Responding to an Accidental Fall in a Nursing Home

nursing assessment after a fall

Accidental falls are a leading cause of nursing home injury. In addition to the minor injuries that can be sustained from a fall, such as scrapes and bruises, more severe injuries are common, such as fractured or broken hips, head injuries, or even death. Nursing home staff has a duty to act immediately upon the knowledge that there has been a fall, and should a procedure in place that details the appropriate course of action. Most procedures follow the same general pattern described below. A sample fall response guide can be viewed here.

As an initial matter, if a resident falls, nursing staff should be called immediately, and a licensed professional should be summoned to the scene to assess the situation. The resident should be encouraged by staff to stay still and not try to move or get up until the nurse finishes his or her assessment. The resident’s vital signs should be taken, and the resident should be asked if he or she has any pain and to what degree that pain is, and the nurse should check the resident for any cuts, scratches, bruising, or discoloration of the skin. The resident’s range of motion should be checked for each extremity, and asymmetry check should be conducted to determine whether a limb has popped out of its joint.

If the nurse does not suspect a fracture or more serious injury than scratches or bruises, and if they believe that the resident can stand or sit up, the nursing staff, as per the nurse’s instructions, should help the resident up to continue the assessment and apply the appropriate first aid. Conversely, a fracture may not be readily apparent, so if the nurse suspects that a fracture has occurred, the nurse should order an x-ray to be obtained, and firmly state that the resident should not get up. Staff should transfer the resident to a gurney, or an ambulance should be called depending on the facilities available at the nursing home. The resident’s physician should be notified regarding the suspected fracture and x-ray, and the fall should be recorded in the resident’s file or record maintained by the nursing home. The family of the resident should also be notified that a fall has occurred.

Assuming there is no fracture, the resident should be monitored for several days following a fall for behavior changes or any other sign that the fall was more severe than it initially appeared. If the fall was not witnessed by anyone, or if there is a suspected head injury, the resident should be checked regularly for neurological damage that may have occurred if there was an impact to the head.

After a fall happens, nursing home staff should take the time to assess why the fall occurred, and take steps to prevent future falls from happening. If the cause of the fall was an external factor, such as something in the environment that could be removed or made safer, the nursing staff should take corrective action to fix the problem. For the most part, accidental falls are largely preventable in nursing homes, and if a fall occurs, it is usually a sign of negligence on the part of the nursing home.

If you have witnessed a fall at a nursing home and suspect that it was not responded to appropriately, or are concerned that your loved one has suffered from a preventable fall in a nursing home, please contact our Illinois Nursing Home Abuse and Neglect law firm at (800) 350-0646.

Photo Credit: Neil. Moralee via Compfight cc

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