Interventions and prevention strategies

General safety interventions

Given the numerous intrinsic and extrinsic factors leading to falls, it is possible to consider each factor and identify positive steps and safe interventions proven effective for preventing falls. A few examples of general interventions might be helpful before discussing measurement and development processes for risk assessment or a comprehensive program to reduce fall incidents.

Fall Prevention interventions examples:

• Instruct the patient or resident to request assistance as needed.
• Instruct the patient to wear non-skid footwear.
• Provide an appropriate armchair with wheels locked at the patient’s bedside.
• Ensure that the pathway to the restroom is free of obstacles and properly lighted.
• Ensure the hallways are clear of obstacles.
• Place assistive devices such as walkers and canes within a patient’s or resident’s reach.
• Raise the side rails as appropriate for access to bed controls, support and repositioning.
• Evaluate chair and bed height.
• Consider peak effect for prescribed medications that affect level of consciousness, gait and elimination when planning patient care.
• Observe environment for potentially unsafe conditions.
  Notify appropriate department(s) of hazardous conditions.
• Do not leave “at risk” patients or residents unattended in diagnostic or treatment areas.
• Ensure patients or residents being transported by stretcher/bed have all side rails in the up position during transport, or if left unattended briefly while awaiting tests or procedures.
• Inform and educate patients and /or family members regarding a plan of care to prevent falls.
• Include the patient’s family in the development of an individualized safety plan, considering age-specific criteria and patient cognition when planning care.
• Collaborate with the patient’s or resident’s family to provide assistance as needed while maintaining the patient’s independent functioning.
• Communicate the patient’s “at risk” status during shift report and with other disciplines as appropriate.

CDC/NIOSH – Slip, trip and fall prevention for healthcare workers

The CDC’s National Institute for Occupational Safety and Health (NIOSH) recently issued a workbook intended to help the healthcare community prevent "slips, trips, and falls" among its workers. Go to: http://www.cdc.gov/niosh/docs/2011-123/?WT.mc_id=, or Download

Equipment and products

Our contracted supplier list contains products and equipment to reduce the risk of falls and/or back injuries.  New contracted suppliers are added on an ongoing basis.  For updates see Premier's Supply Chain Advisor. (Member Login required)

Sitters

Patients or residents with an impaired ability to understand or follow directions, or appreciate the potential for self-harm as a consequence of his/her actions, may have a sitter prescribed by a physician to provide continuous one-to-one observation. Sitters are responsible for observing the patient and maintaining a safe environment.

When sitters are used, they are under the direction and delegation of a registered nurse who monitors the patient’s or resident’s actions. Sitters may be non-licensed patient care staff, or other hospital employees who have completed sitter competencies. Guidelines and sample competency quiz are available.