RISKS &
HAZARDS
HAZARDS
Wet floors, poor lighting, incorrect bed heights, and poorly fitted wheelchairs are examples of this type of hazard that puts residents at greater risk for falls.
ENVIRONMENTAL HAZARDS
T/F: most falls in nursing homes are preventable.
These 2 things should be utilized during all transfers or ambulation.
GAIT BELT AND THE APPROPRIATE ASSISTIVE DEVICE AND SUPPORT.
This is the direction from which you should approach a resident with dementia.
THE FRONT
This can be more frequently utilized to prevent social isolation and to get residents out of their rooms to reduce falls.
SCHEDULED ACTIVITIES, DAY ROOMS, BINS WITH VARIOUS TABLETOP ACTIVIITES LOCATED ON ROLLING CARTS AT EACH STATION
Sedatives, narcotics and anti-psychotics, and their associated side effects, are all examples of this fall risk factor.
MEDICATIONS/POLYPHARMACY
“A sudden change in gait, new confusion, or acute dizziness may indicate this underlying medical issue that increases fall risk.”
“What is an acute medical condition (e.g., UTI, dehydration, orthostatic hypotension)?”
This is expected and standard practice that should be provided every 2 hours, at minimum.
ROUNDING, WHEN YOU OFFERING TO TOILET, ADDRESS INCONTINENCE, HELP RESIDENTS CHANGE POSITION
Allow extra of this when providing cues and instruction to a resident with dementia, so they can process and understand what is being said.
TIME
CONTEXT CLUES, TIMELINE, DETAILS LEADING UP TO FALL, ETC.
This can cause a person to become more tense and hesitant in their movements, which actually increases their fall risk.
FEAR OF FALLING
Approximately 25% of older people who fall and fracture a hip die within this timeframe.
12 months / one year
Where can a CNA look to find a resident's transfer status and potential for falls?
What is the POC for KARDEX
When providing patient care, focus on their ______, not their ______.
ABILITIES, not LIMITATIONS
When completing a fall report, a nurse should ONLY type this in the "short description" box. Nothing more, nothing less, nothing else!
1 of the 6 TYPES OF FALLS (found, witnessed, self-reported, low bed to mat, lowered, stabilized/interrupted).
Muscle weakness, stiffness, incoordination are all examples of this fall risk factor that can make it difficult to walk steadily and safely.
BALANCE/MOBILITY IMPAIRMENTS
“This CMS quality measure tracks the percentage of long‑stay residents who experience a fall with major injury, and facilities aim to keep it as low as possible.”
“What is the Long‑Stay Falls with Major Injury QM?”
These are the 4 P's that should be addressed during every 2-hour round.
PAIN, PERSONAL NEEDS, POSSESSIONS, POSITION
This type of approach is not recommended when providing care to a person with dementia.
Immediate interventions after a fall must be documented in: ___________________
In the Fall Note and Plan of Care
Dementia, confusion or disorientation, memory impairment, and poor safety awareness are all examples of poor _______ that increases someone's fall risk.
COGNITION
“This standardized tool, required in all U.S. nursing homes, identifies residents at risk for falls and includes items such as gait instability, prior falls, and cognitive impairment.”
“What is the MDS Section J?”
This is the first thing a caregiver should do when coming onto shift, prior to providing any patient care.
What is review the patient KARDEX in POC and check with the nurse?
These must be removed from a wheelchair unless you are transporting a resident to a destination.
LEGRESTS (so that a resident does not attempt to stand and trip over them) STORE THEM WHERE RESIDENT WILL NOT TRIP OVER THEM