Chapter 3. Safer Patient Handling, Positioning, Transfers and Ambulation
Chapter 3. Safer Patient Handling, Positioning, Transfers and Ambulation
3.11 Fall Prevention
Patient falls are the most reported patient safety events in British Columbia and account for 40% of all adverse events (BCPSLS Central, 2015). Falls are a major priority in healthcare, and healthcare providers are responsible for identifying, managing, and eliminating potential hazards to patients. Older adults may be at increased risk for falls due to impaired mental status, decreased strength, impaired balance and mobility, and decreased sensory perception (Titler et al., 2011). Other patients may be at risk due to gait problems, cognitive ability, visual problems, urinary frequency, generalized weakness, and cognitive dysfunction. Specific treatments and medications may cause hypotension or drowsiness, which increases a patient’s risk for falls (Hook & Winchel, 2006).
Fall Prevention Strategies
All clients should be assessed for risk factors, and necessary prevention measures should be implemented as per agency policy. Table 3.8 lists factors that affect patient safety and general measures to prevent falls in healthcare.
Table 3.8 Fall Prevention Strategies |
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Prior to ambulation consider the following risk factors:
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Prevention Strategies |
Safety Measures |
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| Look for fall risk factors in all patients. | Identifying specific factors helps you implement specific preventive measures. Risk factors include age, weakness on one side, the use of a cane or walker, history of dizziness or lightheadedness, low blood pressure, and weakness. | ||
| Follow hospital guidelines for transfers. | Transfer guidelines provide a good baseline for further patient risk assessments. | ||
| Orient patient to surroundings. | Orient patients to bed, surroundings, location of bathroom and call bell, and tripping hazards in the surrounding environment. | ||
| Answer call bells promptly. | Long wait times may encourage unstable patients to ambulate independently. | ||
| Ensure basic elimination and personal needs are met. | Provide opportunities for patients to use the bathroom and to ask for water, pain medication, or a blanket. | ||
| Ensure patient has proper footwear and mobility aids. | Proper footwear prevents slips. | ||
| Communicate with your patients. | Let patients know when you will be back, and how you will help them ambulate. | ||
| Keep bed in the lowest position for sedated, unconscious, or compromised patients. | This step prevents injury to patients should they attempt to get out of bed. | ||
| Avoid using side rails when a patient is confused. | Side rails may create a barrier that can be easily climbed and create a fall risk situation for confused patients. | ||
| Keep assistive devices and other commonly used items close by. | Allow patients to access assistive devices quickly and safely. Items such as the call bell, water, and Kleenex should be kept close by, to avoid any excessive reaching. | ||
| Data sources: Canadian Patient Safety Institut