What your profession can do to prevent falls

Falls are everybody’s responsibility

Doctor to:

• review medication
• manage delirium and depression
• treat osteoporosis
• consider calcium and vitamin D supplements.

Nurse to:

• complete the Falls Risk Assessment and Management Plan (FRAMP)
• refer to falls prevention intervention guidelines
• orientate to ward and minimise change
• follow mobility chart
• respond to patient call as a priority
• follow nursing care plan for continence and bed rails, keep call bell and mobility aid in reach.

Physiotherapist to:

• maintain up-to-date mobility chart
• provide appropriate walking aid, and clearly label
• check bed and chair height
• provide appropriate exercise program for balance, strength and mobility.

Occupational therapist to:

• monitor and review equipment
• encourage patient activity
• encourage independence and safe self-care.

Pharmacist to:

• identify medications that may predispose patients to falls and review.

Podiatrist to:

• screen and assess for foot problems and provide appropriate management
• advocate for appropriate footwear.

Patient support staff to:

• return bed to correct height
• place drinks, possessions and call bell within reach
• check mobility chart for level of assistance required.

Collaborating with patients and their family/carers

All staff have a role in educating patients and their family/carers about falls. The following resources from Stay On Your Feet WA^® are useful tools to assist delivery of falls education:

• The Preventing falls – your hospital stay (Healthy WA) webpage provides general advice for patients on how to prevent falls in hospital and also when they return home from their hospital stay. This can be ordered as a brochure from the Online Publication Ordering System (external site)
• The Health advice following a fall flyer (PDF 186KB), a double-sided A4 flyer, should be given to patients who are being discharged from hospital and have had a recent fall. It outlines symptoms to watch out for in case of further problems.
• More patient education resources are available from Stay On Your Feet WA® (external site).

This education should help patients and carers understand their responsibilities around falls prevention while in hospital, and when they go home. Some of these are listed below.

Patient responsibilities may include:

• seeking help when needed and waiting for assistance from staff
• following instructions from staff
• wearing appropriate clothing and footwear
• using mobility and sensory aids/equipment correctly
• staying as active as possible
• moving slowly from lying and sitting
• collaborating in the development of their falls risk management plan.

Family/carer responsibilities may include:

• reinforcing instructions
• facilitating correct clothing and footwear
• leaving bed area uncluttered
• leaving patient items within reach
• encouraging safe exercise and walking.

When staff work in partnership with patients, family/carers and convey clear and consistent messages, all parties become engaged in falls prevention.

This results in:

• improved patient outcomes
• harm minimisation
• a shift in culture to one centred on excellence in patient safety.