【Learning points】
- A fall refers to an "unexpected" falling or sliding to the ground in any place and under any circumstances, regardless of whether it causes physical injury or not.
- Risk factors that may cause falls include: seeking medical treatment due to falls, agitation, poor vision, affecting daily life, needing to go to the toilet frequently (frequent urination or diarrhea), needing assistance for self-transposition and movement, taking drugs that are prone to falling, Dizziness.
- To take care of patients who are prone to falls, relatives and friends need to be arranged to take care of them, and items should be placed within easy reach. The caregiver should sleep close to the hospital bed so that the patient can call easily, and wear non-slip shoes with upper coverings during activities.
I.What is a fall?
Refers to any place, under any circumstances, regardless of whether there is an "unexpected" fall or slide on the ground that causes bodily harm, including having to sit slowly on the ground due to limb weakness or inability to support.
II.Risk factors for falls
- Fell before or admission for falling.
- Irrtation.
- Poor visibiliry to affect daily life.
- Go to toilet ofen (frequent urination or diahrrea).
- Ask for assistance to displacement and activity by yourself.
- Dizzness.
- Taking the medicine that might let you fall. (such as:sedative Hypnotics , opioid , antipsychtics , Antidepressant , etc.)
III.How to prevent falls
- Environment:
- Adjust the bed to the lowest position and fix the brakes. Try to prepare double-sided bed rails or protective equipment, and pull up the double-sided bed rails when lying in bed.
- Note that the indoor and outdoor environments are bright and the floor is kept dry; the bathroom should have appropriate anti-skid facilities and handles, and no debris should be placed in the passageway.
- Use assistive devices for getting out of bed, such as crutches, walkers, wheelchairs, and braces.
- You can use a bathing chair when taking a bath, and install handrails next to the bathroom sink and toilet.
- If the medical equipment in the ward is damaged or inconvenient to use, please notify the medical staff immediately to deal with it.
- What caregivers and patients need to know
- Arrange for family and friends toaccompany you.
- The daily necessities of the case are placed within easy reach.
- The caregiver sleeps close to the bed so that the patient can call.
- Instruct caregivers to accompany them 24 hours as much as possible. If you need to leave for a short time, be sure to arrange the patient properly and inform the nursing staff.
- Observe and record the functional level of physical activity. If the patient needs assistance in activities, he or she should be accompanied by a companion.
- Instruct caregivers and cases that if they are exhausted but have to get out of bed to go to the toilet, they must be accompaniedby the caregivers throughout the process, or use the call bell to seek assistance.
- Do not wear overly long underwear, and wear shoes with covered uppers and non-slip soles.
- Get out of bed gradually when getting up and moving, first sit up and rest for 3 minutes, then sit on the edge of the bed for 3minutes, confirm that there is nodizziness, and then get out of bed accompanied by a caregiver.
IV.Conclusion
Falls will not only cause injury but may also affect the quality oflife. Preventive measures for inpatients’ falls require the cooperation of patients, caregivers and medical teams to make patients aware of the danger of falls and the importance of preventing falls. Only by participating in preventive measures can we truly prevent falls happened.
V.References
- Wu, P.W., Ko, Y.Ch., Ho, Ch.Y., & Yu, W.R. (2020). Exercise prescription for preventing falls in elderly people. Taipei City Medical Journal,17(1), 20-30. https://doi.org/10.6200/TCMJ.202003_17(1).0003
- Xu, Y., & Wu, M.F. (2020). Preventing falls is essential, silver-haired people live a healthy life. Changhua Christian Hospital Journal, 37(1), 22-23.
- Zhao, Sh.X. (2020). Discussion on fall-related drugs and fall prevention care in the elderly population, Changhua Nursing Journal, 27(3), 2-5. https://doi.org/10.6647/CN.202009_27(3).0002
- Kuo, W.Y., Hsiao,T.H., Tsai, H.J., & Lin,T.Ch. (2020). Project of multidisciplinary cooperation for reducing inpatient fall incidence in thoracic medicine ward. Leadership Nursing Journal, 21(1), 104-120. https://doi.org/10.29494/LN.202003_21(1).0009