Falls Risk

Introduction The prevention of falls in the long term care facility is one of the most important interventions the health care team can do to ensure the safety of loved ones under their care. According to the Summary Data of Sentinel Events Reviewed by the Joint Commission (2016), there were 806 falls between 2004-2015 with 95 of those occurring in 2015 . As health care providers, we have a responsibility to incorporate interventions that will help protect the patient while under our care. Interventions as simple as ensuring the use of a gait belt by any team member that transfers the patient, to making sure all team members are aware of the medications that can make certain patients more of a fall risk, will help in the prevention of falls.

It is important that key factors in determining who is and who is not a risk to fall are sought out by the health care team. In this paper we will focus on how to determine who is a fall risk.

Review of National Patient Safety Goal The National Patient Safety Goal (NPSG) for falls in long term care facilities is to identify which patients are at risk for falling and to take action to prevent falls for these residents. (NPSG.09.02.01). There are five elements of performance for NPSG: 1. Assess the risk for falls, 2. Implement interventions to reduce falls based on the resident’s assessed risk, 3. Educate staff on the fall reduction program in time frames determined by the organization, 4. Educate the resident and, as needed, the family on any individualized fall reduction strategies, and 5. Evaluate the effectiveness of all fall reduction activities, including assessment,

Three of them are: does the patient have a history of falls, is the patient at risk of falling, and to identify the cause of a fall (Recommendations 2011). The first recommendation the healthcare team should consider is, does the patient have a history of falls? During the initial assessment the healthcare team should ask the patient and family members present about fall history. Carefully examining the patient's chart for any indicators of past falls is also recommended. These can be clear indicators of the presence of fall risks. Once a patient has fallen once, the likelihood of a second fall is greatly increased. The second recommendation the healthcare team should consider is, is the patient at risk of falling? Both extrinsic and intrinsic factors should be considered. Examination of the patient's chart for a list of current medications being taken, fall history, any underlying conditions, neurological status, and psychological status should be done. Previous studies have shown that psychotropic, diuretic, digoxin, and Class 1a antiarrhythmic medications are associated with significantly increased risks of falls (Kehinde, Pope, & Amella, 2011). An examination of environmental status should also be done. For example, looking at lightning, cords on the floor, slippery floors, whether the call light is accessible, and whether the room