Fall Risk Factors
Environment
Interventions
Medications
Misc.
100
What is the strongest predictor of a future fall?
What is a previous fall.
100
Where do most falls occur in our facility.
Where is resident room. If a resident is in their room, please keep their door open as they allow. If they prefer it closed, frequent checks need to be completed.
100
What are the leaves outside of residents doors for?
Falling Leaf - indicates that a resident is a high fall risk.
100
What type of medication increases urination?
What is a diuretic - being on diuretic increases fall risk because a resident may need to frequently use the bathroom or have incontinence. If a resident becomes dehydrated, their blood pressure will drop, they may be unsteady and fall.
100
True or False: You find a resident that is known to put themselves on the floor, it is still a fall.
True: Per CMS guidelines "unless there is evidence suggesting otherwise, when a resident is found on the floor, a fall is considered to occur." We need to witness a resident placing themselves on the floor for it to NOT be a fall.
200
What is the diagnosis when your blood pressure drops when you stand?
What is orthostatic hypotension. Orthostasis occurs when you stand and you get dizzy/lightheaded and your BP drops. This is very common in the elderly. Contributing factors: medications, dehydration, age, neurological disorders, endocrine disorders (low thyroid or uncontrolled DM)
Best practice is to stay with a resident after standing to ensure they are steady and able to ambulate on their own. Hypotension can last a few minutes.
200
True or False: Keeping the bed in the lowest position for someone that can transfer is best practice.
False - this is considered a restraint.
200
If you aid in preventing a fall, what should you fill out?
What is a good catch entry.
Forms are located at both nurses' stations. All are encouraged to participate!
200
True or False: Taking anticoagulant medications increases your risk for internal bleeding if you fall. If a resident hits their head d/t a fall, should you update the provider?
True - We currently have one resident that is on coumadin. We have a few residents that are on Eliquis (apixaban) and Xarelto (rivaroxaban)
200
True or False: If a resident has a fall with a major injury (fracture, closed head injuries, internal bleeding and death) you don't need to file an OHFC report.
False: Per CMS, "facilities should review incident management systems and ensure timely report and root cause analysis (RCA). You need to report to OHFC for all major injuries.
300
Condition affecting safety awareness and judgement.
What is cognitive impairment
300
What should you do with gripper socks that have no grip left?
What is throw them away.
300
Walking your unit regularly is called what?
Frequent rounding - staff should be assessing residents at least every hour to ensure safety. It would be best to check more often when they are in bed or in their rooms and a known fall risk.
300
True or False: Mr. Doe didn't receive his 1100 dose of Sinemet for his Parkinson's Disease. Missing this medication will not affect his balance or gait.
What is False: Sinemet must be administered as prescribed on time. Sinemet helps to treat tremors, stiffness and muscle control.
300
A resident can still propel themselves in their w/c, but they continue to fall out of their chair. What would it be called to put them in a rock-n-go w/c and make them rely of staff for transportation.
What is a restraint. It is our job to allow a resident to be able to live up to their full independence. It is also our job to check on them more frequently knowing that they are a fall risk when in their standard w/c. This is the residents right.
400
Risk factors related to surroundings.
What are environmental hazards.
400
A resident is refusing to wear hipster pants, what do you need to fill out?
What is a risk benefit. Residents have the right to refuse cares/interventions, but we need to ensure that we are provided proper education as to why the intervention was recommended.
400
True or False: Care plans should be tailored to the individual.
True - Each resident is their own person, and our care plans need to reflect that. What works for one resident might not work for another. This is patient centered care.
400
Medications such as Seroquel and Zyprexa are this type of medication.
What are psychotropics. Psychotropics greatly increase the risk of falls in the elderly and possible death.
400
Who is responsible for preventing falls and ensuring resident safety?
Who is everyone! It doesn't matter what your position is in this building, if you see an unsafe situation that may result in a fall, it is your responsibility to keep them safe and find the help as needed.
500
True or False: New admissions are high fall risk withing the first 24-48 hours of admission.
True: A new environment is a fall risk to our residents. They should be monitored very closely right after admission to prevent falls. Learn what they do, how they move and make the appropriate interventions needed and share your findings with the team.
500
When a resident is not in their room, what level should the bed be left at?
What is transferable height.
You never know when another resident may go into a room and try to get into bed. If the bed is left too high or too low, it greatly increases the risk of falls.
500
What are the 4 P's of reducing the risk of falls?
What is Pain, Positioning, Potty and Personal Possessions.
500
What is the definition when you take several medications each day, often defined as five or more.
What is polypharmacy. We review residents medications regularly with our contracted pharmacist to ensure that the residents are not over medicated. Taking multiple medications increases the risk of falls d/t the side effects
500
Where is the best place to find what safety interventions are in place for a resident?
Where is the Kardex. Each resident has a Kardex hanging in their room, usually in their closet. You can also find them in POC/PCC, or there are blue binders at each nurse's station.
600
What contributed to this fall?
What are stairs, improper footwear, vision concern - glasses fell off
600
True or False: It is 0400 and still dark outside. Residents are awake in the common areas on Evergreen. It is best practice to keep the lights dim.
False: It is best to have adequate light. As we age, our vision worsens and we need more light to see.
600
What is the meeting called that occurs after a fall?
What is IDT (Interdisciplinary Team). M-F at 0930, there is a meeting in the Sunporch to discuss falls/incidents. EVERYONE is welcome to join to share ideas and come up with new interventions.
600
What are some risks with taking bowel medications that may increase the risk of falls?
What is an electrolyte imbalance and dehydration.
Some laxatives, especially stimulant types, can cause dehydration and electrolyte disturbances, which are more dangerous in older adults with reduced kidney function
600
True or False: All households have a 24-hour report sheet for staff to review.
True: At each HST station, there is a 24-hr. board for all staff to review and to add to. This is to increase communication between all team members to provide the most up to date information regarding our residents.