What Are You Doing Now to Prevent Falls?
Too often a facility starts its fall reduction policy too late - after a fall has occurred. In order to have an effective and successful program, fall reduction must start with preventing falls. The first step in preventing falls is to identify those at risk for a fall.
For the sake of this discussion let’s divide your residents into two groups, new admissions and existing residents:
New Admissions
Upon admission, every patient undergoes a full assessment by the nursing department. A score on your nurses fall assessment should indicate high risk or a notation of unsteadiness, impaired balance, lower extremity muscle weakness. In addition, a history of multiple falls should lead to activation of your high-risk fall protocol and a referral to therapy. If the patient is also agitated, confused, disoriented, or delirious, then a med review by the medical director and/or pharmacy is also in order.
Existing Residents
For current patients, a number of things may lead to activation of a high-risk protocol, to include a room change or an increase in urinary and bowel symptoms, such as urinary incontinence, urinary urgency, frequency, or diarrhea. These symptoms may also indicate the need for establishing a toileting schedule and/or possibly other medical actions based on clinical presentation and assessment. Furthermore, a current patient who has a change in meds, a higher quantity of meds (such as 4 or more), or starts new meds (such as benzodiazepines, antipsychotics, antidepressants, anti-hypertensives, diuretics, anti-arrhythmics, narcotics or opiates), would warrant activation of your high-risk protocol as well as contacting the medical director and pharmacy for review.
In addition, quarterly screens of existing residents via the MDS process or through therapy screens may reveal changes in function or gait that could require attention. Remember that anyone in the facility, including family members, may notice and report a change in a resident’s gait. Changes such as shuffling or slowed gait could indicate a new fall risk. Residents themselves may report a new fear of falling. These are all indicators that must not be overlooked. Referrals to therapy and appropriate action by the team can prevent a fall and fall related injury.
Last but not least, the greatest predictor of future falls is a current fall, so each and every fall must be assessed carefully for its root cause and addressed accordingly. It is the job of the interdisciplinary team to determine a fall’s root cause and then ensure that every resident has the assistance, equipment and interventions necessary to prevent falls and fall related injuries.
If you are currently a monthly member of our In-House Therapy Alliance, then you have access to our complimentary Safe Steps Interdisciplinary Program for Fall Mitigation and free facility assessments. If you are not currently working with us, we recommend you find someone who can establish a falls program for you and integrate any missing elements to your existing program to improve your outcomes. We would welcome the opportunity to be that someone for you, email or call Elizabeth at 850-499-4345 and learn more today.
Written by: Elizabeth Johnson, PT, CDP, RAC-CT
About Seagrove Rehab Partners
Our aim is to serve the therapy industry by providing a compassionate, people-centered approach to compliance and management support, including a proprietary solution for SNF in-house therapy programs. Our In-House Therapy Alliance not only helps our partners to be more compliant and profitable, but also puts the patient first. Mark McDavid, president, and our company associates are available to work with skilled nursing facilities, rehab agencies, and other healthcare providers at the client site, by phone, by email, by video conference call and through workshops and seminars.
