NGN Case Study: Fall Risk Walkthrough

High-risk elderly patient: fall prevention, post-fall workup.

Fall case tests fall prevention interventions and post-fall care.

Setting

85 y/o admitted with delirium. On home oxycodone for arthritis. History of stroke with right-sided weakness.

Risk factors

Age, delirium, opioid use, weakness, unfamiliar environment, polypharmacy.

Prevention

Bed alarm. Yellow socks/wristband. Frequent rounding. Call bell in reach. Toileting schedule. Adequate lighting. Bed in low position. Non-skid footwear. Avoid restraints.

Post-fall

Don't move patient until assessed. Neuro check, vitals, head-to-toe assessment for injury. Notify provider. Document. Review meds (especially anticoagulants for head bleed risk).

Frequently asked

Bed alarm vs sitter?

1:1 sitter for highest-risk. Bed alarm for moderate-risk. Layered approach.

Anticoagulated patient falls, head CT?

Even without obvious head injury, low threshold for CT. Delayed bleeds possible.

Quick check

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