1. Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 11 Preventing Falls

2. Slide 2 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  Falls are the most common accidents in nursing centers.  The risk of falling increases with age.  A history of falls increases the risk of falling again.

3. Slide 3 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. CAUSES AND RISK FACTORS FOR FALLS  Most falls occur in resident rooms and bathrooms.  Falls are most likely to occur: Between 1800 (6:00 PM) and 2100 (9:00 PM) Between 1800 (6:00 PM) and 2100 (9:00 PM) During shift changes During shift changes

4. Slide 4 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. FALL PREVENTION PROGRAMS  Nursing centers have fall prevention programs.  Common sense and simple measures can prevent many falls.  The goal is to prevent falls without decreasing the person’s quality of life.

7. Slide 7 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. Bed Rails  The nurse and care plan tell you when to raise bed rails.  If a person needs bed rails, keep them up at all times except when giving bedside nursing care.  Bed rails present hazards.  Entrapment is a risk.  Bed rails are considered restraints by OBRA and the Centers for Medicare & Medicaid Services (CMS).  Accrediting agency standards and state laws affect bed rail use.

9. Slide 9 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  If a person uses bed rails:  Check the person often.  Report to the nurse that you checked the person.  If you are allowed to chart, record when you checked the person and your observations.

10. Slide 10 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  Hand rails are in hallways and stairways.  Grab bars are in bathrooms and in shower/tub rooms.  Bed wheels are locked:  At all times except when moving the bed  When giving bedside care  When you transfer a person to and from the bed  Wheelchair and stretcher wheels are locked during transfers.

14. Slide 14 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. TRANSFER/GAIT BELTS  A transfer belt (gait belt) is a device used to support a person who is unsteady or disabled.  It helps prevent falls and other injuries.  The belt goes around the person’s waist.  Grasp under the belt to support the person during the transfer or when assisting the person to walk.

17. Slide 17 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. THE FALLING PERSON  Falling may be caused by: Weakness, lightheadedness, or dizziness Weakness, lightheadedness, or dizziness Fainting Fainting Slipping or sliding on spills, waxed floors, throw rugs, or improper shoes Slipping or sliding on spills, waxed floors, throw rugs, or improper shoes  Do not try to prevent the fall.  If a person starts to fall, ease him or her to the floor.  Do not let the person move or get up before the nurse checks for injuries. An incident report is completed after all falls. An incident report is completed after all falls.

18. Slide 18 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc.  A confused person may not understand why you do not want him or her to move or get up after a fall.  You may need to let the person move for his or her safety or your own.  Never use force to hold a person down.  Stay calm and call for help.

23. Slide 23 Copyright © 2007, 2003 by Mosby, Inc., an affiliate of Elsevier Inc. QUALITY OF LIFE  A fall can seriously affect a person’s quality of life.  You must help prevent falls.  You must not interfere with the person’s rights.