The document discusses falls prevention for direct care providers. It provides two case examples of patient falls that resulted in serious injuries and long-term disabilities. It then outlines the key elements of a falls prevention program, including creating a safe environment, assessing patient risk factors, reducing individual fall risks, and evaluating intervention effectiveness. The document emphasizes that falls can have tragic consequences and stresses the importance of comprehensive falls prevention efforts.
I won't Fall for that Again!, Evidence based fall prevention in the Elderly, by Neila Shumaker (M.D.), as presented within the GWEP 2018 January Conference
Presented by: Angela Greetham, Bay of Plenty DHB
at OHSIG 2014, Thursday 11/9/14, Limelight Room 1, 11.15am
Video URLs:
HQSC on fall prevention: www.youtube.com/watch?v=NdO7JCXJBO4
Comprehensive geriatric assessment (CGA) is a multidimensional, interdisciplinary diagnostic process to determine the medical, psychological and functional capabilities of a frail elderly person in order to develop a co-ordinated and integrated plan for treatment and long-term follow up
Patients in medical rehabilitation (such as for stroke or spinal cord injury) often have many medical problems that reduce their energy and cognition. If their team decides they are 'psychologically unmotivated' they are discharged prematurely to nursing homes. Appropriate medical intervention can restore 'motivation' as well.
I won't Fall for that Again!, Evidence based fall prevention in the Elderly, by Neila Shumaker (M.D.), as presented within the GWEP 2018 January Conference
Presented by: Angela Greetham, Bay of Plenty DHB
at OHSIG 2014, Thursday 11/9/14, Limelight Room 1, 11.15am
Video URLs:
HQSC on fall prevention: www.youtube.com/watch?v=NdO7JCXJBO4
Comprehensive geriatric assessment (CGA) is a multidimensional, interdisciplinary diagnostic process to determine the medical, psychological and functional capabilities of a frail elderly person in order to develop a co-ordinated and integrated plan for treatment and long-term follow up
Patients in medical rehabilitation (such as for stroke or spinal cord injury) often have many medical problems that reduce their energy and cognition. If their team decides they are 'psychologically unmotivated' they are discharged prematurely to nursing homes. Appropriate medical intervention can restore 'motivation' as well.
To increase the effectiveness of the incident analysis in improving care, analysis can’t be addressed in isolation from incident management (the multitude of activities that take place before and after an incident). Three main topics will be covered in this module: the main steps in the incident management continuum; differentiating between incident analysis (focused on system improvement) and accountability reviews (focused on individual performance), and selecting an incident analysis method.
CAPA management, corrective and preventive action, Rootcause analysis, RCA, Problem mapping, FMEA, Failure Mode effect and Analysis, Fault Tree analysis, Fishbone : ISHIKAWA, CTQ Tree (Critical to Quality Tree), AFFINITY DIAGRAM, 5 Why’s, Human errors,
The process of diagnosing product problems identified during design, manufacture or use brings many challenges. The presentation will discuss ways to alleviate these difficulties using a structured, troubleshooting-based approach, and being aware of some common errors and ways of dealing with them.
• How to analyze data for low frequency failures
• Using the information from RCA for improving both prevention and detection
• Understand why finding a product solution often isn’t enough
Injurious falls is a true geriatric syndrome and serious clinical problems facing older adults.
Falls result in significant morbidity and mortality and an increased rate of nursing home placement.
This video is a talk by Dr. Prakash Khalap on 19 Mar 2016. Topic "Falls in Elderly". This is part of the HELP Talk series at HELP,Health Education Library for People, the worlds largest free patient education library www.healthlibrary.com.
Fall-related injuries can be some of the most common, disabling, and expensive health conditions encountered by adults, especially older adults. According to researcher Janice Morse, approximately 14% of all falls in hospitals are accidental, another 8% are unanticipated and 78% are anticipated falls. Guideline to prevent falls in the hospital has helped to bring down the numbers and improve patient safety.
Amputation is the removal of a limb or part of a limb by a surgical procedure in order to save the life of a person. Amputation is a triple threat. It involves loss of function, loss of sensation, and loss of body image.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
- Video recording of this lecture in English language: https://youtu.be/kqbnxVAZs-0
- Video recording of this lecture in Arabic language: https://youtu.be/SINlygW1Mpc
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Here is the updated list of Top Best Ayurvedic medicine for Gas and Indigestion and those are Gas-O-Go Syp for Dyspepsia | Lavizyme Syrup for Acidity | Yumzyme Hepatoprotective Capsules etc
Antimicrobial stewardship to prevent antimicrobial resistanceGovindRankawat1
India is among the nations with the highest burden of bacterial infections.
India is one of the largest consumers of antibiotics worldwide.
India carries one of the largest burdens of drug‑resistant pathogens worldwide.
Highest burden of multidrug‑resistant tuberculosis,
Alarmingly high resistance among Gram‑negative and Gram‑positive bacteria even to newer antimicrobials such as carbapenems.
NDM‑1 ( New Delhi Metallo Beta lactamase 1, an enzyme which inactivates majority of Beta lactam antibiotics including carbapenems) was reported in 2008
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Novas diretrizes da OMS para os cuidados perinatais de mais qualidade
Falls Prevention Direct Care
1. Falls Prevention A guide for direct care providers Click on arrows at bottom of page to advance or return to previous page
2. My 68 year old wife fell while in the hospital* for some colon surgery. The day I was to take her home she fell and hit her head.She should have been seen by a doctor immediately, but was put back in bed with a knot on her head and an ice-pack. She was on Coumadin. Falls can be tragic in their consequences Actual case—not a KMC patient. Used with permission.
3. By the time the neurosurgeon got notice of her it was 12 hours from the time of the fall. Her hematoma was very large and thick, pushing over the brain. She sustained an acute subdural hematoma. She was in a coma and I was told by two neurologists she would likely not ever gain consciousness.... Falls can be tragic in their consequences Actual case—not a KMC patient. Used with permission.
4. This was thirteen months ago. Today, thirteen months later, she is responsive and aware- but is pretty much paralyzed and speechless. She will move some with her right hand. She will smile, shrug her shoulders, wrinkle her nose, squeeze my hand, move her feet, and others. She has a trach, PEG, and ostomy. She cannot talk well, but can say her name…” She is still bedridden. We attend her everyday in the nursing home. Falls can be tragic in their consequences Actual case—not a KMC patient. Used with permission.
5. A 48 year patient described this incident as follows: “ I had surgery and they were giving me something to keep me from having pain; and they were also giving me something to help me sleep. And sometime during the night, I woke up and didn’t know where I was. ... I managed to get out of bed and I was - - I stood up and I was holding onto the - - I wasn’t completely awake ... I was walking. I was trying to get to the door. And I – - I was holding onto the bed and kind of bouncing up against the wall. And I say bouncing. I mean, you know, just guiding myself with the bed frame and the wall. ... And on the corridors, the hallways, they had some handrails that were - - that were about this wide and thin, you know, and padded and everything. And so I realized I was starting to go down, and I reached over to the left where this handrail was and I grabbed it with my left hand. And I eased myself down to the floor because I could feel that - - I was scared I was going to pass out.” Falls are costly, emotionally and financially… Actual case—not a KMC patient. Used with permission.
6. The patient reports that he twisted as he went down to the floor while holding onto the rail. Although he denied sustaining injury from this incident, he stated that sometime afterwards he began experiencing right shoulder pain that prevented him from sleeping. Over the course of the next two days the pain became worse. Eventually the patient required surgery to repair a torn rotator cuff, and has not been able to return to his former occupation. Falls are costly, emotionally and financially… The patient was awarded a large settlement. Actual case—not a KMC patient. Used with permission.
7. Imagine if you were caring for either of these patients Could you have prevented these falls? Could you have intervened more effectively after they fell? This module outlines the steps you can take to prevent falls and minimize their negative outcomes
8. Objectives: List environmental and patient factors that contribute to falls Describe interventions to reduce environment hazards Describe interventions to address patient factors Describe steps following a fall
9. The factors contributing to patient falls can be classified as environmental factors or patient factors Environmental factors refer to the environment of care, such as lighting, placement of equipment and furniture, floor coverings, maintenance, and other related factors
10. The factors contributing to patient falls can be classified as environmental factors or patient factors. Patient factors refer to patient characteristics, demographics and medical history.
11. Falls Prevention involves four elements Create a safe environment This involves addressing environmental factors that contribute to patient falls
12. Falls Prevention involves four elements Create a safe environment Assess a patient’s risk This involves evaluating a patient for the presence of risk factors
13. Falls Prevention involves four elements Create a safe environment Assess a patient’s risk Reduce falls risks Individualized interventions to address patient risk factors
14. Falls Prevention involves four elements Create a safe environment Assess a patient’s risk Reduce falls risks Evaluate Interventions How effective are falls reduction efforts and interventions following a fall?
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20. Test yourself How many environmental risk factors for falls can you name: 1. 2. 3. 4. 5. 6. … Answers on next page (test yourself before advancing)
21. Create a safe environment Environmental factor that contribute to falls: Inadequate lighting Controls beyond reach Improper Bed position/side rails Clutter: Furniture or equipment in pathways Slippery floor due to spills or overly polished Unfamiliar setting
22. Assess a patient’s risk In order to effectively intervene to reduce falls one must be aware of the various patient factors that contribute to falls…
23. Factors for Falls Patient risk factors for falls can be considered in four broad categories
24. Factors for Falls Demographic factors Older age (especially >=75 years) Female White race Living alone Common Causes of Patient Falls Accident, environmental hazards, fall from bed (Environmental factors) Gait disturbance, balance disorders or weakness, pain related to arthritis Vertigo Medications or alcohol Acute illness Chronic illness (especially two or more) Confusion and cognitive impairment Postural hypotension Visual disorder Central nervous system disorder, syncope, drop attacks, epilepsy *--Listed in approximate order of occurrence.
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26. Factors for Falls Demographic factors Older age (especially >=75 years) White race Living alone Historical factors Use of cane or walker Previous falls Acute illness Chronic conditions, especially neuromuscular disorders Medications, especially the use of four or more prescription drugs Physical deficits Cognitive impairment (However, in one large study, the majority of falls involved patients who were alert and oriented) Reduced vision, including age-related changes Difficulty rising from a chair Foot problems Neurologic changes, including age-related Decreased hearing, including age-related changes
27. Factors for Falls Demographic factors Older age (especially >=75 years) White race Living alone Historical factors Use of cane or walker Previous falls Acute illness Chronic conditions, especially neuromuscular disorders Medications, especially the use of four or more prescription drugs Physical deficits Cognitive impairment Reduced vision, including age-related changes Difficulty rising from a chair Foot problems Neurologic changes, including age-related Decreased hearing, including age-related changes Others Environmental hazards Risky behaviors
28. Factors for Falls Demographic factors Older age (especially >=75 years) White race Living alone Historical factors Use of cane or walker Previous falls Acute illness Chronic conditions, especially neuromuscular disorders Medications, especially the use of four or more prescription drugs Physical deficits Cognitive impairment Reduced vision, including age-related changes Difficulty rising from a chair Foot problems Neurologic changes, including age-related Decreased hearing, including age-related changes Others Environmental hazards Risky behaviors
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30. Test Yourself What are the four broad categories of patient risk factors? Answers on next page (test yourself before advancing)
31. Demographic Other (Example: risky Behavior) Physical Deficits Historical Test Yourself What are the four broad categories of patient risk factors?
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34. Reduce falls risks All patients identified as high risk will have a comprehensive risk reduction plan developed with the patient and family. High risk patients will be identified in a manner that respects personal privacy and dignity. “Catch a Falling Star” signs are to be used to identify high risk patients.
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36. Ruby Slippers Red (Ruby) non-slips sock are available from Central Supply for patients who are at risk for falling. Ruby slippers are easily recognizable by staff members as indicating a patient who has been identified as an increased falls risk, even when the patient is away from his or her room. The red slipper socks are to be used in addition to any sign in and near the patient’s room.
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38. Toileting and falls A highest percentage of falls are elimination related. In other words, the single most common activity associated with falls is a patient going to the bathroom. In addition to instructing and reminding patients to use the call light, regular rounding to ensure patient comfort, and keeping commode at bedside (when appropriate) can reduce falls.
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40. Patient education and falls reduction A high percentage of falls occur in patients who are alert and oriented. Patients and their families are often unaware of how their condition, medications, or procedures may effect their strength or balance. Consequently they may over estimate their ability to transfer or ambulate independently. It is up to care providers to educate patients on the various factors that might increase the risks of a fall, emphasize the use of the call light, and be available to attend to patient care and comfort needs. As with all patient education, document your interventions
41. Reduce falls risks Individualize interventions to address patient and environmental risk factors What about restraints? It is the philosophy of Kootenai Health to prevent, reduce and eliminate the use of restraints as much as possible. Interventions to reduce falls risk often have the effect of reducing the need for restraints as well. While it is preferable, it is not always possible to avoid the use of restraints,and when used properly they are a life-saving and injury sparring interventions. If restraints are needed, be aware of patient factors (such as, age, culture , past history) that place patient at higher risk of adverse response to restraints. In all cases the least restrictive alternative is the preferred means of restraints.
42. Reduce falls risks Use the resources of all members of the health care team Pharmacy - Does your patient’s medicine increase falls risk? What about the interaction of different medications? Physical Therapy- Does this patient require gait training, or other rehabilitation assistance? Nursing- Are assessments complete and up to date? Does patient history accurately reflect all risk factors? Physicians- Are all diagnostic information, treatments and interventions communicated between care providers? Others- Who else has or needs relevant information?
43. Evaluate interventions Complete Post Fall Assessments & Incident reports to allow the Falls Team to evaluate the effectiveness of interventions After a fall Individualize interventions based on complete patient picture. Ask, “What high risk factors does this patient have for complications from a fall?” (Previous injuries, medications, etc.) Periodically Evaluate the effectiveness of falls prevention measures. Have the rate of falls decreased? Keep up to date on evidence based practices to prevent falls.
45. This could have been prevented… Create a safe environment Were there any environmental hazards that if addressed could have prevented this fall?
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47. This could have been prevented… Reduce the patient’s risk Before the fall: environmental and patient factors could have been addressed. After the fall: high risk factors need to be addressed
48. This could have been prevented… Evaluate interventions Ineffective interventions had a tragic result
49. And so could this… High risks: Post surgery Pain medications and sleep aids Bed alarm or closer monitoring could have prevented this fall Ineffective assessment and intervention immediately post fall
50. Falls Prevention involves four elements Create a safe environment Assess a patient’s risk Reduce the patient’s risk with Individualized interventions Evaluate interventions
51. Falls Prevention involves four elements Create a safe environment Assess a patient’s risk Reduce the patient’s risk with Individualized interventions Evaluate interventions Remember the fifth element
52. You Your actions to: C reate a safe environment A ssess a patient’s risk R educe risks, and E valuate the effectiveness of interventions Make all the difference…
54. Falls Prevention Congratulations, you’ve completed the Module… Now what? Take the Falls Prevention knowledge assessment (last page of this presentation)
56. References American Geriatric Society, British Geriatric Society, and American Academy of Orthopaedic Panel on Falls Prevention (2001). Guideline for the Prevention of Falls in Older Persons. Journal of American Geriatric Society (49) 664-672 Evans, D., Hodgkinson, B., Lambert, L. and Wood, J. (2001) Falls Risks in the Hospital Setting: A systematic Review. International Journal of Nursing Practice (1) 38-45 Tinnetti, M. (2003) Preventing Falls in Elderly Persons. New England Journal of Medicine . 348 (1), 42-49 For any questions regarding this module or its contents contact Education Department X2720
57. Falls Prevention Knowledge Assessment- print, complete, and submit to Education Department via interoffice mail or drop in 1. Factors contributing to patients falls can be classified as : _____________________ and ___________________________ 2. The four elements of Falls Prevents are: ________________________________ ________________________________ ________________________________ ________________________________ 3. Give an examples of an environmental risk factors and appropriate interventions: Factor ___________________________________________________________ Intervention_______________________________________________________ 4. Restraints are the preferred intervention to reduce falls True False 5. Alert and oriented patients can be assumed to be low risk for falls True False 6. The activity most frequently associated with falls is going to the bathroom True False 7. Both the number of medications and types of medications are risk factors for falls True False 8. Risk of falls increases with age True False 9. The only time it’s necessary to assess for falls risk is on admission True False Printed name ____________________________________________ Title ___________________ Dept. ____________________________________________ Date _____________ Signature ___________________________ (signature certifies that I have read and understand the material in this presentation and in the Falls Prevention Guide) To print , find and click on this symbol above on left Important: When a box like this opens, under Print Range select Current page Then click OK