A Florida agency tackles a fall prevention program
Citrus Memorial Hospital in Inverness, FL, has created a successful fall prevention program that included teaching nurses how to identify patients at risk for falling and teach them strategies to prevent falls.
The agency built its program from this outline, which it shares with Homecare Quality Management:
Fall Prevention Program
• Fall definition: An event resulting in a person or body part of the person coming to rest inadvertently on the ground or other lower surface level.
I. Stages of Fall Prevention
A. Prefall (primary prevention): Preventing or decreasing the likelihood of falls
1. identify persons at risk;
2. educate for prevention;
3. modify environment;
4. adaptations for mobility safety;
5. maintaining/improving fitness.
B. Actual falling event (secondary prevention): Decreasing the morbidity that results from falls
1. identify current mobility status;
2. limit injury.
a. teach balance techniques;
b. teach assistive devices.
C. Postfall (tertiary prevention): Decreasing disability from falls; preventing complications
1. ensure medical attention is available;
2. rehabilitation.
II. Identification of Risk Factors
A. History of previous falls
B. History of neurological defects
C. History of dizziness
D. History of compromised mental status
E. History of impaired sensory function
F. Environmental hazards present
G.History of health problems
H. Frequently degree of social isolation or lack of personal support in home
I. Female older than 75 years of age
J. History of usage of assistive devices
K. History of general inactivity, decreased mobility
L. History of multiple medications
M. History of alcohol/substance abuse
III. Procedure
A. Admission
1. RN will initiate fall risk assessment if appropriate.
2. If fall risk assessment score indicates program participation, RN initiates fall prevention program.
3. RN issues fall prevention guidelines to patient/family, begins education. The nurse and patient/caregiver will sign form.
4. RN may contact physician for physical therapy evaluation.
5. RN will instruct home health aide (as appropriate) on program participation and enter interventions on aide care plan.
B. Ongoing
1. Nurse and/or therapist will review the status of the program, including compliance on a weekly basis with the patient, caregiver, team, and document ongoing status.
2. If patient is not on the fall prevention program and a fall occurs, nurse will initiate fall prevention program on that patient.
3. At any time that nurse/supervisor deems necessary/appropriate, nurse can initiate program on patient.
a. may be referred through home health aide department;
b. may be referred through therapy discipline.
4. Supervisor/nurse will contact physician as necessary to inform physician of occurrence and patient status.
C. Documentation
1. Nurse will document on initial assessment that fall prevention program has been initiated.
2. Nurse will enter aide participation onto home health aide care plan as appropriate.
3. Nurse will maintain documentation on clinical notes, delineating teaching, interventions performed, and patient/caregiver response to teaching and interventions.
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