1 / 27

Falls Prevention

Falls Prevention. Shawna Cassidy, Physiotherapist Shoshana Berliner, Occupational Therapist North York General Hospital March 2006. Fall prevention. Definition of a fall:

jael
Download Presentation

Falls Prevention

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Falls Prevention Shawna Cassidy, Physiotherapist Shoshana Berliner, Occupational Therapist North York General Hospital March 2006

  2. Fall prevention • Definition of a fall: • A fall is considered “an event that results in a person coming to rest inadvertently on the ground or floor or other lower level.” (Registered Nurses Association of Ontario, 2002) • According to the Institute for Healthcare Improvements, a fall also includes “patients assisted to the floor”.

  3. Overview • Definition of a fall • Importance of fall prevention (incidence and outcomes) • Fall risk factors • Overview and goals of Falls Program • What is involved in the Falls Program • Assessment of falls • Falls interventions • Program Outcomes

  4. Incidence of falls • What? • Who? • When? • Where? • Why?

  5. Outcomes of falls • psychological effects (fear of falling) • decreased level of functioning and independence • injuries • mortality • delayed discharges

  6. Case Study

  7. poor lighting floor surfaces unsteady furniture telephone, call bells not in easy reach height of seating cluttered pathways ill-fitting clothing, diapers non-working hearing aids dirty or improper eyeglasses inappropriate footwear Risk factors: Environmental

  8. Risk factors: Physical • age • history of falls • illness • neurologic disease • mobility or balance impairment • postural hypotension • sensory impairments • incontinency • poor nutrition

  9. Risk Factors • Cognitive • Pharmacological (benzodiazepine/sedatives, polypharmacy >5 meds)

  10. Overview of Falls Prevention Program • Need for program • Patient safety • Multidisciplinary approach • Program will only work if everyone helps out!

  11. Goals of program • Identification of patients at risk to fall • Implementation of preventative measures to decrease falls • Examination of circumstances surrounding a fall • Educational program for staff • Increase in patient and family participation and awareness of falls and fall prevention • Monitoring of incidence, time and location of falls, severity of injury and overall effectiveness of the program

  12. Procedure • Flow chart

  13. Falls Screening • SPPICES

  14. Assessment • SPLATT (Falls History) S - symptoms at time of fall(s) P - previous number of falls or near falls L - location of fall(s) A - activity at time of fall(s) T - time of fall(s) and time on ground T - trauma or injury with fall(s) [physical, emotional]

  15. What happens after a fall • Incident Report

  16. Simplify tasks Avoid changes or make changes gradually Remove excessive stimulation Use clear, concise communication Provide consistency in staff and routine Provide orientation cues (calendars, clocks) Interventions: Cognition

  17. Interventions: Cognition • Increase light at twilight • Provide meaningful activity • Follow “Least Restraints Guidelines” • Encourage family members/friends/sitters to remain with patient

  18. Interventions: Physical Status • Place hearing/visual aids close by • Encourage toiletting routine (q2hrs) • Provide bedside commode • Ensure urinal is within reach • Reduce fluid intake after dinner • Ensure patient maintains adequate nutrition • Encourage patient to dangle before standing/walking • Encourage patient to perform ankle pumping in sitting position before walking • Encourage patient to sit down immediately if feeling dizzy

  19. Interventions: Mobility/Gait • Make sure patient uses proper gait aid • Place gait aids at side of bed (canes at bottom of bed) • Ensure gait aids are at appropriate height • Provide visual cues/signs to remind patient of safety techniques for transfers, ambulation

  20. Interventions: Mobility/Gait • Ensure patients wear shoes/non-skid socks at all times • Provide patient and/or family with Falls Prevention Pamphlet • ROM exercises, prevention of deconditioning • Review fall prevention techniques with patient and/or family

  21. Interventions: Environmental • Ensure height of bed/chair is at level where the patient’s feet touch the floor • Keep bottom bedrails down • Ensure easy access to call bell, radio/tv controls • Ensure improved lighting, minimize glare • Maintain straight paths to bathroom

  22. Interventions: Environmental • Use bedside commodes for patients who can transfer independently but are unsafe to ambulate independently to bathroom • Ensure clean, dry floors • Place higher risk patients in room near nurse's station • Place higher risk patients in bed by bathroom • Ensure brakes on equipment are operational

  23. Interventions: Environmental • Encourage use of appropriate footwear and properly fitting clothing • Place garbage under sink and no basins on bathroom floor • Remove equipment not in use • Place IV equipment at top of bed • Ensure nightlights are operational and in use • Push bed against wall; place mattress on floor, beside bed, if patient climbing out of bed

  24. Interventions: Meds • Review medication list for drugs which may predispose patient to falls • Decrease use of benzodiazepines • Diuretics given in the morning

  25. Community Resources • Day Hospital • Falls Programs • CCAC • Day Programs • Emergency Response Systems • MOW • Assistive Devices Program • Wheel Trans

  26. Outcomes of Program • Staff, patients, families educated on fall prevention • Increased awareness of need for teamwork to keep patients safe • Decrease number of falls and injuries secondary to falls

More Related