6.1 Fall Prevention in Illinois Long-Term Care Facilities
Key Takeaways
- Falls are the leading cause of injury in long-term care and the most common incident reported to IDPH
- 50-75% of nursing home residents fall each year; many falls are preventable
- Key prevention: call light within reach, bed in lowest position, non-slip footwear, toileting schedule
- Do NOT try to catch a falling resident — guide them safely to the floor and protect their head
- After a fall: stay with the resident, call for help, do not move them until nurse assesses
- Document all falls with an incident/occurrence report as required by Illinois regulations
Last updated: March 2026
Falls are the leading cause of injury and death from injury in adults over 65, and they are one of the most common reportable incidents in Illinois long-term care facilities. IDPH closely monitors fall rates, and facilities with excessive falls may face citations and corrective action plans. As a CNA, you are on the front line of fall prevention.
Fall Statistics in Long-Term Care
- 50-75% of nursing home residents fall each year (compared to 30% of community-dwelling elderly)
- Falls result in serious injury 10-25% of the time
- Hip fractures are the most serious fall-related injury — 25% of elderly hip fracture patients die within one year
- Falls are the most common incident reported to IDPH in Illinois LTC facilities
- Many falls are preventable with proper assessment and intervention
Fall Risk Factors
| Category | Risk Factors |
|---|---|
| Intrinsic (Patient) | Age >65, history of previous falls, weakness, unsteady gait, confusion, vision impairment, urinary urgency/incontinence, depression, fear of falling |
| Medication-Related | Sedatives, hypnotics, antihypertensives, diuretics, opioids, psychotropic medications, polypharmacy (4+ medications) |
| Extrinsic (Environmental) | Wet floors, cluttered pathways, poor lighting, improper footwear, unfamiliar environment, bed height, absence of grab bars |
| Situational | Toileting attempts, first day post-admission, nighttime, after position changes (orthostatic hypotension) |
Fall Prevention Strategies for CNAs
Patient-Centered Interventions:
| Strategy | Implementation |
|---|---|
| Call light | Always within reach — check every time you leave the room |
| Bed position | Lowest position when not providing care, wheels ALWAYS locked |
| Non-slip footwear | Proper-fitting shoes or gripper socks — never bare feet or loose slippers |
| Assistive devices | Walker, cane, wheelchair within reach and in good condition |
| Toileting schedule | Anticipate needs — take residents to the bathroom on schedule |
| Night lights | Ensure adequate lighting, especially path to bathroom |
| Personal items | Glasses, hearing aids, phone within arm's reach |
| Gait belt | Use during transfers and ambulation per care plan |
| Orientation | Orient new residents to their room, call light, and bathroom |
Environmental Safety:
| Area | Safety Measures |
|---|---|
| Room | Clutter-free, clear pathway to bathroom, bedside commode if needed |
| Bathroom | Grab bars, non-slip mats, elevated toilet seat, call light accessible |
| Hallways | Handrails, clear of obstacles, adequate lighting |
| Floors | Clean, dry, free of spills — report wet floors immediately |
| Wheelchair | Brakes locked when seated, footrests positioned correctly |
What to Do if a Resident Falls
IMPORTANT: Do NOT attempt to catch a falling resident — you risk injuring both yourself and the resident.
If you witness or discover a fall:
- Stay with the resident — Do NOT leave them unattended
- Call for help — Use the call light or yell for assistance
- Do NOT move the resident — Wait for the nurse to assess for injuries
- Keep the resident calm — Reassure them that help is coming
- Observe — Note any injuries, level of consciousness, and what happened
- Assist the nurse — Help with assessment and safe transfer as directed
- Document — Complete an incident/occurrence report as required
- Implement post-fall protocol — Follow facility policy for increased monitoring
Incident Reporting for Falls
Illinois requires documentation of all falls:
| Report Element | What to Include |
|---|---|
| Date and time | When the fall occurred or was discovered |
| Location | Exactly where the fall happened |
| Witnesses | Who saw the fall or discovered the resident |
| Circumstances | What the resident was doing when they fell |
| Injuries | Observed injuries or complaints of pain |
| Vital signs | Taken after the fall as directed by the nurse |
| Notification | Who was notified (nurse, physician, family) |
| Interventions | What was done after the fall |
Test Your Knowledge
You see a resident starting to fall in the hallway. What should you do?
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Test Your Knowledge
What is the MOST important fall prevention measure a CNA can implement for every resident?
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