E M I LY F O N TA I N E , S P T

FALL PREVENTION AND SAFETY

OVERVIEW

• The importance of fall prevention• Assessing the risk of a patient• Fall Precautions• Safety with transfers• Patient education

WHY FALL PREVENTION?

• Falls are the leading cause of injury death in people 65 and older• Falls make up the largest category of reported

incidents in hospitals• Patients who fall often sustain injuries that lead to

hospitalizations

AN ACTIVITY

• An activity before we begin:• Get a pair of glasses• Walk around with the glasses on• Trying going upstairs

ACTIVITIES CONT.

Think about our patients who have physical weaknesses and balance problems on top of their bad eye sight.• It is incredibly easy to fall!• Their safety is extremely important

HOW TO ASSESS A PATIENT’S RISK

• Morse Fall Scale (MFS) is used with all patients to assess fall risk• Nurses will perform this test, but the entire

medical team will utilize it

MORSE FALL SCALE (MFS)

United States Department of Veteran Affairs

DO THE MATH!

• You are asked to complete the MFS for a new patient, Ted. Ted fell a week ago while in acute care at MGH. He uses a rolling walker because his strength is weak and is a moderate assist for walking. He doesn’t need an IV pole and has normal mental status what would his MFS number be?

50

RISK LEVEL WITH MORSE SCALE

• No risk: 0 – 24 points• Low risk: 25-50 points• High risk: 51 points or greater

• Ted will be a low risk, but very close to high. This is a patient that will need to be monitored very closely during transfers and gait.

FALL PREVENTION STATUS

• Low Fall Risk: 25-50 on MFS• Assess the patient’s coordination and balance before

transferring or mobilizing the patient

• High Fall Risk: 50 or more on MFS• This will be made clear in the patient chart• Use bed alarms, bed rails, and a sitter if necessary so

patient does not get out of bed without assistance• Make sure medications to decrease fall risks are taken on

schedule

TRANSFERRING

• Know the patient’s transfer status (independent, minimal assist etc.) and fall risk• While transferring• Make sure the bed is lowered and locked• Move any possible obstacles that are on the floor• Have the patient wear shoes or treaded socks• Block the patient’s knees if necessary• Transfer patients towards their strong side• Don’t allow patients to lean on moveable equipment

• We will now demonstrate two transfers

AMBULATION

• Know the risk of the patient• Use gait belts and assistive

devices when necessary• Use the Berg Balance Scale• Assesses independence • See Physical Therapy Floor

Manager for more details

• We will now demonstrate how to utilize the gait belt

Berg Balance Test

PATIENT EDUCATION

• Do:• Wear appropriate

footwear• Arrange furniture so

you can walk easily• Install railings on the

stairs and nonslip mat in shower• Use a night light

• Don’t:• Walk and talk at the

same time• Attempt a task

that’s too difficult that will cause you to get tired while doing it• Walk in the dark

QUESTIONS?

WORKS CITED

1. Care Company Website. http://dev.thecarecompany.biz/. Accessed October 20, 2012.

2. “Fall Prevention.” In Total Home Health. Accessed October 8, 2012, from http://www.totalhomehealthinc.com/fall-prevention.htm.

3. “Fall Prevention in Hospitals.” Premier. Retrieved October 8, 2012, from https://www.premierinc.com/safety/topics/falls.

4. Pelczarski and Wallace. (October 15, 2009). “Hospitals Collaborate to Prevent Falls.” In Patient Safety and Quality Healthcare (PSQH). Accessed October 8, 2012, from http://www.psqh.com/novemberdecember-2008/91-november-december-2008/277-hospitals-collaborate-to-prevent-falls.html.

5. “VA National Center for Patient Safety.” United States Department of Veterans Affairs. Accessed October 8, 2012, from http://www.patientsafety.gov/CogAids/FallPrevention/index.html#page=page-1