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Cheatography

Falls: Tips for Investigating a Fall Cheat Sheet (DRAFT) by [deleted]

Falls: Tips for Investigating a Fall

This is a draft cheat sheet. It is a work in progress and is not finished yet.

Introd­uction

A thorough evaluation of each fall is necessary to understand why an individual resident falls as well as identify facili­ty-wide trends and process problems. Analysis of the fall invest­igation will assist the facility and the care team to take steps to prevent recurrence of falls. Looking at the whole enviro­nment and care needs related to the resident will help the team create a reside­nt-­spe­cific plan of care.

Time

Include the day of the week and the time of the day. This may help identify falls related hypnotic, poor lighting, or staffing issues.

Medication

This includes new medica­tions, changes in dosage and admini­str­ation time as well as listing ntipsy­cho­tics, antihy­per­ten­sives, antide­pre­ssants, antian­xiety medica­tions, and hypnotics. The care team may identify other medica­tions for further observ­ation.

Contri­buting medical condition

Certain sided weakness, neurop­athy, and many others. Possible new acute illness.

Use of devices

Cleanl­iness of glasses, approp­ria­teness of footwear, and use of needed assistive devices.

Location

Most falls occur in the resident room or bathroom. Perhaps there are safety problems associated with those locations or unmet resident needs such as toileting.

Activities at time of fall

This may include leaning over to pick up a dropped object, attempting to go to the bathroom, sudden feeling of faintness when standing up, slipped, or got lost.
 

Haddon's Counte­rme­asures

Symptoms at time of fall

Dizziness, light-­headed feeling, nausea, legs gave way. Excessive pain.

Enviro­nment hazards

Wet floor, change of furniture location, poor lighting.

Cognitive status

Determine cognitive status.

Witnesses

As many falls in the nursing home are not witnessed, it is essential to obtain inform­ation from witnesses who can give an account of resident activity just prior to a fall. Exact details must be elicited as part of obtaining inform­ation for analysis. Witnesses may be visitors, family members, volunt­eers, facility non-nu­rsing staff as well as facility caregi­vers.