The Falls Management Program: A Quality Improvement Initiative for Nursing Facilities
Appendix B18: Handout for Inservice #2, How to Reduce Falls in Nursing Facilities
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.
- 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.
- 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.