If we have a resident who has a bed that is lowered very close to the floor, and we have a mat beside the bed, and the resident rolls or moves off of the bed onto the mat, is that considered a fall?



Unfortunately, as you will see in this section from the RAI manual, page J-28, whenever the resident has changed position, coming to rest on the mat from the bed, this would be considered a fall.

FALL DEFINITION: Unintentional change in position coming to rest on the ground, floor or onto the next lower surface  (e.g., onto a bed, chair, or bedside mat).

First you would want to do a root cause analysis as to why the resident is coming out of the bed, and address what you determine as the underlying cause. If you have addressed all possible causes, i.e., pain, need for toileting, hunger, restlessness, need for comfort or socialization, etc. then you will want to focus on interventions to reduce injury risk.

So this does not mean that the low bed and fall mat are not effective interventions. If you are able to show that these interventions are successful in preventing injury, and they pose no risks to the resident, you would want to continue using them. The only thing you will want to consider further is, the more the resident comes out of the bed, even if it is on the mat, the greater the risk that an injury may occur. You might want to make sure you have looked at the following:

      • All furniture and equipment is kept away from the side of the bed so the resident will not hit or bump it as they come out onto the mat.
      • The mat is placed such that it will cushion all of the resident as they come out of the bed, in other words, it is long enough and wide enough for the whole body.
      • None of the exposed surfaces of the bed frame pose an injury risk as the resident comes out of the bed, no sharp edges, no protruding knobs or bars that might cause an injury etc.
      • The thickness of the mat is sufficient to cushion the fall that occurs from 7 inches above.
      • If the resident is ambulatory, the mat does not pose a trip risk, increasing the chance of fall.

Check out Proactive’s Fall Prevention & Management webinar for more information regarding falls.

Blog by Janine Lehman, RN, RAC-CT, CLNC, Proactive Medical Review

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