Fall Prevention in the Acute Rehabilitation Setting

Patients in the acute rehabilitation phase of recovery from a brain injury are at a high risk of falls, largely because of physical limitations and cognitive impairments. But some prevention strategies implemented at Shepherd Center have proven successful in reducing fall rates significantly in this setting. Falls among these patients can occur because patients experience weakness, confusion, impulsivity, impaired safety awareness, and poor judgment and reasoning. They may also have uncontrollable spasms or movements that increase the risk of sliding out of a bed or a chair. Also, assisted falls may occur when a patient with limitations is learning new ways of moving and attempting to rebuild strength and endurance. Strategies to prevent falls among these patients can be simple, but effective. Shepherd Center uses bed alarms on all brain-injured patients, seatbelt alarms, one-on-one attendants and frequent rounding on patients. Also, leadership engages staff members in maintaining a culture that recognizes the high risk of falls requires a high sense of urgency in responding to alarms, and that safety has to be more important than privacy for the brain-injured patient. Shepherd Center Brain Injury Unit nursing manager Gail Greene, RN, is here to explain how Shepherd Center uses an interdisciplinary, collaborative approach to teaching and reinforcing the use of these strategies.