Risk Factors
True or False: a client who has previously fallen before may experience a higher risk of falling again.
TRUE
True or False: a resident/patient, Power of Attorney, or their Substitute Decision Maker should not be involved in their individualized care plan
FALSE
True or False: The Apotex and Hospital Falls Prevention Policy are the same and can be used interchangeably
FALSE
True or False: near-miss and unwitnessed falls require SERS reports, even when there is no injury
TRUE
List 3 different environmental/situational fall risk factors:
1) Poor lighting, 2) uneven surfaces, 3) slippery floors, 4) inappropriate footwear or clothing, 5) improperly maintained or used assistive devices, 6) low toilet seat, 7) no grab bar, 8) prolonged hospital stay, 9) unsafe transferring, 10) restraints
What is a device that helps a patient or resident ask for assistance before getting up?
Staff can look at a patient or resident's specific fall risks and their support needs in their individualized:
Care Plan
A patient or resident has been falling for the same reason within a month. What may need to be done?
Reassessing the resident and revising their individualized falls prevention interventions
What are three side effects of medications that might increase a person's fall risk?
1) Dizziness or Faintness, 2) Drowsiness, 3) Confusion, 4) Sudden Blood Pressure Changes, 5) Blurred Vision, 6) Difficulty with Balance
Name 3 potential assistive devices or equipment that a patient or resident might need
Mobility aids and walking supports (walkers, canes), fall detection devices or monitoring technology (fall alerts, bed/chair alarms), fall prevention clothing (hip protectors, grip socks), bathroom safety equipment (grab bars, shower chairs, raised toilet seats)
Define fall, assisted fall, and unwitnessed fall
Fall - any unintentional change in position where the client ends up on the floor, group, or other level
Assisted fall - any unintentional change in position where the client ends up on the floor, group, or other lower level as assisted by another person
Unwitnessed fall - occurs when the fall is not observed by another person and the client is found on the floor, ground, or other lower level
When you are in a common area or in a non in-patient/resident care area and you see a fall, what are the first few steps you should take?
1) Do NOT move the person, 2) Stay with the person, 3) Call ext. 5555 for a medical alert
What are three different positions that can be used to take orthostatic blood pressure for a client?
1) After lying down for 5 minutes, 2) After sitting for two minutes, 3) After standing after 2 minutes
What is a medication review?
This review can identify medications contributing to dizziness, sedation, or falls
An interdisciplinary/interprofessional team approach to fall prevention and management can include... name at least 4 potential professions that could be part of this team.
1) Pharmacist, 2) Occupational Therapist, 3) Physiotherapist, 4) Recreational Therapist, 5) Doctor, 6) Registered Nursing Staff, 7) Dietician, 8) Personal Support Worker
What are the rehab-related professionals who would be involved with supporting changes in mobility?
Physiotherapy or Occupational Therapy
History of fall(s), nutritional deficiencies, incontinence, sudden changes in blood pressure and impaired vision are WHAT kind of fall risk factor?
Intrinsic/biological risk factors
Name at least 4 environmental prevention strategies that clinical staff should consider for a patient or resident.
Functional Status and Footwear; Ambulation and Assistive Devices, Lighting, Layout, & Environment, Low Bed, Locked Brakes, & Alarms; Sensory, Cognition, & Communication; Alerting Mechanisms & Education; Fluids, Elimination, & Medical Factors
A patient or resident at Baycrest must have a Falls Risk Assessment completed based on certain conditions:
Hospital: 1) within 24 hours of admission or 2) 24 hours post-transfer to another unit, 3) after a fall, 4) every 3 months or sooner if clinically necessary
Apotex: 1) within 24 hours of admission or re-admission from Hospital, 2) as triggered by the MDS Resident Assessment Protocol, 3) a significant change in status
After a fall, these are some of the things that staff responsible for providing care for a patient or resident should do - name 3.
1) look for contributing factors, 2) make sure that the care plan is updated and review any changes, 3) routinely monitor the resident and report any changes to the relevant staff, 4) ensure that appropriate referrals are made, 5) have a designate inform family/POA/SDM, 6) notify the physician or Most Responsible Practitioner, 7) make a report on SERS and Meditech