Falls Resulting in Broken Bones or Other Serious Injuries

What is it: Not all falls are preventable, but in the long-term care setting a fall risk assessment is routinely undertaken to identify those who are at risk for falls, so that appropriate interventions can be undertaken. While it is generally not appropriate to restrain a resident who is at a high risk for falls, a number of interventions can be taken to prevent falls or at least prevent the injuries that result from falls. These interventions include the use of bed alarms, chair alarms, lap buddies, appropriate transfer techniques and equipment, floor mats at the edge of the bed, and the use of low beds so that falls from bed are not as likely to result in a serious injury.

Investigation of fall-related injury claims requires the best understanding of what the fall risk was known to be, what interventions were recommended, and actually undertaken, and the details of how the fall happened.

All too often, the fall itself is only part of the claim, as the post-fall resident assessments and timely medical attention are very important in the treatment of injuries. While a fall may not be preventable, and may be the result of just an unfortunate set of circumstances, there is no excuse for a facility’s failure to timely obtain appropriate care for the injuries sustained in a fall. All too often, residents languish with broken bones or intracranial bleeding that go unchecked and untreated for hours or even days before a family member starts asking questions about why their loved one is not acting the same –these delays are neglect.

Possible causes of Falls / Fractures/ Bruising/ Unexplained Injuries

  • Improper lifting of a patient in/out of bed
  • Failure to support patient while they are standing or moving into a wheelchair
  • Failure to place a patient’s feet securely in chair holds (off the ground and away from the wheels)
  • Ignoring a diagnosis such as osteoporosis
  • Poorly fitted shoes or care of feet
  • Environment hazards such as equipment in hallways or stacking equipment high on shelves where it can fall.

Preventing Falls / Fractures/ Bruising/ Unexplained Injuries: Interventions to prevent falls can begin at the patient, staff and organizational levels. The most effective interventions include:

  • Use of hip pads to prevent hip fracture if a resident takes a fall
  • Exercise activities to improve strength and balance for a resident
  • Reviewing medications to see if there is a potential risk for falls, fractures, bruising, or injury