Falls Risk Preventions The Concept of Safety: Falls Risk Preventions Raven Wright, Casey Niles, Jerrica Cashaw, Qunisha Crawford, Marisela Lopez, Echo Borges, Katie Kirchner

Risks Key risk factors common to assessments include: History of falls: All patients with a recent history of falls, such as a fall in the past 3 months, should be considered at higher risk for future falls. Mobility problems and use of assistive devices: Patients who have problems with their gait or require an assistive device (such as a cane or a walker) for mobility are more likely to fall. Medications: Patients on a large number of prescription medications, or patients taking medicines that could cause sedation, confusion, impaired balance, or orthostatic blood pressure changes are at higher risk for falls. Mental status: Patients with delirium, dementia, or psychosis may be agitated and confused, putting them at risk for falls. Continence: Patients who have urinary frequency or who have frequent toileting needs are at higher fall risk. Other patient risks include being tethered to equipment, such as an IV pole, that could cause the patient to trip; impairment in vision that could cause a patient not to see an environmental hazard; and orthostatic hypotension, which could cause the patient to become lightheaded or pass out when standing.

Risk Other factors that can lead to falls at home include loose rugs clutter on the floor or stairs carrying heavy or bulky things up or down stairs not having stair railings not having grab bars in the bathroom Simple changes can help make your home safer. The section called Fall Proofing Your Home offers some tips for preventing falls at home.

Assessment Tools For Homecare Professionals Fall Prevention Medication Review Checklist - This simple checklist helps homecare professionals identify and eliminate medication side effects and interactions that increase the risk of falls. It provides space to note recommendations made or actions taken Falls and Vision Loss Fact Sheet - This fact sheet for clinicians describes age-related vision diseases and how they hinder older patients' ability to safely negotiate their environment. It was developed for the Fall Prevention Center of Excellence. The GEM Environmental Assessment - This comprehensive assessment tool helps identify safety problems in each room of a patient's home and possible modifications. (Developed by staff in the Division of Geriatrics and Gerontology at the Weill Medical College of Cornell University for Project GEM - Gerontologic Environmental Modifications.) Orthostatic Hypotension Protocol - This brief protocol is helpful for educating clinicians about orthostatic hypotension (OH). It includes a table of commonly used groups of drugs that can cause or exacerbate this problem in older patients.

Interventions What are universal fall precautions? Familiarize the patient with the environment. Have the patient demonstrate call light use. Maintain call light within reach. Keep the patient's personal possessions within patient safe reach. Have sturdy handrails in patient bathrooms, room, and hallway. Place the hospital bed in low position when a patient is resting in bed; raise bed to a comfortable height when the patient is transferring out of bed. Keep hospital bed brakes locked. Keep wheelchair wheel locks in "locked" position when stationary. Keep nonslip, comfortable, well-fitting footwear on the patient. Use night lights or supplemental lighting. Keep floor surfaces clean and dry. Clean up all spills promptly. Keep patient care areas uncluttered. Follow safe patient handling practices.

References http://qsen.org/wp-content/uploads/formidable/132.-Final-Presentation-Example.pdf http://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/fallpxtk3.html http://nihseniorhealth.gov/falls/causesandriskfactors/01.html  http://www.champ-program.org/page/99/falls-prevention-toolkit