etc Increased morbidity due to complications. Cost of falls – emotional, physical and financial loss of independence – restrict activity and social isolation
FALLS PREVENTION PROGRAMS Proactively raise awareness of risk factors and preventing falls Work as a team to prevent falls Take part in audits to identify risks Reduce/remove hazards Report and document hazards you cannot correct
EXTRINSIC RISK FACTORS Improper footwear Unstable objects Loose or frayed rugs Poor, glary or inconsistent lighting Cluttered environment Wet slippery floors Uneven floors And many more
Hearing impairment Hypotension Peripheral neuropathies Lower extremities weakness from degenerative diseases Poor balance Cardiac arrhythmias Trans ischaemic attacks Urinary frequency and urgency Medications – sedatives antipsychotics
INDICATORS OF RISK OF FALLING Loose shoes Loose clothing Person is lost or confused Person looks tired Person is clutching on to things for support Person is short of breath And many more
SAFE FOOTWEAR Should be firm and well fitting but not too tight Should be lace up, buckled or velcro Should be flat and broad based Soles should be flexible and not too thick. (thick soles make it difficult to detect changes in the ground)
SAFE FOOTWEAR CONT. Have non slip soles with a grip pattern. But soles with grip can be a problem fro residents with Parkinson’s who tend to shuffle Shoes should be maintained Shoes should be cleaned regularly eg. They can get a build up of oil, grit or grass.
FALLS PREVENTION STRATEGIES Fully orientate resident to new surroundings Monitor residents overall condition in first two weeks as this is the most vulnerable time Ensure resident knows how to use call bell Have call bell accessible to resident Answer call bell promptly
Place walking sticks or frames in an easily accessible place Ensure resident has safe clothing and footwear Has appropriate aids and uses them properly Teach resident and visitors basic rules for safety Bed at its lowest height and brakes applied Encourage resident to walk frequently to maintain muscle strength and improve balance.
COPMPLETE FOOTWEAR AUDIT by looking at the shoes provided and evaluating there appropriateness