Preventing Falls.

1. Module 3
Preventing Falls
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2. Learning Objectives
• At the end of this lecture the student will be able to:
1. Define the key terms and key abbreviations in this chapter.
2. Identify the causes and risk factors for falls.
3. Describe the safety measures that prevent falls.
4. Explain how to use bed and chair alarms safely.
5. Explain how to use bed rails safely.
6. Explain the purpose of handrails and grab bars.
7. Explain how to use wheel locks safely.
8. Describe how to use transfer/gait belts.
9. Explain how to help the person who is falling.
10. Perform the procedures described in this chapter.
11. Explain how to promote PRIDE in the person, the family, and yourself.
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3. KEY TERMS
 Bed rail: A device that serves as a
guard or barrier along the side of the
bed.
 Position change alarm: Any
physical or electronic device that
monitors a person’s movement and
alerts staff of movement.
 Transfer belt and Gait Belt: A
device applied around the waist and
used to support a person who is
unsteady or disabled; gait belt.
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4. KEY TERMS
 Hazard: A Hazard is a potential
source of harm or adverse health
effect on a person or persons.
 Risk: Risk is the likelihood that a
person may be harmed or suffers
adverse health effects if exposed to a
hazard.
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5. Key Abbreviations
• CDC : Centers for Disease Control and Prevention
• CMS : Centers for Medicare & Medicaid Services
• ID: Identification
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6. INTRODUCTION
 The risk of falling increases with age.
 Persons older than 65 years are at risk.
 A history of falls increases the risk of falling
again.
 Falls are the most common accidents in
nursing centers.
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7. INTRODUCTION
 According to the Centers for Disease Control and
Prevention (CDC):
 Each year, over ¼ of adults aged 65 and older fall.
 Falls are the main cause of injuries and injury-
related deaths in older adults.
 Falls can cause serious injuries. Head injuries and
fractures of the wrist, arm, ankle, and hip are
examples.
 Fear of falling affects quality of life. The person
may limit daily and social activities. Depression,
feelings of helplessness, and social isolation can
result. Less active, the person becomes weaker
with an increased risk of falling.
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8. What is a fall?
The Centers for Medicare & Medicaid Services (CMS) defines a fall as:
• Unintentionally coming to rest on the ground, floor, or other lower
level. Force, such as being pushed, was not involved.
• When a person loses balance and would have fallen if staff did not act
to prevent the fall.
• When a person is found on the floor unless matters suggest otherwise.
• When a person falls but is not injured. A fall without injury is still a fall.
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9. Causes and Risk
Factors for Falls
Most falls are caused by many risk factors. The more
risk factors present, the greater the risk of falling.
Fall Risk Factors
 Care Setting
 The Person
 Long-Term Care-Home Care
 Teamwork and Time Management
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10. Fall Risk Factors
• Care Setting
• Bed height: too low or too high
• Care equipment: IV (intravenous) poles, drainage
tubes and bags, and others
• Floors: cluttered, wet, slippery, or uneven
• Furniture out-of-place
• Lighting: poor or glares
• No handrails or grab bars
• Restraint use
• Setting: new, strange, and unfamiliar
• Throw rugs or other tripping hazards
• Wet and slippery bathtubs and showers
• Wheelchairs, walkers, canes, and crutches:
improper use or fit.
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11. Fall Risk Factors
• The Person
• Age: over 65 years
• Alcohol: over-use
• Balance problems
• Blood pressure: low or high
• Confusion; disorientation
• Depression
• Dizziness or light-headedness; dizziness on standing
• Drug side effects
• Confusion and disorientation
• Coordination: poor
• Diarrhea
• Dizziness
• Drowsiness
• Fainting.
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12. Fall Risk Factors
• The Person
• Low blood pressure when standing or sitting
• Unsteadiness
• Urination: frequent
• Elimination: incontinence (urinary or fecal),
frequency, urgency, urinating at night (nocturia)
• Falls: history of; fear of falling
• Foot problems; foot pain
• Gait: unsteady
• Joint pain and stiffness
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13. Fall Risk Factors
• The Person
• Judgment: poor
• Memory problems
• Mobility: impaired
• Pain
• Reaction time: slow
• Shoes that fit poorly; no shoes or shoes without
slip-resistant surfaces
• Sleep problems
• Vision problems
• Weakness; leg weakness
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14. Fall Risk Factors
• Long-Term Care
Nursing center residents are at increased risk
for falls. Weakness and walking problems are
common causes. Care setting hazards are other
causes—poor lighting, wet floors, incorrect bed
height. Other risk factors are transfer problems,
shoes that fit poorly, and improper use or fit of
wheelchairs, walkers, canes, and other devices.
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15. Fall Risk Factors
• Home Care
In the home, many factors increase fall risks.
Hazards include:
• Cluttered rooms, stairways, and hallways
• Objects on the floor and stairways—wires, cords, shoes,
books, magazines, blankets, and so on
• Throw rugs
• Pets
• Flooring problems—loose tiles and floorboards, raised
linoleum, frayed carpet
• Wet floors and slippery bathtub or shower floors
• Ice or snow on driveways, steps, and sidewalks
• Loose or missing handrails and grab bars
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16. Fall Risk Factors
• Home Care
• Poor lighting
• No footwear or unsafe footwear—slippers,
shoes without slip-resistant surfaces, and shoes
with long shoelaces
• Adaptive (assistive) devices that need repair—
walkers, canes, wheelchairs
• Having to climb or reach for objects
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17. Fall Risk Factors
• Teamwork and Time Management
• The health team must protect the person. If you
see something unsafe, tell the nurse at once. Do
not assume the nurse knows or that the matter
is being corrected.
• Answer call lights promptly. This includes the
call lights of patients and residents assigned to
co-workers.
• During shift changes, staff are busy going off
and coming on duty. Confusion can occur about
who gives care and answers call lights. Falls can
result. Know your role during shift changes.
Nursing staff must work together to prevent
falls.
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18. 4. Every family has a structure.
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19. Copyright © 2018 Wolters Kluwer • All Rights Reserved
Family Life
Cycle

20. 3. Every family has its own cultural values and rules:
Family culture is the acquired knowledge that family members use to interpret their
experiences and to generate behaviors that influence family structure and function.
Family culture considerations:
A. Family members share certain values that affect family behavior.
B. Certain roles are prescribed and defined for family members.
C. A family’s culture determines its distribution and use of power.
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21. 3. Every family has certain basic function
A. Providing
affection
B. Providing
security and
Acceptance
C. Instilling
identity
D. Promoting
affiliation and
Companionship
E. Providing
socialization
F. Establishing
controls
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22. Family Values and Their Effect on Behavior
 Every family has its own set of values and rules for operation.
 Like all cultural values, many family values remain outside the conscious awareness of family
members.
 These values, often not verbalized, become powerful determinants of what the family believes,
feels, thinks, and does.
 Family values include those beliefs transmitted by previous generations, religious influences,
immediate social pressures, and the larger society.
 Values become an integral part of a family's life and are difficult to change
 Cultural values such as the following shape most decisions and choices in our lives: Education,
Sex roles, Health care, Courtship/marriage, Lifestyle, and Childrearing

23. Types of families
1. Nuclear
2. Single-adult families
3. Multi-generational families
4. Single-parent family
5. Childless family.
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24. Types of families :
1. Nuclear = husband , wife and kids

25. 2- Single-adult families = one adult living alone either by choice or because of separation, divorce, or
death.
TYPES OF FAMILIES :

26. 3- Multi-generational
families- Several
generations or age
groups living together
in the same
household.
TYPES OF FAMILIES :

27. TYPES OF FAMILIES :
4. Single-parent family: One adult caring for a child or
children as a result of separation, divorce, death, or by
choice.

28. TYPES OF FAMILIES :
5- Childless family is simply a group of people for
whatever reason, have never had children.
• Due to the aging of the population or couples deciding not to have
children.
• Families without children have different interests, more free time
and often greater financial resources than couples with children.

29. Characteristics of healthy family
A. Healthy interaction among members
Effective communication
Discuss problems
Confront each other
Share idea and concern….etc.
B. Enhancement of individual development
Promote each member growth
C. Effective structuring of relationships.
Structure their role relationship to meet changing family needs over time
(flexibility of role).
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30. Characteristics of healthy family
D. Active coping efforts
- Actively attempt to overcome life’s problems and issues
E. Healthy environment and life-style
- Create safe and hygienic living conditions for their members.
F. Regular links with the broader community
- Maintain dynamic ties the broader community
- Participate regularly in external groups and activities
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31. Role of the family health nurse
1. Help the families to cope with illness and chronic disability, or during time of stress
2. Give advice on lifestyle and Health risks factors as well as assisting families with
matters concerning health.
3. Through prompt decision, they can ensure that the health problems of families are
treated at an early stage.
4. Identify the effects of socio-economic factors in a family‘s health and refer them to
the appropriate agency.
5. Can facilitate the early discharge of people from the hospital by providing nursing
care at home, and act as the lynchpin between the family and the family health
physician.
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32. Reference
Rector, C. & Stanley, M. (2022) Community and Public
Health Nursing: Promoting the Public’s Health. 9th. ed.
Wolters Kluwer.

33. Any Question
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