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BSI Blog

Strategies to Prevent Patient Falls

by Lynn Wagner, Healthcare Resource Specialist at BSI

Patient FallsAccording to a recent white paper by InPro Corporation, between 700,000 and 1 million hospital patients fall each year, with nearly 35% of the falls resulting in injuries. In a 2012 report by The Center for Health Design, it was noted that up to 50% of elderly patients fall while hospitalized. As part of the effort to reduce the incidence of patient falls, the Centers for Medicare and Medicaid Services are encouraging organizations to re-evaluate their fall-prevention programs. They have eliminated reimbursements for fall-related injury treatments, labeling falls as “Never Events”. Approaches to reducing falls include evaluating both intrinsic (patient-centered) and extrinsic (environmental) risk factors.

Here are some concrete ways that the physical environment can assist in reducing fall risks:

Intrinsic Risks meet Extrinsic Interventions:  Falls usually occur when two or more risk factors are present (i.e.: poor balance combined with dim lighting).  According to a 2008 CDC report on Preventing Falls, environmental factors play a role in about 50% of all falls. This means there is a significant opportunity to impact fall rates through making environmental changes.  History of falls, confusion, visual impairment, and incontinence or toileting frequency are intrinsic risk factors that can be minimized through extrinsic intervention, namely, careful design.

Signage can aid in orienting potentially confused patients, and can be used by staff to identify and monitor those with a fall history or current fall risk.  Products such as well-designed communication boards can help to remind patients of where they are, precautions they may have, and how to ask for help.  Clear wayfinding signage can also help to eliminate confusion and reduce falls in common areas of a facility, not only for patients, but visitors as well.

Adequate lighting/illumination levels can help all people safely navigate in an unfamiliar environment, but especially those who may have impaired vision.  Careful selection of bulbs is important (i.e.: don’t select a bulb with delayed warm-up time in a bathroom where immediate illumination is needed for safety).  Choosing healthcare lighting fixtures and a lighting designer who understands the extensive range of needs throughout a facility is important.

Grab bar placement (following ADA guidelines) and careful product selection in bathrooms can impact fall rates, especially for those with toileting issues. Consider grab bars with a contrasting color to the wall finish, for easy visibility and use a textured, matte finish. Grab bars along corridors and within patient rooms should also be considered.  The white paper by Inpro discussed the concept of installing high-low grab bars for people of varying heights.

Patient room layout, including the location of the bathroom relative to the bed, size of the bathroom, and location of the toilet within the bathroom, have been studied at length.  Some reports have hypothesized that a bathroom on the headwall side of the room (with supportive environmental features such as grab bars along the path, and angled doorways for improved sight lines) can reduce falls.  Placing the toilet itself with the back against the closest side wall also reduces turning, thereby decreasing the likelihood of a fall.  If building new or remodeling, work with a designer trained in healthcare design.

What You Can Do

Be proactive in reducing trip/fall hazards in your facility by:
  • Eliminating clutter, and storing medical equipment in its designated space (not in hallways)
  • Minimizing rearrangement of furniture in common areas.
  • Using non-slip flooring, and minimizing transitions.
Contact me to learn more about environmental interventions available to reduce falls in your facility.

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