Fall Prevention

Goal: The patient does not experience a fall and remains free of injury.

1. Perform hand hygiene and put on PPE, if indicated.

2. Identify the patient.

3. Explain the rationale for fall prevention interventions to the patient and family/significant others.

4. Include the patient’s family and/or significant others in the plan of care.

5. Provide adequate lighting. Use a night light during sleeping hours.

6. Remove excess equipment, supplies, furniture, and other objects from rooms and walkways. Pay particular attention to high traffic areas and the route to the bathroom.

7. Orient patient and significant others to new surroundings, including use of the telephone, call signal, patient bed, and room illumination. Indicate the location of the patient bathroom.

8. Provide a ‘low bed’ to replace regular hospital bed.

9. Use floor mats if patient is at risk for serious injury.

10. Provide nonskid footwear and/or walking shoes.

11. Institute a toileting regimen and/or continence program, if appropriate.

12. Provide a bedside commode and/or urinal/bedpan, if appropriate. Ensure that it is near the bed at all times.

13. Ensure that the call bell, bedside table, telephone, and other personal items are within the patient’s reach at all times.

14. Confer with primary care provider regarding appropriate exercise and physical therapy.

15. Confer with primary care provider regarding appropriate mobility aids, such as a cane or walker.

16. Confer with primary care provider regarding the use of bone-strengthening medications, such as calcium, vitamin D, and drugs to prevent/treat osteoporosis.

17. Encourage the patient to rise or change position slowly and sit for several minutes before standing.

18. Evaluate the appropriateness of elastic stockings for lower extremities.

19. Review medications for potential hazards.

20. Keep the bed in the lowest position during use. If elevated to provide care (to reduce caregiver strain), ensure that it is lowered when care is completed.

21. Make sure locks on the bed or wheelchair are secured at all times.

22. Use bed rails according to facility policy, when appropriate.

23. Anticipate patient needs and provide assistance with activities instead of waiting for the patient to ask.

24. Consider the use of an electronic personal alarm or pressure sensor alarm for the bed or chair.

25. Discuss the possibility of appropriate family member(s) staying with patient.

26. Consider the use of patient attendant or sitter.

27. Increase the frequency of patient observation and surveillance; 1- or 2-hour nursing rounds, including pain assessment, toileting assistance, patient comfort, personal items in reach, and patient needs.

28. Remove PPE, if used. Perform hand hygiene.