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Safe Mobility

The nurse is sitting in on a treatment team meeting about reducing the risk of falls on the unit. In the last year, the unit has had five elderly people fall from bed or while getting up to void at night. Administration would like the treatment team to develop and implement a fall-prevention program. This would include the development of a risk assessment tool when patients are admitted to the floor to determine who is at high risk for falls and then implementing educational opportunities for all staff involved.
Instructions:

Answer the following questions:
a. What interventions are of high importance to be implemented for all high-risk patients in this program while on the unit?
b. What other educational opportunities are there for educating staff, patients, and family?

Full Answer Section

Mobility:
- Strength and balance training: If appropriate, incorporate exercises to improve leg strength and balance as tolerated.
- Assistive devices: Provide appropriate assistive devices like canes, walkers, or gait belts for safe mobility.
- Staff assistance: When needed, offer staff assistance with activities like transferring in and out of bed or using the restroom.
- Appropriate footwear: Encourage patients to wear well-fitting, closed-toe shoes with good traction.
Communication:
- Call bell accessibility: Ensure the call bell is within easy reach for patients to summon help when needed.
- Toileting schedule: Encourage a regular toileting schedule to minimize nighttime urges that might lead to rushing to the bathroom.
- Pain management: Adequate pain control reduces the risk of falls due to pain-related instability.
Medication review:
- Review medications that may cause dizziness or drowsiness, and discuss potential adjustments with the doctor.

Educational Opportunities:

Staff Education:
- Fall risk assessment training: Train staff on using the fall risk assessment tool to accurately identify high-risk patients.
- Safe patient handling techniques: Educate staff on proper techniques for transferring and assisting patients to minimize fall risks.
- Communication strategies: Train staff on effective communication with patients regarding fall prevention measures.
Patient and Family Education:
- Fall prevention strategies: Educate patients and families about the implemented fall prevention measures and their importance.
- Environmental modifications at home: Discuss potential home modifications to reduce fall risks after discharge.
- Importance of communication: Encourage patients to call for assistance whenever they feel unsafe.
- Benefits of exercise: Highlight the importance of strength and balance exercises for fall prevention (if applicable).

By implementing these interventions and educational opportunities, the treatment team can significantly reduce fall risks for high-risk patients on the unit.

Sample Answer

Interventions for High-Risk Fall Patients:

Here are some high-importance interventions to be implemented for all high-risk fall patients in this program:

Environment:
- Low bed positioning: Keeping the bed in the lowest position reduces the distance to the floor if a fall occurs.
- Clutter-free walkways: Ensure clear pathways around the bed and room to avoid tripping hazards.
- Adequate lighting: Provide nightlights or easy-reach lighting controls for nighttime visibility.
- Grab bars: Install grab bars near the toilet, shower, and bed for additional support when transferring.
- Non-slip mats: Use non-slip mats in the bathroom and by the bedside to prevent falls on wet surfaces.