Improving Patient Safety in Long-Term Care Facilities
Appendix 3-A. Suggested Slides for Module 3
Participants will understand:
- Why falls are an important safety issue.
- The risk factors for falls.
- Which residents are at high risk of falling.
- How falls can be prevented.
- How nursing assistants and licensed nurses can work together to prevent falls.
Participants will be able to:
- Describe nursing interventions to prevent falls, including:
- Interventions that may be initiated by nursing assistants.
- Interventions that may be initiated by licensed nurses.
- Use particular interventions for particular risk factors.
- Work as members of a nursing team to:
- Choose one or more interventions for a particular case.
- Assess whether an intervention is effective.
Case Study: Mr. P
- What are his risk factors for falling?
- How might you, as his nursing assistant, help protect him from having an injurious fall during the night?
Facts About Falls
- One of the biggest safety challenges is preventing falls.
- Three of every four nursing center residents fall each year.
- Most nursing centers have more than 100 falls per year.
- There are many interventions that providers can use to reduce the number of falls.
- Nursing staff must have the knowledge and skills to prevent injury from falls.
A Safe and Enjoyable Environment Requires:
- Sharing and teamwork.
- Reporting and supporting by:
- Learning through talking with team members.
- Avoiding blame.
- Fixing "accidents waiting to happen."
- Expecting teamwork.
Is it a fall?
A fall is an unintentional change in position, coming to rest on the ground or the next lower surface that does not result from:
- Being pushed down.
- Collapsing from a sudden medical condition.
Resident Risk Factors for Falls
- Previous falls.
- Diminished strength.
- Gait and balance impairments.
- Alzheimer's disease or dementia.
- Vision impairment.
Environmental Risk Factors for Falls
- Design problems.
- Lack of Space.
- Equipment misuse or malfunction.
- Staffing and organization of care.
HEAR ME Tips to Help Prevent Falls
Hazards—Notice and eliminate hazards in the environment.
Educate—Educate residents about safety.
Anticipate—Anticipate the needs of residents.
Round—Round frequently to learn residents' needs.
Materials—Ensure materials and equipment are in working order
Exercises—Assist residents with exercise and ambulation.
Responding to a Fall or Near Fall
- Observe and evaluate.
- Investigate and document.
- Implement an individualized care plan.
- Develop a falls management program.
Examples of Fall Prevention Interventions
To prevent falls, you should address:
- Things about the environment (e.g., rearrange the resident's furniture).
- Things about the resident (e.g., review medications).
- Things about the equipment or care plan (e.g., monitor blood pressure frequently).
- Things about the nursing center (e.g., provide education on falls prevention).
Things to Remember
- Not every fall is just a fall.
- There are many risk factors for falls.
- Using the HEAR ME tips can help reduce falls.
- Appropriate interventions can minimize future falls.
- Awareness is a watchword in falls prevention.
- Teamwork is necessary to prevent falls.
- Fall prevention requires active engagement.
- You must go beyond an incident report to develop a revised care plan.
- Forgetting to do a falls assessment for a resident.
- Failing to make a new falls assessment and care plan for a resident who has fallen.