Table 1 Components of the interdisciplinary falls prevention program
Referring discipline | |
|---|---|
Screening of all patients at admission for risk of falls: | Primary nurse |
- History of falls (i.e. 2 or more falls in the last 6 months) | |
- Impaired mobility (e.g., unsteady, weak gait) | |
- Impaired cognition (e.g., confused, forgetful) | |
Examination of patients considered at risk for falling: | Physician |
- Note circumstances and consequences of earlier falls | |
- Examine patients for acute or chronic medical condition(s) | |
- Review medications | |
- Assess gait, balance, vision, neurological function, and mental status | |
Interventions for all patients to provide safety in the hospital: | Primary nurse |
- Orient patients to surroundings/"set up" of room | Nursing staff |
- Place call bell and personal belongings within reach | |
- Keep bed in low position | |
- Ensure safe footwear and adequate fit of clothing | |
- Provide nightlight at bedside | |
- Ensure walking aids (devices) are fitted and used appropriately | |
- Lock wheels on wheelchairs, beds, night commodes | |
Interventions in patients considered at risk for falling: | Physician |
- Modification of medication | Primary nurse |
- Instruction of patients (family) about risk factors | Nursing staff |
- Post fall risk sign in patient's record | Physiotherapy staff |
- Assist unsteady patient with ambulating | |
- Toilet patient regularly | |
- Use half-length side rails instead of full length side rails | |
- Exercise program, gait/balance training | |
- Provision of hip-protectors | |
Reassessment of those patients who fell: | Physician |
- Evaluation of circumstances and consequences of the fall | Primary nurse |
- Reassessment of patient risk factors for falls | |
- Continuing or implementation of preventive interventions |