Appendix B18: Handout for Inservice #2, How to Reduce Falls in Nursing Facilities

The Falls Management Program Manual

Residents' Living Space and Personal Safety

  • Remove clutter. Keep a clear path 2 to 3 feet wide around the bed, from the bed to the hall, from the bed to the bathroom, and from the bed to the lounge chair.
  • Keep the bed wheels locked at all times. Report beds with broken wheel locks.
  • Remove lightweight furniture. Keep the overbed table across the bed when it is not in use.
  • Report loose handrails and toilet seats.
  • Report torn linoleum and loose carpet edges. Wipe up wet spots when you see them.
  • Report burned out light bulbs.
  • Keep the call light, water pitcher, glass, and any personal items within arm's length of the resident.
  • Use footwear which has tread on the bottom, a firm shape, and a low, even heel. Use gripper socks when the resident cannot wear safe shoes.
  • Give proper foot care.

Residents' Transfer and Mobility

  • Know which residents need assistance during transfer and walking. Give help when needed.
  • Watch all residents closely during the first 2 to 3 weeks after admission and after a health decline or acute illness. Increase assistance during these times.
  • For most residents, keep bed in the lowest position at all times. Use a raised toilet seat when ordered.
  • Dress the resident in easy-to-manage clothing such as those with elastic bands and Velcro fasteners.
  • Provide toileting, food, drink and activity based on the resident's individual schedule.
  • Check the resident often. Ask volunteers and family to help.

Equipment Use

  • Check the wheelchair brakes often. Report ones that do not hold the chair firmly in place.
  • Report all broken or lost parts of wheelchairs, walkers and canes.
  • Use all of the seating items which are ordered for the resident.
  • Report any resident who leans over, slides down, or leans to one side while seated in a wheelchair.
  • Do not share wheelchairs among residents.
  • Make sure all equipment is labeled with the resident's name.

Psychotropic Drugs

  • Know which residents take a benzodiazepine or an antipsychotic.
  • Watch residents who are on these drugs for side effects such as confusion, drowsiness, dizziness, changes in gait, loss of balance, and changes in mental status.
  • Use behavior management skills to lessen the need for these drugs.
Page last reviewed February 2010
Internet Citation: Appendix B18: Handout for Inservice #2, How to Reduce Falls in Nursing Facilities: The Falls Management Program Manual. February 2010. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/injuries/fallspx/fallspxmanapb18.html