4 Nursing Interventions for Fall Prevention
Learn how to assess individual fall risks, match them with practical nursing interventions, and evaluate and revise a safety plan.
Assess individual fall risks
Effective begins by assessing the person’s circumstances and matching each identified risk with a practical action. Staff, patients, and caregivers need to carry out the plan consistently, and the plan should be communicated to the care team.
A can include fall history, gait and balance, light-headedness when standing, medication effects, toileting needs, footwear, use of an , and hazards in the environment. For example, a person who feels unsteady, has fallen twice in the past year, becomes light-headed on standing, takes a sleeping medication, and urgently needs the bathroom at night has several distinct risks to address.
Match risks with practical interventions
Match each risk to an intervention that addresses the person’s needs. A person who needs to use the bathroom at night may benefit from scheduled or prompted toileting and assistance during identified high-risk times. Keep the call light and needed items within reach, clear the route to the bathroom, and provide appropriate lighting and footwear.
Use a prescribed and follow the person’s planned assistance level. Position the device correctly before the person stands. Furniture is not a reliable substitute for a properly fitted, maintained device. If the device or the person’s ability to use it appears unsuitable, consult an appropriate clinician, such as physical therapy, for assessment.
When an immediate environmental hazard is found, first assist the person to a safe position. Then correct the hazard—for example, place the walker within reach, remove a loose cord from the path, and improve dim lighting. A bed alarm does not replace individualized assessment, assistance, or a safe environment. Bed rest is not a substitute for an individualized mobility and safety plan, and restricting all activity indefinitely is not an appropriate response described for ongoing risk.
Address medication-related risks
Dizziness or daytime sleepiness that begins after a medication dose change warrants assessment of safety and relevant clinical findings, followed by a with the prescriber or pharmacist. Include prescription and nonprescription products in the review. Sedating medicines and medicines that may lower blood pressure can contribute to dizziness, sleepiness, or falls.
Do not independently stop or change medicines, recommend abrupt changes without clinical direction, or advise a person to stop all medicines. For example, a medication list that includes a sedative, an antihypertensive, and an over-the-counter antihistamine should be considered in the review when the person reports new dizziness and daytime sleepiness.
Set measurable outcomes
The plan should link identified risks to specific actions and an observable outcome. For a person who has fallen while rushing to the bathroom at night and needs one-person assistance to walk, an outcome could specify that during the next shift the person will use the call light for bathroom assistance and transfer with the assistance stated in the plan. Staff can document whether assistance was provided and whether any near-falls occurred.
A statement such as “patient will be safe” or a general reminder to “be careful” does not specify observable actions in the way a does. The plan should reflect the person’s needs and be communicated to the care team.
Evaluate and revise the plan
A fall-prevention plan is ongoing, not a one-time action. Reassess after a fall, a change in condition, a medication change, or a change in mobility. Continued attempts to walk alone to the bathroom and two near-falls are reasons to examine contributing factors and the circumstances of the events, even if no injury occurred.
Ask the patient and care team what is and is not working, then revise and communicate the plan. Possible adjustments include toileting timing, assistance, call-light access, or supervision, while continuing to support safe mobility. Evaluate whether the plan is being followed and whether it improves safety; observable measures include use of planned assistance, near-falls, falls, and completion of interventions. Revise the plan when the person’s condition or the results indicate a need.