falls prevention in care homes. aim to raise awareness of the causes and prevention of falls and...
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Falls Prevention in
Care Homes
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Aim
To raise awareness of the causes and
prevention of falls and fractures in older people
living in residential or nursing homes.
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Outcomes
By the end of the session delegates will be able
to: Identify risk factors for falls Identify risk factors for Osteoporosis Understand that some risk factors can be
modified or reduced and some are not modifiable at all.
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Definition A fall is an unexpected event resulting in the
Person coming to rest on the floor or other
lower level.
It includes: Falling out of bed Falling off a chair or toilet Falling while walking Falling downstairs.
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Risk factor
Something associated with a condition or
an event that makes it more likely to
happen.
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Falls
Falls in older people are due to the interaction of their personal risk factors with their environment.
Falls in older people are multi-factorial – not caused by one factor.
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Risk factors for falling Personal Environmental BehaviouralOf these, some are Modifiable or reversible Non-modifiableThe more risk factors a service user has, the greater the risk of falling.
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Risk factors
Reversible/modifiable Non-reversible
Poor footwear
Environmental hazards
Taking lots of medicines
Postural Hypotension (Blood pressure dropping on standing)
Muscle weakness
Poor balance
Unsteady walking
Confusion due to urine infection
Medical conditions e.g. Stroke
Vision e.g. blindness
Loss of feeling in feet and legs due to Diabetes
Confusion due to Dementia
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Bone Health
Bone density reduces with ageOsteoporosis affects 1 in 2 women and 1 in 5 men over the age of 50
A person with osteoporosis is at very high risk of breaking a bone if they fall
95% of hip fractures are caused by a fall
Vertebral (spinal ) fractures occur without falling, are often unrecognised and very painful
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normal osteoprotic
What Osteoporosis looks like
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Preventing hip fractures Assess and reduce fall risk factors for every resident as
much as possible Check all residents’ weight and think about their food
intake Encourage weight-bearing exercise, good posture and
back care Discourage smoking and excess alcohol intake Encourage residents to sit outdoors in the summer for 20
minutes Check that all residents are having Calcium & Vitamin D
supplementation to help their bones and their balance Hip protectors can reduce the risk of a hip fracture if
worn and correctly fitted.
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How can we reduce falls?Evidence suggests that the number of falls andinjuries can be reduced when: an older person receives an individual
assessment of their risk factors their reversible risk factors are identified and
reduced their care plan shows action taken to reduce fall
and fracture risk all staff are aware of residents likely to fall everyone works together – falls need team work!
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Comfort checksA method of providing care to a resident on a regular basisA comfort check would include: Asking how the person is, if they have any pain Asking if they would like to go to the toilet or for a walk Offering a drink Checking they have good footwear on Checking the area around them for trip/fall hazards Ensuring that their walking aid/glasses/call bell are close
at hand Telling the resident that you will be back again to see
how they are in an hour.
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Posture and SeatingGood posture is important for residents
Poor posture can cause: Pressure ulcers Pain in muscles and joints Risk of falling out of the chair Difficulty eating, talking, breathing Poor balance and higher risk of falls when
standing
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Top tips Change position often – stand up every 2 hours Rest on the bed for an hour after lunch, allows joints
and muscles to stretch and takes weight off the bottom When sitting, ensure feet are on the ground or footrest Hip, knee and ankle should be at 90° Encourage residents to sit symmetrically, not leaning to
one side If the chair is too low, raise the height through the legs,
rather than adding extra cushions If a resident can’t move well in a chair, help them to
stand up and sit down again Encourage activity and mobility
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Top tips for maintaining mobility
Regular (daily if possible) exercise Encourage residents to walk whenever
possible, check walking aids are clean and in good condition and the right size
Ensure you use the correct techniques for assisting residents to stand up and walking
Ensure (as far as possible) that all residents have good, safe footwear, light shoes are better than loose slippers.
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Bedrail use
Falling out of bed can cause a head injury or fractured hip
Bedrails are not to be used to prevent residents getting out of bed i.e. as a restraint
Do not use for residents who are confused and mobile enough to climb over or round them
There is a risk of limbs becoming trapped in bedrails, so bumpers/covers should be used
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Action following a fall: 1
Most falls in Care Homes are un-witnessed Assume a head injury may have been sustained
unless proven otherwise Refer to post fall protocol Consider whether the resident needs to be
moved – ‘don’t add insult to injury’ Head injury observations for un-witnessed falls
as well as when there is clear evidence of a head injury
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Action following a fall: 2
Complete accident/incident book Inform the GP Inform the relatives Complete the resident’s falls register Update the falls care plan Ensure all staff are aware of the fall
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1 2
3 4
5 6
7 8 9 10 11 12
13 14 15 16 17 18
19 20 21 22 23 24
25 26
Days since last fall
27 28
___ days 29 30 31
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To prevent falls you need to Carry out regular audit by managers/senior
staff of fall numbers, times, locations, injuries Feedback to all staff about fall rates Have good handover and communication
between staff Ensure there are regular falls training updates
and induction for new staff Involve residents and families in falls
prevention measures and education