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.
Include the day of the week and the time of the day. This may help identify falls related hypnotic, poor lighting, or staffing issues.
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.
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.
Symptoms at time of fall
Dizziness, light-headed feeling, nausea, legs gave way. Excessive pain.
Wet floor, change of furniture location, poor lighting.
Determine cognitive status.
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.