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University of Nebraska Medical Center

Interventions to Reduce Fall Injury Risk

illustration of bandages
Despite our best efforts, some patients will fall. Therefore, it is also appropriate to consider interventions that reduce a patient’s risk of injury, in the event a fall occurs. An easy way to think about injury risk is the ABCs (age, bone, coagulation, and surgery).

Potential Interventions

A list of interventions that may be of benefit to these patients include:

Potential Intervention Rationale
Bed in low position Lowering the height a patient may fall from if he/she leaves the bed unassisted will help attenuate force to reduce the risk of fracture and bruising.
Bedside floor mats Attenuate force to reduce risk of fracture and bruising if the patient attempts to leave the bed unassisted and falls.
Handoff to communicate risk Transfer important information about a patient’s fall risk to another staff member caring for that patient.
Hip protectors Redirect or attenuate force at the hip to reduce risk of fracture if a patient falls.
Medication review by pharmacy Some medications, while necessary to prevent blood clots, may place the patient at higher risk of internal bleeding in the event of a fall. A pharmacist can help appropriately manage the use of anticoagulants and assess for the need to adjust other medications which may contribute to fall risk.
Patient/family education Help patients and families understand potential consequences of falls.
Supervised toileting Provide close monitoring and/or physical assistance as needed to reduce fall risk or assist a fall, should one occur. While there are competing tensions between patient privacy and safety when it comes to toileting, the bathroom is an important place for staff to provide supervision and assistance due to the difficulty patients may have with transferring and managing clothing, as well as multiple hard surfaces that can cause injury in the event of a fall.
Visible identification of risk Use of signage, colored bracelets, and/or socks helps all staff visually identify if a patient is at risk for falls.

Injury Risk Education

  • Implementation Guide: The Implementation Guide for Fall Injury Reduction from the Veterans’ Affairs National Center for Patient Safety Falls Toolkit provides a definition of injury, goals for injury risk reduction, and an overview of the ABCs as risk factors for injury (see Appendix A).