Q:
There is a resident in our facility that has frequent falls, and we are out of ideas for interventions. How can we update the care plan if we do not know what new interventions to add?
A:
The first step to take after a fall occurs is completion of a thorough root cause analysis. It is best practice to physically go to the location of the event to assess the environment, placement of the furniture or personal items, flooring, etc. and consider possible factors which may have contributed to the fall event. Keeping in mind the specific abilities, routines and risk factors of the resident, what may have contributed to this fall occurrence? When reviewing this fall in combination with other recent falls, analyze whether there are particular patterns to fall events (time of day, specific activities they are undertaking, where falls occur, etc.) Determine clinical factors that may have played a role in falls—for example, pain, personal needs or new medications or treatments. Gather information from the resident, staff and family members to seek input on possible contributing factors to falls and potential interventions and care plan updates. Each resident and situation is unique, but the best interventions are person-centered with a focus on individual risks, responsive to past incidents, and are reasonable for caregivers to consistently carry out.
The care plan should be updated in a timely manner after every fall, with interventions put in place that address the root cause of that specific fall and outline the facility’s ongoing efforts to prevent future falls.
Need specific intervention ideas for residents with chronic falls? Access Proactive’s on- demand Winning the Fall Prevention Battle webinars to assist with your fall program.
Other tools: Centers for Disease Control and Prevention. (2019). Preventing Falls in Older Patients. https://www.cdc.gov/steadi/pdf/STEADI-PocketGuide-508.pdf
Brandy Hayes, RN, RAC-CT, RAC-CTA
Clinical Consultant
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