5.1 Fall Prevention and Safe Environment
Key Takeaways
- Falls are a major risk in long-term care and often result from toileting needs, poor footwear, clutter, weakness, or confusion.
- Keep the bed low, wheels locked, call light within reach, and pathways clear.
- Use the resident's care plan for transfers and mobility assistance.
- Never leave an unsafe resident standing, on a bedpan, or at the edge of bed unattended.
- After a fall, do not move the resident unless there is immediate danger; call the nurse.
Fall Prevention Is Daily Care
Fall prevention begins before a resident stands. CNAs reduce risk by anticipating needs, keeping the environment safe, and using the correct level of assistance.
High-risk residents may have:
- Weakness or poor balance.
- Confusion or impulsivity.
- Urinary urgency.
- Dizziness or low blood pressure.
- New medication effects.
- Poor vision.
- Unsafe footwear.
- History of falls.
Room Safety Checklist
| Safety Item | CNA Action |
|---|---|
| Bed | Low position unless providing care |
| Wheels | Lock bed and wheelchair before transfers |
| Call light | Keep within reach |
| Pathway | Clear clutter, cords, and spills |
| Footwear | Use non-skid shoes or socks |
| Assistive devices | Keep walker, cane, or wheelchair available |
| Lighting | Use adequate light, especially at night |
Toileting And Falls
Many falls happen when residents rush to the bathroom. Answer call lights promptly. Offer toileting on schedule for residents with known urgency.
If a resident is on a bedpan, provide privacy but do not abandon safety. Keep the call light in reach and return promptly.
After A Fall
The CNA should stay with the resident, call for the nurse, and avoid moving the resident unless there is immediate danger. Moving the resident can worsen an injury.
Report exactly what happened and what you observed. Do not blame, hide, or assume the resident is fine.
Exam Tip
The safest answer usually prevents a fall before it happens. If the fall already occurred, the safest answer protects the resident from further injury and gets the nurse.
A resident is found on the floor beside the bed. What should the CNA do first?
Which setup best prevents falls?