December 15, 2014
1) Train staff on incidence and causes of falls:
- 1/3 of all elderly will fall each year for no apparent reason.
- Approximately 25% of those who fall will have a moderate to severe injury, i.e. fracture of one or more bones or head trauma.
- Falls are the leading cause of injury and death in the elderly.
- If a resident has a history of falls they are 2 -3 times more likely to fall again. Communication to staff is imperative for the resident’s safety.
- Each shift staff should critically survey resident spaces for hazards and correct or change areas for safety of the resident.
- Staff must know how a resident should safely use a cane or walker and assist the resident as needed.
- If special shoes or hip protectors are ordered and obtained make sure all staff use them every shift.
- Encourage exercising and walking to strengthen muscles.
2) Train staff on what to do if a fall occurs:
- Observe area surrounding the resident to see if reason for fall is evident, i.e. is hassock tipped over sideways or is lap robe under feet, etc.
- Do not move resident until evaluated by a health professional or trained personnel
- If obvious injury has occurred or if a resident is on an anticoagulant and has hit head, cover resident with blanket, staunch any bleeding and call 911 to transport to the emergency room. DO NOT move the resident off the floor and into a bed or chair as you can cause further injury to the resident or even to the staff.
- If there is no apparent injury, resident does not display signs or symptoms of pain and is alert and oriented or has no change in level of consciousness, take vital signs and then get resident up to sit in chair. Be aware that the resident may be dizzy from change in position from floor to standing or sitting so stay with the resident until you are sure of their steadiness.
- Fill out incident report completely right after the fall so details are not forgotten.
- Be cognizant that a subdural hematoma ( a bleed in the brain) can develop slowly, and if a resident develops a prolonged headache that can worsen with time, confusion, change in speech, sudden change in size of one pupil compared to the other, have the resident immediately return to the emergency room for evaluation.
- Communicate with the family and physician after every fall.