Preventing Falls While You Are Admitted to a Hospital Ward

The aim of this leaflet is to help you to reduce your risk of falling during your hospital stay.

The Nurses and Doctors looking after you will be more than happy to answer any questions you may have about reducing the risk of falls.

While it is not possible to prevent all falls, by making you and your family aware of the potential risks, we can reduce your chances of having a fall during your stay.

How can I reduce the risk of falls during my hospital stay?

By following the advice below, you can reduce the risk of falls:

• As part of your admission assessment, you will be asked about your history of falls. Please let the team know if you have any concerns about falling.

• Use your call bell if you need help to get out of bed, particularly if you need help to go to the toilet.

• If you need glasses, please remember to bring them with you and use them while you are in hospital.

• If you require a walking aid, you should arrange to have it with you while you are in hospital. It is important that you always have it close by and use it when required.

You should not lean on hospital furniture. Hospital furniture is often on wheels and using this for support is a major risk.

• If you have been lying down, it will help if you sit up on your bed for a few moments before standing up.

• You should stand up slowly and make sure you are steady on your feet before you start walking.

• Simple leg exercises before standing up will help you to stand up steadily. It will help if you do the following exercises while lying in bed:
  • Point to your toes and then relax your hands. Do this a few times.
  • Tighten the muscles in your calves and then release them.
  • If you move your legs up and down a few times, this will help with blood circulation to your legs.

• If you feel dizzy, we advise that you stop what you are doing and rest on your bed. You must let the team looking after you know if you have any dizziness.

• It is important that you eat well and drink regularly while you are in hospital. Having plenty of energy is important to keep up your strength and preventing falls.

• It is important that your path is clear before you walk. Ask for any clutter to be moved before you stand up. It will also help if you are familiar with your environment.

• It is important that you have your own shoes with you during your stay in hospital. Make sure all of your footwear fits well. Your risk of a fall increases if your shoes/slippers are able to fall off. The nursing staff can provide soft grip socks if you have no appropriate footwear.

• Make sure you take care while using the bathroom or the toilet. Please ask for assistance if it is needed.

How can family, friends and carers help?

If family, friends and carers can also help to reduce the risk of falls during your stay. The following suggestions will help with this.

They should tell the ward staff if:

• They think you are at risk of falling or you have a history of falls.

• They have noticed that you are feeling dizzy, you are confused or you are not feeling yourself.

• They know that you have a condition that may increase your risk of falls, such as dementia or visual impairment.

• They notice a spill or any other potential hazard.

Before your visitors leave the hospital;

• They should where possible, move any obstacles or tripping hazards around your bed.

• Make sure that your call bell works and that any required walking aids or glasses are within your reach.

• Make sure that they take any belongings with them that are not needed during your stay.

• Make sure not to adjust bed rails if an assessment has been completed.

What can be done on the ward to help reduce the risk of falls?

The list below shows recommendations and how they can help to reduce the risk of falls.

• Call bells should always be within reach of a patient. If you cannot move safely without help, you must use your call bell to ask for assistance.
• All patients should have their vision assessed when staying in hospital. This could be a simple test, like reading a newspaper at a distance. If you cannot see where you are going, it makes it difficult to avoid obstacles. Even if you wear glasses, you should still have your vision assessed to make sure your glasses are correct.
• Patients should have their medications reviewed and changed if appropriate. Some medications – or combinations of medications – make people dizzy and increase the chances of falls. A Doctor or a Pharmacist can sometimes adjust the medications to make these side effects less likely.
• Patients who need walking aids should be able to reach them. If you need a walking aid to walk safely, it is important that you have it before you start walking.
• Patients should have their lying and standing blood pressure measured. Some people experience a drop in blood pressure when they stand up. This makes them dizzy and can cause them to faint. If the people treating you are aware that you get dizzy when you stand up, they may be able to change parts of your care or give you tips to prevent this from happening.
• Tests should be made to check for dementia or delirium (confusion). Dementia is a syndrome that causes memory loss and difficulties with daily life. Delirium is a state of confusion which can develop while in hospital.
• Patients with delirium or dementia should have a special care plan. If you are confused and having trouble remembering things, an unfamiliar environment can be particularly tricky. Patients who have dementia or delirium need special care to help with their stay in hospital.
• Patients who have continence issues should have a continence care plan. If you have difficulties with bladder control, there needs to be a plan in place to help you move regularly and safely to the toilet.
• Safe footwear should be worn. Well-fitted shoes or slippers with gripping soles will help you to move safely while in hospital.
• Immediate bedside environments should be clear from clutter and hazards. Keeping the space around your bed and the route to the nearest toilet clear makes it easier to move around safely.
• Use of bed rails. The ward staff will make sure that bed rails are being used when they can help to make your stay in hospital safer. For some patients, bed rails can help in preventing falls. For some patients, bed rails may not help, especially if the patient is likely to try climb over them.

References

Falls Prevention in Hospital: A Guide for Patients, their Families and Carers, The Royal College of Physicians, October 2016.

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