Nursing Strategies to Reduce Fall Risk: Impaired Mobility
- Impaired mobility (i.e., an inability to ambulate and transfer safely and independently) is a major fall risk factor.
- Diseases directly affecting mobility (i.e., strength, flexibility and balance) include acute and chronic conditions that affect the muscular, skeletal or neurological systems and limit a patient’s ability to move about safely.
- Disorders such as stroke, arthritis, diabetes, and Parkinson’s disease may affect a resident’s muscle strength and reaction time. As a result, walking becomes more difficult and balance control and coordination are affected.
- Any weakness or impairment of the legs and/or arms (e.g., from arthritis, muscular weakness, stroke, etc) can inhibit safe transfers, ambulation and balance. Diseases such as arthritis, diabetes, and stroke can alter muscle strength in the legs and arms. As a result, using leg and arm strength while getting out of a bed or up from a chair or toilet becomes much more difficult. This can easily lead to balance loss and increased fall risk.
Risk Reduction Strategies
- Anticipatory care (anticipate patient’s toileting needs, hunger, thirst, etc. and meet those needs, as appropriate)
- Supervision/observation (monitor at-risk patients and provide assistance with ambulation/transfers when necessary). Consider use of fall alarm to assist with monitoring.
- Continuously assess for environmental hazards interfering with safe mobility/eliminate as appropriate
- Beds (adjust to a height that allows patients to transfer easily)
- Chairs (seat height should allow patient to sit and rise easily)
- Bathrooms (install handrails around the toilet for safe transfers)
- A gait belt should be used whenever possible, especially when assisting a patient during transfers/ambulation
- Instruct patients on the proper use of the nurse call bell, including when and how to call for assistance. Consider the use of a fall alarm for those patients non-compliant with use of call bell
- Teach safe transfer techniques from bed, chairs, toilet, and wheelchairs.
- Make sure that canes, walkers, and wheelchairs are in good condition
- Arrange furniture to allow for wide walking/wheeling spaces.
Add to the discussion. What strategies do you use to prevent falls in patients with impaired mobility? Your comments are most welcome.