Fall Prevention in the Bathroom
What is the most common reason patients fall in the bathroom?
Slippery Floors
Poor Lighting
Attempting to get up without assistance
Loose Rugs
3
Attempting to get up without assistance
Which of the following is NOT an effective way to redirect a patient trying to get out of bed?
Offer a distraction like a TV show or conversation
Firmly tell them “You cannot get up” without further explanation
Ask if they need to use the bathroom or if they’re uncomfortable
Reposition them and check if they are in pain
2
Firmly tell them “You cannot get up” without further explanation
If you experience a problem with a patient or have any questions about their plan of care, who is the FIRST person you contact?
PRIMARY RN
Situation: Mr. Thompson, a 78-year-old patient with mild dementia, is restless in bed and keeps trying to get up. He insists he needs to go home immediately.
Question: How would you redirect Mr. Thompson while keeping him safe?
Acknowledge his feelings: “I understand you want to go home. For now, we are going to wait for your doctor to get here and we can go from there”
Offer comfort and distraction: “Let’s get you comfortable, and I'll check with the nurse about your discharge plan.”
Ensure his needs are met: Ask if he needs the bathroom, is in pain, or is uncomfortable.
Situation: Mr. Anderson, a 75-year-old with recent surgery, insists he doesn’t need a walker and tries to get up without it, even though he has poor balance.
Question: What’s the best way to convince him to use the walker?
Appeal to his safety: “Using the walker will keep you strong enough to go home sooner.”
Make it positive: “You’re doing great - let’s keep you steady so you stay independent.
Demonstrate proper use: Show how the walker helps and encourage him to try it
What is the best way to prevent a patient from falling when using the toilet?
Leave the patient alone for privacy
Stay with the patient/ keep visualization of the patient at all times
Allow the patient to hold onto the sink for support
Only check on the patient after they call for help
2
Stay with the patient/ keep visualization of the patient at all times
TRUE OR FALSE
Using a calm, reassuring voice can help prevent a patient from becoming agitated when redirecting them from getting out of bed
TRUE
Using a calm, reassuring voice can help prevent a patient from becoming agitated when redirecting them from getting out of bed
If you have concerns, experience a problem with a patient or have questions about the patient’s plan of care, but you cannot get into contact with the Primary RN, who would be your SECOND point of contact?
UNIT CHARGE RN
Situation: Ms. Patel, a 65-year-old post-op hip replacement patient, is urgently trying to get out of bed to use the bathroom without calling for help. She refuses to wait for staff assistance.
Question: What should you do to prevent a fall while addressing her urgency?
Stay calm and reassure: Ms. Patel, I see you need the bathroom. Let me help you safely”
Offer alternatives: A bedside commode or urinal if she cannot wait
Ensure assistance: Call for help if needed to provide proper support.
Situation: Ms. Torres, an 80-year-old with mild cognitive impairment, keeps getting out of bed without asking for assistance, even though she has been reminded multiple times.
Question: What strategies can help her remember to call for assistance.
Verbal reinforcement: Frequently remind her, “I'm here to help you- just let me know what you need help with!”
Offer toileting or repositioning frequently.
Which of the following should be done before assisting a patient to the bathroom?
Check for clutter and ensure proper lighting
Encourage the patient to go quickly to avoid accidents
Give the patient a walker and let them go alone
Only assist if the patient asks for help
1
Check for clutter and ensure proper lighting
What is one effective strategy to keep a restless patient in bed?
Ignore them until they calm down
Offer a warm blanket, comfort measures, or engagement activities
Restrain them so they cannot get up
Raise all four bed rails
2
Offer a warm blanket, comfort measures, or engagement activities
If you previously spoke to the PRIMARY RN and UNIT CHARGE RN, and have still not received a meal break, who would you contact next, based on Chain of Command?
Unit Manager/ANM
or
Your Manager/ANM
or
Nursing Supervisor
Situation: At 3AM, Mr. Johnson, a 82-year-old patient with delirium, is found standing next to his bed, attempting to leave the room. When asked where he is going, he insists he has to “go to work.”
Question: How do you redirect him and prevent a fall?
Use a calm approach: “Mr. Johnson, I see you’re up. Can you tell me about your job.”
Validate his feelings and offer reassurance: “It sound like work is important to you. Let’s sit back down and talk about it for a minute.”
Redirect: Guide him back to bed while offering a distraction (e.g., warm blanket, meal, conversation)
Situation: A patient’s family member insists their loved one “has always been independent” and encourages them to walk unassisted, despite staff warnings.
Question: How do you handle this situation professionally?
Educate the family: “We want to keep your loved one safe and prevent a fall. Even though they were independent before, they need extra support right now.”
Offer alternatives: You can help by encouraging them to call for assistance instead of getting up alone.
Show evidence: Explain fall risks based on their condition.
TRUE OR FALSE
Patients who are confused or have cognitive impairment should always be supervised while using the bathroom.
TRUE
Patients who are confused or have cognitive impairment should always be supervised while using the bathroom
Which phrase is the best way to redirect a patient who is trying to get out of bed?
“STOP!” You are not allowed to get up!”
“Why are you trying to get up? You know you can’t do that.”
“I see you’re trying to get up. How can I help you?”
“You’ll hurt yourself if you don’t listen to me!”
3
“I see you’re trying to get up. How can I help you?”
What is ONE way to get in touch with the patient’s PRIMARY RN?
Press Call Bell
or
Yell Out (EMERGENCY)
Situation: Ms. Rivera, a 72-year-old with Parkinson’s, insists she can walk to the bathroom alone, even though she has had multiple near falls. She refuses to use the call bell or wait for help
Question: How do you encourage her to wait for assistance without making her feel powerless?
Use encouragement: “Ms. Rivera, I love that you want to stay independent! Let’s work together to make sure you stay safe.”
Offer a plan: “If you allow me to help you, I can make sure you don’t fall and that will keep you strong!”
Set reminders: Offer frequent bathroom trips to prevent urgency.
Situation: Mrs. Green, a 70-year-old patient, has recently received sedation for a procedure. She is still groggy and is attempting to get out of bed, unaware of her surroundings.
Question: How would you handle this situation to prevent her from falling?
Reassure her: “Mrs. Green, you’re in the hospital, and I’m here to help you.”
Keep her in bed: Gently guide her back to a comfortable position, ensuring her safety.
Monitor her closely: Stay near her to ensure she doesn’t try to get up again, and offer assistance as needed.
Use assistive devices: Make sure the bed alarm is on to alert staff and get quick assistance if she tries to get up.
What is the best way to prevent a patient from getting up to use the bathroom on their own?
Ensure they use the bathroom regularly before they feel urgency
Lock their bed rails up so they can’t leave
Tell them to call only if it’s an emergency
Move the call bell out of their reach
1
Ensure they use the bathroom regularly before they feel urgency
If a confused patient insists on getting out of bed, what should you do FIRST?
Physically block them from moving
Offer to help them get comfortable or go to the bathroom
Call Security
Tell them they are not allowed to move
2
Offer to help them get comfortable or to go to the bathroom
What is ONE of the FOUR Spectra Link numbers used by our nursing supervisor team?
71977
71978
71979
76743
Situation: Mr. Lee, a 68-year-old recovering from a stroke, repeatedly tries to get up without assistance despite being a high fall risk. He becomes irritated when staff try to stop him.
Question: What can you do to prevent falls without escalating his frustration?
Acknowledge his frustration: “I know it must be frustrating to have to wait for help.”
Explain safety: “I’m here to keep you safe. Let me help you so you don’t risk another injury.
Offer alternative engagement: Provide a TV show, music, or a task to keep him occupied.
Situation: Mr. Harris, an 80-year-old patient who has a history of falls, has been encouraged to let you know when he needs assistance. He frequently tries to get out of bed without your assistance stating he can manage on his own.
Question: What approach can you take to ensure he stays safe and remembers to call for assistance?
Positive reinforcement: “Mr. Harris, you’re doing so well. Please let me know when you want to get out of bed so I can help you.”
Offer regular check-ins: Remind him that you’re available to help him, even if he hasn’t asked for help.
Encourage scheduled bathroom breaks.