Fall Prevention and Safety

Fall Prevention and Safety Emily Fontaine, SPT

Overview • The importance of fall prevention • Assessing the risk of a patient • Fall Precautions • Safety with transfers • Patient education

Why Fall prevention? • Falls are the leading cause of injury death in people 65 and older • Falls make up the largest category of reported incidents in hospitals • Patients who fall often sustain injuries that lead to hospitalizations

An activity • An activity before we begin: • Get a pair of glasses • Walk around with the glasses on • Trying going upstairs

Activities Cont. Think about our patients who have physical weaknesses and balance problems on top of their bad eye sight. • It is incredibly easy to fall! • Their safety is extremely important

How to assess a patient’s risk • Morse Fall Scale (MFS) is used with all patients to assess fall risk • Nurses will perform this test, but the entire medical team will utilize it

MORSe Fall Scale (MFS) United States Department of Veteran Affairs

Do the math! • You are asked to complete the MFS for a new patient, Ted. Ted fell a week ago while in acute care at MGH. He uses a rolling walker because his strength is weak and is a moderate assist for walking. He doesn’t need an IV pole and has normal mental status what would his MFS number be? 50

Risk level with morse scale • No risk: 0 – 24 points • Low risk: 25-50 points • High risk: 51 points or greater • Ted will be a low risk, but very close to high. This is a patient that will need to be monitored very closely during transfers and gait.

fall prevention Status • Low Fall Risk: 25-50 on MFS • Assess the patient’s coordination and balance before transferring or mobilizing the patient • High Fall Risk: 50 or more on MFS • This will be made clear in the patient chart • Use bed alarms, bed rails, and a sitter if necessary so patient does not get out of bed without assistance • Make sure medications to decrease fall risks are taken on schedule

Transferring • Know the patient’s transfer status (independent, minimal assist etc.) and fall risk • While transferring • Make sure the bed is lowered and locked • Move any possible obstacles that are on the floor • Have the patient wear shoes or treaded socks • Block the patient’s knees if necessary • Transfer patients towards their strong side • Don’t allow patients to lean on moveable equipment • We will now demonstrate two transfers

Ambulation • Know the risk of thepatient • Use gait belts and assistive devices when necessary • Use the Berg Balance Scale • Assesses independence • See Physical Therapy Floor Manager for more details • We will now demonstrate how to utilize the gait belt Berg Balance Test

Patient education • Do: • Wear appropriate footwear • Arrange furniture so you can walk easily • Install railings on the stairs and nonslip mat in shower • Use a night light • Don’t: • Walk and talk at the same time • Attempt a task that’s too difficult that will cause you to get tired while doing it • Walk in the dark

Questions?

Works cited • Care Company Website. http://dev.thecarecompany.biz/. Accessed October 20, 2012. • “Fall Prevention.” In Total Home Health. Accessed October 8, 2012, from http://www.totalhomehealthinc.com/fall-prevention.htm. • “Fall Prevention in Hospitals.” Premier. Retrieved October 8, 2012, from https://www.premierinc.com/safety/topics/falls. • Pelczarski and Wallace. (October 15, 2009). “Hospitals Collaborate to Prevent Falls.” In Patient Safety and Quality Healthcare (PSQH). Accessed October 8, 2012, from http://www.psqh.com/novemberdecember-2008/91-november-december-2008/277-hospitals-collaborate-to-prevent-falls.html. • “VA National Center for Patient Safety.” United States Department of Veterans Affairs. Accessed October 8, 2012, from http://www.patientsafety.gov/CogAids/FallPrevention/index.html#page=page-1

Fall Prevention and Safety