Chapter 14: "Preventing Falls" (pp. 191-203)

Chapter 14: "Preventing Falls" (pp. 191-203)

Clinical Health Occupations

​Mr. Major & Mrs. Mercado

​2021-2022

​Preventing Falls - Intro (p. 191)

• ​Risk of falling increases w/ age

  • ​> 25% of adults age 65 and older fall

• ​Main cause of injuries & injury-related deaths in older adults

​Causes & Risk Factors for Falls (p. 192)

• ​LTC:

  • ​Nursing home residents @ increased risk for falls

    • ​Weakness

    • ​Walking problems

  • ​Care Setting Hazards

    • ​Poor lighting

    • ​Wet floors

    • ​Incorrect bed height

  • ​Other

    • ​Transfer problems

    • ​Poorly fitted footwear

    • ​Improper use/fit of devices

      • ​W/c; walker; cane

• ​Home Care:

  • ​Clutter (rooms, stairway, hallway)

  • ​Objects on floor/stairway

    • ​Wires & cords

    • ​Books & magazines

    • ​Shoes, blankets, etc

  • ​Throw rugs

  • ​Pets

  • ​Flooring problems

    • ​Loose tile, wet, etc.

  • ​Ice/snow

  • ​Loose/missing hand rails (p. 197)

  • ​No footwear or incorrect footwear

  • ​Adaptive devices that need repair

​(p. 192)

Multiple Choice

Most falls are caused by __________.

• Good lighting

• Many risk factors

• Steady gait

• Achieving REM sleep cycles

Multiple Choice

In order to protect patients from harm, the CNA needs to __________.

• Keep bed rails in the up position for all patients/residents

• Report unsafe equipment at the end of the shift

• Answer patient call lights promptly

• Wipe up spills when finished with his or her assignment

​Fall Prevention Programs (pp. 193-94)

• ​Agencies have fall prevention programs

• ​Measures in Box 14-2 (p. 193) are part of program & pt's care plan

• ​Goal = prevent falls without decreasing pt's quality of life

​Fall Prevention Programs (pp. 193-94)

• ​

Multiple Choice

To prevent falls, the CNA must __________.

• Always lower the pt's bed to the lowest position when finished providing care

• Keep bed wheels locked except for when providing bedside care

• Keep the bed in its lowest position when providing bedside care

• Always have a coworker present when providing care

Multiple Choice

Which measure will help prevent falls?

• Slip-resistant footwear is worn in bed.

• The call light is always within the pt's reach.

• Bed wheels are unlocked for pt transfer.

• Clothes/Gowns are loose and floor-length

Multiple Choice

TRUE or FALSE:

The risk of falling increases with age.

• TRUE

• FALSE

​Position Change Alarms (p. 195)

• ​Several types

  • ​Chair/bed sensor pads (Fig. 14-3)

  • ​Bedside alarm mats

  • ​Alarms clipped to pt's clothing

  • ​Seat-belt alarms

  • ​Wireless motion sensors

• ​Device alerts all staff within hearing

  • ​Makes sound

    • ​Alarm; beep; chime; music; etc.

    • ​Recorded message

      • ​"Please sit down & use your call light for help."

​-> any physical/electronic device that monitors patient & alerts staff of movement.

Position Change Alarms (p. 195)

​

• ​Alarms do NOT replace close observation!

  • ​Pts at risk for falls must be checked frequently

  • ​Careful & frequent observation is vital

​Bed Rails (p. 196)

• ​1/4, 1/2, 3/4, or full length of bed

• ​RN/Care plan dictates when to use

  • ​Unconscious/sedated pts

  • ​Confused/disoriented pts

  • ​Bed rails up @ all times except during bedside care

• ​Bed rails also present hazards:

  • ​Entrapment -> pt may get caught, trapped, strangled

• ​Considered restraints if:

  • ​Pt cannot get out of bed

  • ​Bed rails cannot/will not be lowered to allow pt to exit bed

​-> device that serves as guard/barrier along side of bed.

​(p. 196)

​​(p. 197)

Multiple Choice

TRUE or FALSE?

Bed rails are safe for patients who are trying to get out of bed without help.

• TRUE

• FALSE

​Hand Rails & Grab Bars (p. 197)

• ​Hand rails are in hallways & stairways (Fig. 14-6)

  • ​Support for weak/unsteady pts while ambulating

• ​Grab bars (safety bars) are in bathrooms, showers, & tub rooms (Fig. 14-7)

  • ​Support for pts while sitting down or getting up from toilet

  • ​Used when pts stand in shower & to get in/out of shower/tub

​Wheel Locks (p. 197)

• ​Wheels are locked at all times except when moving the bed

• ​Make sure bed wheels are locked when:

  • ​Providing bedside care

  • ​Transferring the pt to and from bed

• ​W/c & stretcher wheels must also be locked during pt transfer

Multiple Choice

TRUE or FALSE?

The pt's bed is in its lowest horizontal position except when the CNA performs bedside care.

• TRUE

• FALSE

​Transfer/Gait Belts

(pp. 198-99)

• ​Transfer Belt: used to transfer pt

  ​Gait Belt: used to help pt walk

  • ​Goes around waist

  • ​CNA grasps belt underneath for support during transfer or to assist pt to walk

  • ​Some have handles

• ​Standard size fits up to 51 inches

• ​Bariatric size fits up to 71 inches

• ​If pt's waist is > 71 inches?

  • ​Follow RN directions & care plan

​-> support device applied around the waist of a pt

who is unsteady or disabled

​Transfer/Gait Belts

(pp. 198-99)

Multiple Choice

Which statement regarding transfer/gait belts is correct?

• They are utilized to support pts who ambulate steadily.

• They are assist devices used to help prevent falls & other injuries.

• The belt is always applied underneath the pt's clothing.

• The belt is positioned slightly off-center & across the pt's chest.

​The Falling Person (p. 200)

• ​Usually occurs when pt is standing or walking

  • ​Weak; light-headed; dizzy

  • ​Slipping or sliding on spills, waxed floors, throw rugs, improper shoes

• ​Do not try to prevent the fall!

  1. ​Bring pt close to body during fall

     • ​Control

  2. ​Ease pt to floor, protecting head

  3. ​Pt should not try to get up = call RN to check for injuries

• ​Complete "Incident Report" (s/p all falls!)

​The Falling Person (p. 201)

Multiple Choice

TRUE or FALSE?

If a pt begins to fall, the CNA should try to prevent the fall.

• TRUE

• FALSE

​Moving the Person from the Floor (p. 201)

• ​If a manual lift is required, the CNA must protect him/herself from injury!

  • ​Proper body mechanics (Ch. 18)

  • ​Roll pt on side to position assist device

    • ​E.g. blanket; draw sheet (Ch. 19)

  • ​Avoid reaching across/over patient

  • ​At least 2 staff members on each side of pt

    • ​Larger the pt = the more staff needed

  • ​Bend knees (NOT back!); avoid twisting

• ​For the lift:

  • ​Kneel on 1 knee -> Grasp assist device -> Lift smoothly w/ legs on count of "3"

Multiple Choice

TRUE or FALSE?

Following a fall, the CNA should not attempt to get the pt up from the floor; s/he must call for the RN, who will assess the pt for injuries.

• TRUE

• FALSE

Multiple Choice

Which of the following colors is universally recognized as "FALL RISK?" For example, which color wristband would a fall risk patient at Anderson Hospital be wearing?

• Blue

• Green

• Yellow

• Red