Falls program

Several components of the program and illustrations in this publication are used courtesy of the Department of Preventive Medicine in the Vanderbilt University School of Medicine. PDF version 7. Content last reviewed December Browse Topics.

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Next Page. Introduction and Program Overview Chapter 2. Fall Response Chapter 3. Long Term Management Chapter 5. Potential consequences for facilities are listed in Figure 2. Figure 2. Adverse consequences of falls for nursing facilities Increased paperwork for staff. Increased levels of care required for fallers. Poor survey results. High insurance premiums. Many nursing facilities have fall programs in place, but recognize that there is always room for improvement.

While not all falls and injuries can be prevented, it is critical to have a systematic process of assessment, intervention and monitoring that results in minimizing fall risk.

Causes of Falls The FMP helps facility staff to identify and intervene, whenever possible, on the common causes of falls.

Figure 3. Common fall risk factors Intrinsic factors Effects of aging on gait, balance and strength. Acute medical conditions. Chronic diseases. Deconditioning from inactivity. Behavioral symptoms and unsafe behaviors. Medication side effects. Extrinsic fall risk factors Environmental hazards. Unsafe equipment.

Unsafe personal care items. Figure 4. Examples of specific extrinsic risk factors Poor lighting. Cluttered living space.

Uneven floors, wet areas. Unstable furniture. Unstable bed wheels. Ineffective wheelchair brakes. Missing equipment parts. Improper footwear. Hard-to-manage clothing. Inaccessible personal items. Culture of Safety The term "culture of safety" is used to describe how the behavior of staff and management affects the safety of residents.

Figure 5 Figure 5. Culture of safety checklist Strong leadership. Clearly defined safety policies. All staff to identify and report safety concerns. Empowerment of staff to correct safety problems. Enforcement of safety policies by supervisors and managers. Regular measurement of staff safety performance. Analysis and review of procedures. Safety data and trends provided to all staff. Table 1. Responsibilities of the administrator and director of nursing Appoint a nurse coordinator, a back-up coordinator, and a falls team to meet each week.

Set specific goals for the facility using key indicators. Be involved in the team meetings on a regular basis. Give the falls team members enough time away from other duties to meet weekly and implement the program.

Ensure that the team members are given the authority to complete appointed tasks. Help identify and remove barriers that prevent the team members from completing their tasks. Provide a small budget to repair safety problems found in the environment and with equipment. Provide a small budget to adapt wheelchairs and to obtain seating items and specialized equipment. Monitor progress and guide data collection and analysis. Teamwork Interdisciplinary teamwork is essential for success in the FMP and the selection of members is an important first step.

Figure 6. Falls Team Falls Nurse Coordinator. Falls Nursing Assistants Falls Therapist. Falls Engineer. Table 2. Team meeting agenda Clarify objectives The goal of this meeting is to discuss program implementation by team members, residents who fell this past week and this month's falls data. Review agenda Report from all team members about activities for the week.

Example: The Falls Engineer reports he has completed 10 wheelchair inspections this week. Discussion about individual residents who fell during the past week. Presentation of this month's falls data. Work through agenda Discuss barriers that members may be experiencing when trying to complete their assignments.

Ask administration for support if needed. Example: The CNAs have not had time to do any room inspections this past week. The Otago Exercise Program OEP is a series of 17 strength and balance exercises delivered by a Physical Therapist or a Physical Therapy Assistant in the home, outpatient or community setting that reduces falls between 35 and 40 percent for frail older adults.

This evidence-based program calls for Physical Therapists to assess and progress older adults through an eight-week clinical phase and then the older adult is transitioned to a self-management phase for four to 10 months.

During this time, the older adult is supported by monthly phone calls and check ins at months six and 12, if needed. There are opportunities for Physical Therapists to collaborate with community providers to support dissemination and implementation of the OEP. Stay Active and Independent for Life.

Performing exercises that improve strength, balance, and fitness are the single most important activity that adults can do to stay active and reduce their chance of falling. The entire curriculum of activities in the SAIL program can help improve strength and balance, if done regularly. SAIL is offered three times a week in a one-hour class. SAIL exercises can be done standing or sitting. The SAIL program is able to accommodate people with a mild level of mobility difficulty e.

About 30 percent of older people who fall lose their self-confidence and start to go out less often. Inactivity leads to social isolation and loss of muscle strength and balance, increasing the risk of falling.

Stepping On aims to break that cycle, engaging people in a range of relevant falls prevention strategies. Tai Chi for Arthritis and Falls Prevention.

Many studies have shown Tai Chi to be one of the most effective exercises for preventing falls. Tai Chi for Arthritis and Falls Prevention helps people with arthritis to improve all muscular strength, flexibility, balance, stamina, and more. Tai Chi for Prime. Tai Chi Prime is a six-week class series proven to reduce the risk of falling. Classes feature instruction in tai chi and qi gong basics, home practice coaching, home practice, and exercises to embed into activities of daily living.

Each session consists of warm-up exercises; core practices, which include a mix of practice of forms, variations of forms, and mini-therapeutic movements; and brief cool-down exercises. Moving For Better Balance is a week instructor-led group program designed to improve strength, mobility, flexibility, and balance for enhanced overall physical health and better functioning in daily activities. Participation in the program may also result in better mental health, reduced stress, improved memory and cognition, and increased self-esteem.

The program, based on the principles of Tai Chi, teaches eight movements modified especially for falls prevention.