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ELDERLY PATIENT FALLS
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NEEDS ASSESSMENT:
The following needs assessment is based on a scale from 1 to 5, with 5 being Complete
Agreement with the statement and 1 being Does Not Agree At All. Read each statement and
choose a number 1 through 5 that best describes whether you agree.
1. Elderly patients who are known to be at high risk should be evaluated at regularly
scheduled intervals to be assured their condition is not deteriorating. The assessment
should be performed by a qualified health care practitioner who specializes in diseases
and illnesses of the elderly. Family members should also be required to report any
possible changes that may be occurring while the patient is at home or away from the
facility.
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2. Nurses and health care practitioners should use all resources available to evaluate
an elderly person to determine their risk of falls and accidents. Past medical history,
interviews with family members and a physical assessment of the patient should all be
used. Utilizing past health records and charts is an important way to determine if falls are
becoming more frequent or are establishing a pattern.
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ELDERLY PATIENT FALLS
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3. Nurses bear a large amount of responsibility in monitoring patients while they are
providing care. Patients and their family member’s must bear modest amounts of
responsibility in reporting falls and making sure the family member is safe and their
environment is secure. The patient, depending on their level of comprehension, must also
share a portion of the burden if a fall occurs.
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4. Nurses and other health care practitioners must learn safety measures to protect both
themselves and their patients from injury. Proper lifting techniques must be used when
lifting or assisting patients on an off the commode or transferring them between furniture
and bed or wheelchair. Safety apparatus’ that are available for use must be in place and
operational at all times to help secure patients.
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5. Patients who may be experiencing an increase in falls or an increase in the overall risk of
falls and accidents must be put through an intervention. The intervention will take place
to determine if the individual meets the criteria needed for them to be removed from their
home and placed in a rehabilitation center or long term assisted living facility.
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ELDERLY PATIENT FALLS
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6. Elderly patients may be required to change their living arrangements if their risk of
falling increases to a point that it is no longer safe for them to live or work on their own.
They must be made to accept the fact that their health and well-being is more important
than their independence and desire to remain in their own home. Patients may also be
forced to consider taking in a roommate or some type of caregiver that can assist with
tasks such as bathing, cooking and cleaning.
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7. Nurses should be able to remove any object from a patient’s environment that increases
their risk of falling or reduces their level of safety. A patient’s family must be able to
take possession of the items and remove them from the living area to reduce the elderly
patient’s risk of falls and other types of accidents. Nurses, physicians and other qualified
health care practitioners should have the right to refuse the placement of an object within
the patient’s living area, if it is known that it will increase the risk of injury to the patient
due to a fall or other accident.
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8. Nurses and other qualified health care practitioners should be able to add more beneficial
foods to an elderly patient’s diet plan to help increase overall health and reduce the risk
of injury if a fall or accident should occur. Physicians should also be able to alter the
patient’s diet so that healthier nutrients are more prevalent than junk food or foods with
empty calories.
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9. Fall prevention plans for elderly patients should be discussed and implemented whether
or not it has been determined the patient classifies as high risk. Developing a plan after
the first fall will allow for action to be taken if falls occur in the future. Nurses and health
care practitioners should base the plan on a combination of the patient’s overall health
and research performed on patients who have had similar conditions.
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10. Nurses and qualified health care professionals in charge of creating a needs assessment
for a patient who is at high risk for falling should gain information from as many sources
as possible, including performing a thorough evaluation of the patient’s current living
environment. Families should be required to answer any and all questions pertaining to
the health issues of their family member. Physicians and health care practitioners should
also be relied upon to produce the necessary documentation that will allow the nurse
to make an informed, detailed and accurate assessment. Obtaining all of the pertinent
information will ensure the safety of the patient and help to prevent them from being
injured during a fall.
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11. Every employee in a facility is responsible for the health and safety of the patient. If a
patient falls, everyone who is employed for the facility should be held responsible for
their injuries. From the CEO to the dietician, each person plays a role in helping to keep
each patient safe within the facility. It is everyone’s obligation to observe the patient’s
ELDERLY PATIENT FALLS
and the environment they reside in and report any possible dangers to members of
management or nurses who can correct the issue.
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PRE-TEST QUESTIONNAIRE
1. As a caregiver and a nurse, what do you foresee as your responsibility in caring for your
patients?
a. Evaluating each patient’s potential risk for falls on a regular basis
b. Eliminating obstacles that increase the patient’s risk of falling
c. Charting falls and documenting details
d. All of the above.
2. If a patient who has a high risk of falls is placed under your care, how do you ensure their
safety?
a. Evaluate their condition to determine how mobile they are.
b. Remove any obstacles that might be in their way.
c. Make sure they have enough room to maneuver through an area
d. All of the above
3. How do you determine if a patient is at risk for falls if they are not labeled as high risk?
a. Monitor their movements
b. Evaluate how stable they are when they walk and move
c. Ask them how confident they are with their ability to walk and move
d. Read through their chart to determine if they have fallen before
e. All of the above
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4. What factors determine if a patient is at risk for falls?
a. Past medical history
b. Progression of current conditions such as Alzheimer’s, arthritis, etc.
c. Level of physical strength
d. All of the above
5. How do you notify others that a patient is at high risk for falls?
a. Chart extensively about the patient’s past history of falling
b. Discuss the patient and their needs with the person who takes your position in the
following shift
c. Discuss the situation with the attending physician
d. Let the patient notify them
6. How do you establish a safe environment for patients who are at high risk of falling?
a. Monitor their overall health to determine if they are stable enough to move around
without assistance
b. Notify other caregivers of the situation
c. Remove unneeded furniture and obstacles
d. Chart any changes in their health
e. All of the above
7. If a patient falls who is not labeled as high risk, who is responsible?
ELDERLY PATIENT FALLS
a. the nurse
b. the physician
c. the patient
d. the burden is equally shared
8. What are the most important factors when assessing a patient?
a. age
b. health condition
c. medications being taken
d. past medical history
9. What is the least important factor when assessing a patient?
a. behavioral problems
b. time of day
c. state of mind
d. number of obstacles in the room
10. What steps can a facility take to prevent falls from occurring?
a. Monitor patients often, especially those labeled high risk
b. Keep pathways wide open and clear of obstacles
c. Assist patients at all times when moving from one place to another
d. All of the above
11. Who is responsible for informing a patient after they have been labeled as high risk?
a. The family of the patient
b. The physician
c. The nurse
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ELDERLY PATIENT FALLS
d. The physical therapist
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12. When documenting a fall, what information do you include?
a. The cause of the fall
b. The patient’s condition at the time
c. Any injuries or abnormalities that resulted from the fall
d. All of the above
13. How should a caregiver react when a patient wants to do something that increases his or her
risk of falling?
a. Explain to the patient why they should not attempt it
b. Tell the patient to discuss it with the physician
c. Talk to the family
d. Tell them no
14. How do you prevent a “high risk” patient from wandering?
a. Use restraints
b. Tell them no
c. Limit their area of movement
d. Sedate them
15. Who has the final decision on when restraints can and should be used?
a. The patient
b. The patient’s family
ELDERLY PATIENT FALLS
c. The physician
d. The nurse
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16. What are the steps in the reporting process when documenting a patient’s fall? List in order.
a. Chart the fall and document all details
b. Assist the patient and evaluate for injuries
c. Determine the cause and prevent it from happening again
d. Call the physician to let them know the situation and condition of the patient.
ELDERLY PATIENT FALLS
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POST TEST QUESTIONNAIRE
1. After taking the course, who do you feel is responsible if a patient falls?
a. The physician
b. The patient
c. The nurse
d. All of the above
2. Who is responsible for charting and documenting a patient’s fall?
a. The patient
b. The physician
c. The nurse
d. Whoever witnessed the fall
3. What factors do you feel should be used to label a patient high risk for falls?
a. age
b. health conditions
c. use of medications
d. past and current medical charts and records
4. What is a nurse’s main responsibility when caring for their patients?
a. Ensuring their safety by preventing falls and mishaps
b. Keeping them comfortable
c. Tending to their health care needs
ELDERLY PATIENT FALLS
d. All of the above
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5. What are some identifiable risks that could cause a patient to fall?
a. Cluttered aisles and walk ways
b. Unstable gait due to the progression of a degenerative disease
c. Overmedication
d. All of the above
6. What are a nurse’s responsibilities when advocating for their patients?
a. Reporting observations that could change the patient’s treatment plan
b. Monitoring a patient’s condition and keeping family informed of changes
c. Ignoring a patient’s request for help
d. Not charting accurately or leaving out information
7. To what extents are nurses allowed to go to when ensuring the safety of their patients?
a. Discuss needed changes with the attending physician
b. Don’t allow the patient to get out of bed or move on their own
c. Tell the patient’s family they are high risk
d. Discuss the patient’s condition with other staff members
8. What is the most important factor in preventing falls?
a. Ensuring the safety of the patient
b. Eliminating obstacles
c. Discussing possible treatment plans
d. Limiting the patient’s ability to wander
ELDERLY PATIENT FALLS
e. All of the above
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9. If a high risk patient refuses their right to receive health care and attempts to leave?
a. Let them leave
b. Talk to them and try to change their mind
c. Call for the attending physician
d. Place them in restraints.
10. Who is responsible for removing obstacles in a patient’s home environment?
a. The family of the patient
b. The patient
c. The physician
d. The nurse
11. If a patient disregards their physician’s advice and falls after being warned not to do
something, who is liable?
a. The patient
b. The family of the patient
c. The nurse
d. The physician
12. Which element of charting is most important?
a. The cause of the fall
b. Injuries sustained in the fall
c. Patient’s medical condition at the time of the fall
ELDERLY PATIENT FALLS
d. The aftermath of the fall: preventative measures, etc.
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13. What elements should be present in relation to working with a patient’s family?
a. Honesty
b. Compassion
c. Open lines of communication
d. All of the above
14. Who should discuss major changes in a patient’s high-risk classification when talking to
their family?
a. The patient’s primary physician
b. The nurse
c. A physical therapist
d. Another family member
15. When working in a long term health care facility, who is responsible for monitoring a
patient’s living quarters?
a. The nurse
b. The patient’s family
c. The patient’s physician
d. The patient
16. What are the necessary tools for performing the duties of a nurse when caring for patients
who fall frequently?
a. The ability to evaluate a patient’s health condition
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b. The ability to accurately chart all facets of the patient’s health care and treatment plan
c. The ability to assess a patient’s environment and secure it for their safety
d. All of the above
17. What is needed to help convince family members that a patient’s environment should
change?
a. Pros and cons of the patient losing their independence
b. The potential risks of the patient staying in a dangerous environment
c. The liability issues involved with not ensuring a patient’s continued safety
d. All of the above
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