PREVENTING FALLS

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Most occur in bedrooms and bathrooms. Causes of falls include:

Throw rugs poor lighting cluttered floors furniture that is out of place Pets underfoot Slippery floors Slippery bathtubs and showers The need to urinate

PREVENTING FALLS: HAND RAILS Handrails and grab bars used in

Hallways Stairways bathrooms

provide support Persons who are weak or unsteady when walking Sitting down on or getting up from a toilet Getting in and out of the bathtub

PREVENTING FALLS

The risk increases with age. A history of falls increases the risk Most occur in the evening

between 1800 (6:00 pm) and 2100 (9:00 pm).

more likely during shift changes.

PREVENTING FALLS: BED RAILS raised and lowered on hospital beds. lock in place with levers, latches, or buttons. half, three quarter, or full length. nurse and the care plan tell you when to raise

bed rails. If needed keep up at all times, except when

giving care

PREVENTING FALLS: BED RAILS Bed rails present hazards.

The person can fall when trying to climb over them. The person cannot get out of bed to use the

bathroom. Entrapment is a risk.

Gaps can occur: Between half-length rails Between the rail and the headboard or footboard Between the bed rail and the mattress

Injury or death can occur.

PREVENTING FALLS: BED RAILS Persons at greatest risk

confused or disoriented Are restrained (Chapter 11) Are small in size Have poor muscle control

Bed rails are considered restraints under OBRA and the Centers for Medicare and Medicaid Services (CMS).

PREVENTING FALLS: BED RAILS rules

cannot be used unless needed to treat a person’s medical symptoms.

person or legal representative must give consent for raised bed rails.

The need must be carefully noted in the medical record and care plan.

PREVENTING FALLS: BED RAILS Accrediting agencies and many states

have standards for bed rail use. The procedures in this book include using

bed rails to help learn correct use nurse, care plan, and assignment sheet

tell you who uses them

PREVENTING FALLS: BED RAILS Focus on children: bed rails The space between crib rail slats must be no more than 2 3/8

inches. If larger, the baby’s head can get caught. The baby can suffocate and die.

If the mattress is smaller than the crib, gaps occur between: (1) The crib rail and the mattress (2) The crib rail and the headboard (3) The crib rail and the footboard

Two adult fingers should fit between these spaces. Larger spaces can trap the baby. The baby can suffocate and die.