Q:
Is there a certain amount of time allowed before an RN needs to complete a resident fall follow-up? Also, what should a fall follow-up entail?
A:
While there is no specified time frame for RN assessment, guidance tells us the proper actions following a fall include:
- Ascertaining if there were injuries, and providing treatment as necessary;
- Determining what may have caused or contributed to the fall, including ascertaining what the resident was trying to do before he or she fell;
- Addressing the risk factors for the fall such as the resident’s medical conditions(s), facility environment issues, or staffing issues; and
- Revising the resident’s plan of care and/or facility practices, as needed, to reducethe likelihood of another fall.
The IDT should investigate fall circumstances to identify intrinsic and extrinsic factors that contributed to the fall. An Immediate intervention should be put in place to prevent another similar fall. The longer the time between the fall event and the intervention, the greater the risk that additional falls may occur. Promptly thereafter, a review to determine the effectiveness of the immediate intervention, and whether other interventions should be implemented based on the IDT investigation. In follow-up to the fall event, the fall assessment should be reviewed and/or revised for changes. In addition, review and revise the plan of care to ensure all risk factors are identified with interventions in place to address the risk factors, including any new interventions put into place. Monitor staff compliance and resident response to the interventions. The resident should be evaluated and monitored for 72 hours after the fall. Follow-up documentation should include not only a physical assessment for injuries, but also include the resident’s response to the interventions that have been put into place. Interventions should address the cause or what contributed to the fall and should be personalized to the resident to increase success of the intervention.
Brandy Hayes, RN, RAC-CT
Clinical Consultant
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