Table 1

Components of the interdisciplinary falls prevention program

Referring discipline


Screening of all patients at admission for risk of falls:

Primary nurse

- History of falls (i.e. 2 or more falls in the last 6 months)

- Impaired mobility (e.g., unsteady, weak gait)

- Impaired cognition (e.g., confused, forgetful)


Examination of patients considered at risk for falling:

Physician

- Note circumstances and consequences of earlier falls

- Examine patients for acute or chronic medical condition(s)

- Review medications

- Assess gait, balance, vision, neurological function, and mental status


Interventions for all patients to provide safety in the hospital:

Primary nurse

- Orient patients to surroundings/"set up" of room

Nursing staff

- Place call bell and personal belongings within reach

- Keep bed in low position

- Ensure safe footwear and adequate fit of clothing

- Provide nightlight at bedside

- Ensure walking aids (devices) are fitted and used appropriately

- Lock wheels on wheelchairs, beds, night commodes


Interventions in patients considered at risk for falling:

Physician

- Modification of medication

Primary nurse

- Instruction of patients (family) about risk factors

Nursing staff

- Post fall risk sign in patient's record

Physiotherapy staff

- Assist unsteady patient with ambulating

- Toilet patient regularly

- Use half-length side rails instead of full length side rails

- Exercise program, gait/balance training

- Provision of hip-protectors


Reassessment of those patients who fell:

Physician

- Evaluation of circumstances and consequences of the fall

Primary nurse

- Reassessment of patient risk factors for falls

- Continuing or implementation of preventive interventions


Schwendimann et al. BMC Health Services Research 2006 6:69   doi:10.1186/1472-6963-6-69

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