The last few articles have reviewed the role of a number of factors and their impact on patient falls. The role of the environment cannot be overstated in maintaining patient safety, especially in the area of preventing falls.
A comprehensive assessment of the home environment should be part of the other assessments mentioned in identifying the risk for patient falls.
Screening for Hazards
The following are questions which can be asked while doing a walk through with a patient or a family member.
| Assessments | Recommendations |
| When you walk through a room, do you have to walk around furniture or piles of paper? | Move the furniture so your path is clear. |
| Do you have throw rugs on the floor? | Remove throw rugs or use double-sided tape or a non-slip backing so the rugs won’t slip. |
| Are there papers, books, towels, shoes, magazines, boxes, blankets, or other objects on the floor? | Pick up any objects that are on the floor. |
| Do you have to walk over or around wires or cords (like lamp, television, or extension cords)? | Coil or tape cords and wires next to the wall so you can’t trip over them. If needed, have an electrician put in another outlet. |
| Do you have slick floors? | Use non-slip or non-skid floor wax or none at all. If you have hardwood floors, consider carpet. |
| Do you have burned out bulbs or dim lighting in your home? | Replace burned-out or dim bulbs with the highest wattage bulbs allowed for each fixture in all rooms and stairways. |
| Do you have non-working or no flashlights in your home? | Replace non-working flashlights. Put several flashlights throughout your house and check the batteries regularly. |
| Can you reach your phone from the floor? | Keep a phone on a low table within reach of the floor. |
| Are there papers, shoes, books, or other objects on the stairs? | Pick up any items that are on the stairs. |
| Are some steps loose, broken, or uneven? | Fix loose, broken, or uneven steps. |
| Is your stairway dark? | Have an electrician put in an overhead light at the top and bottom of the stairs. |
| Is the carpet on the steps loose or torn? | Make sure the carpet is firmly attached to every step, or remove the carpet and attach non-slip rubber treads to the stairs. |
| Are the handrails loose or broken? Is there a handrail on only 1 side of the stairs? | Fix loose handrails or put up new Ones, making sure handrails are on both sides of the stairs and are as long as the stairs. |
| Are the things you use most on high or low shelves? | Move items so that the things you use most often are on shelves at about waist level. |
| Is your step stool unsteady? | • If you must use a step stool, get one with a bar to hold on to. Never use a chair as a step stool. |
| Is the tub or shower floor slippery? | Put a non-slip rubber mat or self-stick strips on the floor of the tub or shower. |
| Do you need support or help when you get in or out of the tub or up from the toilet? | Install grab bars inside the tub and next to the toilet. |
| Is the path from your bed to the bathroom dark? | Put in a night light so you can see where you’re walking. Some night lights go on by themselves after dark. |
Source: Home safety plan from Falling Less in Kansas
- Walking around a patient’s house and intervening early by making a few modifications can be a very powerful step in significantly reducing the risk for falling.
Sources
- Ellenbecker, C.H., Samia, L., Cushman, M.J., Alster, K. (). Patient Safety and Quality in Home Health Care. Retrieved from http://www.ahrq.gov/qual/nurseshdbk/docs/EllenbeckerC_PSQHC.pdf
- Wichita State University. Falling Less in Kansas (Falling LinKS). http://webs.wichita.edu/?u=AGING&p=/FallingLinKS/Page1/
