Who needs to be concerned about safety?
Safety strategies to protect your bones are important for individuals of all ages. It is imperative for everyone to protect their bones and overall health by wearing seatbelts in any moving vehicle and by using appropriate protective equipment when participating in sports. If you have been diagnosed with osteoporosis, you may be more likely to break a bone as a result of a fall. In fact, most broken bones happen as a result of a fall. Falls happen for many reasons, most of which can be avoided.
How common are Falls?
Anyone is at risk for a fall, however, falls are especially concerning in the older adult population. 30% and 40% of community-dwelling men and women aged 65 and older fall each year, with about one-third of those falls resulting in serious injury.; Each year an average of 863 New York State Residents over the age of 65 die as a result of an injury from a fall. This is equal to 2.4 deaths a day in New York that could be attributed to falls. In the elderly approximately 1 in 10 falls results in serious injury such as head injury, soft tissue injury or fracture Approximately 90% to 95% of hip fractures are the result of a fall.
What are the risk factors for falls?
There are several factors that can increase the risk of a fall. These risk factors for falls include:
lower body weakness
problems with gait and balance
use of multiple (4 or more) medications
a previous history of falls
Knowing your personal risk for falls can help you take steps to prevent falls and the potential for a fall-related fracture. For example, by participating in safe physical activity, you can help strengthen the muscles that protect your bones in the event of a fall.
How can I reduce my risk for falling in my home?
It is important to do a home safety check on a regular basis to identify and modify falling hazards. Sometimes it is hard to recognize hazards in your own home so consider asking a friend or family member to help you safeguard your home. Using a checklist can assist you in safe-proofing your environment. (See: National Center for Injury Prevention and Control Publication entitled “Check For Safety: A Home Fall Prevention Checklist for Older Adults”, the National Osteoporosis Foundation Falls Prevention Checklist). Just a few of the steps that you can take to fall-proof your environment include securing throw rugs, using nightlights and installing grab bars in your bathroom. In addition, it is also very important to prevent and avoid wet, slippery floors both inside and outside of your home.
What are some other strategies for fall prevention?
Get regular vision and hearing exams – Poor vision and hearing loss are common reasons for falls. It is important to have your hearing and vision checked on a regular basis by your healthcare professional. Know the side effects of the medications that you take – If you take medications, it is important to know the possible side effects. Some medications can cause dizziness or lightheadedness and increase your risk for falls. For more information about the potential side effects of your medication, speak to your pharmacist. Take precautions for outdoor safety – It is important to avoid walking on slippery surfaces and to be cautious walking on cracks and uneven surfaces.
Another wise safety choice is to park in well-lit areas at night. Use assistive devices properly and safely when needed – There are many assistive devices such as canes, walkers and grabbers that can help individuals who are at increased risk for falling. When used properly and safely, these devices can promote independence and reduce the risk of falling. A consultation with a physical therapist or occupational therapist is beneficial to find the right assistive device for you and learn how to use it properly to ensure your safety. Avoid excessive alcohol consumption – Consuming excessive alcohol can impair balance and increase your risk for falling. Use proper body mechanics and the principles of safe movement. Select clothing and footwear with safety in mind.
A falls risk assessment is recommended as part of a routine medical examination for all older adults as well as for individuals with medical conditions that effect gait and balance. If you have a history of falls or or if you have been diagnosed with osteoporosis or fractures related to osteoporosis, it is imperative to speak to your healthcare provider about your personal risks for falling and about the fall prevention steps you should take to protect your bones.
1.3 When circumstances could lead to more injury, risk of head or spinal injury and if it causes danger to anybody. The person supporting the fallen/falling person should never put his life in danger or life threatening when intervening, ensure policies and procedures are followed. 1.4 When you are not open to danger or to others this will depend on circumstances ie when the person is about to trip, trip or fall. Example as follow: I was assisting Mrs x who was not too well but Mrs x was fully mobile and only required assistance of one staff while walking Mrs x to the lavatory she felt dizzy and was about to fall I grabbed hold of her at once I shouted for more help.
2.1 When the person require minor assistance and the person is fully mobile ensuring there are other staff to help with lift. Example as follow continuity of 1.4: When I shouted for help one of my colleague came at once, as Mrs x was still conscious and was in her sense so she hanged on until the other staff came for more assistance. My colleague brought a chair and help me to assist Mrs X to sit down until Mrs X felt better a drink was given ensuring she was comfortable. 2.3 This will be on occasion when it can cause danger unsafe to do so or could lead to more injury or the person has been unconscious or the injured person is lacking mobility to do so or lack of any other staff for help.
Example is as follow: One of the staff slipped on a slippery floor and she could not move at all I did not try to move or help her to get up because I did not want to cause more damage as she was crying of pain and discomfort. I had to ring for ambulance. Assist her, ensured she was on a recovery position and was comfortably laid down. 2.4 When it is appropriate to do so, ensuring the person has been check for any injuries before trying to get the person up if it is serious the emergency should be call out at once. Ensure the person can take instruction, keep calm and use clear instructions. Furniture can be used to hold on to for extra support when the person is trying to get up. Lifting equipment can used such as slings, lifting belts, hoists and assistance of adequate staff.
2.6 Ensure the person’s self-respect and dignity is maintained at all time by ensuring that the person is decently covered up if the person had a fall and their clothes has been lifted of showing bare skin any how this is by using blanket or any clothes available at that moment. This will depend on where or which part of the building the person has fallen if fallen in the person’s own bedroom then the door should be closed ensuring her privacy is maintained if the person share room with other individual then the bedroom screen should be in used and again this to maintained her dignity, self-respect and privacy as much as possible. 3.1 The information of the incident or accident should be recorded foremost in the accident/incident book/form the information are as follows: Name of the person who had the fall
Date & time the incident/accident happened
Where the accident/incident took place
Summary of how, what and what was involve with the accident/incident The name of the person who witness the accident/incident
Name and signature of the person who filled the accident/incident book/form Date it was filled in
This information are filled in the person’s daily needs diary and care plan. 3.2 Poor health can lead to changes when it comes to moving and handling risk assessment i.e if a person health deteriorate and end up bed bound in this situation the person will require assistance of more than one staff using of lifting aids such as hoist slings belt transfers etc. Or if a person has constantly having falls and accidents this could lead to lack of confidence i.e if the person using a walking stick but experience a few falls in past the person will be reluctant to walk with his walking stick and give up walking all together in this situation the person might end up with a Zimmer frame or wheel chair bound this will depend on the risk assessment.
Standing hoist is a sit to stand hoist, standing lift, stand‑aid hoist) A specific type of mobile hoist designed to assist people between sitting and standing positions. Standing hoists are designed to fit under and around chairs is a specific type of mobile hoist used to move a client from one seated surface to another, such as from a chair to a toilet. The hoist has a platform or footrest on which the client stands. The client is supported by a sling fitted around their trunk (a special sling known as a ‘stand aid sling’) and by a leg brace or knee block that has strapping to hold the client’s legs in place.
Standing hoists are suitable for clients who are partially weight bearing and can support most of their own weight while standing. Standing hoists are useful as they allow more access to clients’ clothing than sling hoists. For this reason, they are useful for moving clients from one seated position to another and can assist with toileting partially mobile clients. They also have a therapeutic benefit for clients in providing an opportunity to increase weight‑bearing tolerance. They should only be used for transporting clients for short distances, such as within a room or to an adjacent bathroom, not for longer distances such as corridors.
Points to note about standing hoists
• It may be easier to use a standing hoist rather than a mobile or overhead hoist for toileting as long as the client has sufficient weight‑bearing capacity • Extra care needs to be taken with clients with specific clinical conditions, such as low muscle tone, osteoporosis, spinal metastasis and difficulty standing with their feet flat • Standing hoists should have adjustable legs to go under and around chair and toilets. The handling/hoisting plan should contain the risk reduction measures i.e. equipment & techniques. The following guidelines assume that the handler has received relevant and current moving and handling training. Safety checks prior to each use, prepare environment for hoisting, ensure there is sufficient space to use the hoist safely.
Safe working load (SWL) of the hoist and is clearly displayed The hoist is fully charged and the battery fitted correctly There are no obvious signs of damage
Any leads are connected correctly
The emergency stop button is set correctly
There are no fluid leaks
The lifting tape is intact and not frayed (applies to ceiling track, certain mobile hoists) The castors are moving freely i.e. free from carpet fibres/fluff etc (mobile & standing hoists) The base adjustment moves freely (mobile & standing hoists) The raise/lowering mechanism works
To use the correct and appropriate sling and is fit for purpose The sling is compatible with the person and the hoist
All labels are legible and show SWL and unique identifier There are no signs of fraying, tears etc
All stitching is intact
The fabric is not worn/wearing
The velcro (if applicable) is clean and free of fibres/ fluff etc The buckle (if applicable) has no signs of damage etc
The loops/clips have no obvious signs of damage, fraying etc The sling is clean
There is sufficient space to use the hoist safely
The floor is clear of obstacles
There is sufficient access around and under furniture
There is a suitable and safe area to store and charge (if applicable) the hoist The environment is prepared for the task
If a fault is identified with either the hoist or sling it should be immediately withdrawn from use and follow reporting procedures. Read the handling/hoisting plan and ensure it is current and relevant. All hoisting tasks should be performed with two handlers (unless otherwise risk assessed), communicate with all involved in the task at all times. Ensure safety and comfort of person at all times and reassure the person at all times, ensure brakes are applied during the hoisting procedure Apply sling first, bring hoist in last and then double check the sling attachments and the sling and person are in the correct position prior to raising ensure the support surface is ready to receive the person then hoist the person just above both support surfaces to obtain sufficient clearance avoid using the hoist to transport over distances, thresholds and different surfaces unless otherwise stated in the risk assessment.
Control the decent of the spreader bar and lower to the level of the person’s chest or below for sling attachment Follow policies and procedures with regard to care and cleaning of the hoist. c) When an person falls to the floor, it is best to get them to a seated position first. Use whatever safe props available. In other words, if a sturdy table or chair is nearby or a walker or wheelchair are regularly used, these can be of assistance. However, make sure the area is safe and the device is not going to move unexpectedly.
Do not have them stand up on a throw rug or use a chair with wheels. If no devices can be used, put the individual in the recovery position — the person needs to be laying on his left side, right side if it is weaker. Position him with his left arm extended on the ground and supporting his head. Help him bend his knees. Place the right arm in front of the body with palm down close to the chest. Ask the person to help push himself up to a seated position while you assist or if easier to get on all fours on knees and hands. From all fours, the person can lift the hips and buttocks higher. Put hands around the person’s waist to help them lift to an upright position.
Ensure that a risk assessment is been put in place for the resident it should contain the relevant factors which are: Task, Individual capabilities (handler), Load (person), Environment for any significant change.
Changes of the individual’s mobility whether deteriorated or improved i.e a fully mobile individual who had a hip fractured ended up being totally dependant on more than one staff and chair bound but then after a month or two through positive outcomes such as physiotherapy, encouragement and motivation of staff, friends and families, with daily exercises.
This individual would be able to walk with zimmer frame and improved in his mobility. In other hand some might be more depressed and cause to get worst the individual might stop eating loss of weight. The person might get grumpy and agitated. Some situation the person might get confused. All these changes and any minor changes is reported and recorded in the individual’s care plan for the well being of the individual.
b) When it come to environment, if the person is depressed due to his lack of mobility overcrowded rooms could make him worst or agitated and frustrated this has to be reported at once and recorded. Or the person might need more room if the person is chair bound and require hoisting with all transfers i.e move furniture around or shift to other rooms de-clutter the area to avoid hazards. Ensure the room has enough lights so that it is quite visible to use equipment
b) Ensure that a risk assessment is been put in place for the resident it should contain the relevant factors which are: Task, Individual capabilities (handler), Load (person), Environment, significant change.
The handling/hoisting plan should contain the risk reduction measures i.e. equipment & techniques. The following guidelines assume that the handler has received relevant and current moving and handling training. Safety checks prior to each use, prepare environment for hoisting, ensure there is sufficient space to use the hoist safely. C) Equipment should be serviced and checked on a yearly basis this should be recorded. Any faulty this has to be reported at once. It is the responsibility of the manager to make sure that staff are fully trained to use the equipment in the correct manner.