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Nursing Skills On – Line: Module 07, Safety (Lesson 1 – Safety Equipment and Fall 

Prevention) 

Potter & Perry Pages: 775-780, 1190, 1201 

 Articles: (2005). Improving patient and health care 

 provider safety: task force develops recommendations on patient handling. PT:

Magazine of Physical Therapy , 13(4), 48.Retrieved from CINAHL database.

Sadowski, A. (2003). Training staff in resident transfers. Nursing Homes: Long Term Care Management , 52(8), 44-45.

Retrieved from CINAHL database.

Rapp, K., Lamb, S., Büchele, G., Lall, R.,Lindemann, U., & Becker, C. (2008).Prevention of falls in nursing homes: 

subgroup analyses of a randomized fall  prevention trial.  Journal of the American

Geriatrics Society , 56(6), 1092-1097. Retrieved from CINAHL database.

Sjösten, N., Vahlberg, T., & Kivelä, S. (2008).

The effects of multifactorial fall prevention on depressive symptoms among the aged at 

increased risk of falling. International Journalof Geriatric Psychiatry , 23(5), 504-510.

Retrieved from CINAHL database.

 Websites:http://www.patient.co.uk/doctor/Preventio

n-of-Falls-in-the-Elderly.htm

Primary prevention: 

 This means taking measures to prevent falls inpeople who have not fallen. Examples

include:

  Increasing exercise and physical activity   Reviewing medication  Changing adverse environmental factors  Improving management of any medical

conditions

Secondary prevention:

 This means taking measures to preventfurther falls in those who have had a previousfall. Those who have already had a fall are atmuch higher risk of further falls.

Remember:

  Many clients fall when attempting to get outof bed to use the toilet. So, try to scheduletheir elimination.

  Be aware of any illnesses and physicalconditions can affect your client’s strengthand balance as well as your own.

  Make sure client has grab bars put in theirbathtub, shower and toilet area.

  Minimize the chance of wet surfaces(especially bathroom)

  Use proper interventions if your client has asensory problem.

Prevention a Possible Fall 

It is better to be safe than sorry.

By: Hashim Ali Jaffery

Ryerson, Centennial, George Brown,

Collaborative Nursing Degree Program

Centennial Site

Transferring a Client with One

Sided Weakness

And

How to Prevent a Possible Fall 

References and Resources

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Use the proper equipment.

  Use of a transfer belt (called a gait belt whenused for walking with a client) helps preventcaregiver back injuries and aids in the safetransfer of the client. The belt encircles theclient's waist and has handles attached for thenurse to hold. It is applied over the client'sclothing, never over bare skin.

  Use mechanical or hydraulic lift to transfer theclient when necessary. Make sure the equipmentis functioning properly and being of how tocorrectly use it.

 After any transfer:

   With each transfer, evaluate the client’stolerance and level of fatigue and comfort.

   After each transfer, evaluate the client’s body alignment.

  Praise the client’s progress, effort, andperformance.

Clients with severe one sided weakness:

  Remember to compensate for that weaker side when lifting and transferring.

  Place a wheelchair on the patient's unaffectedside. Instruct the patient to pivot and bear asmuch weight as possible on the unaffected side.Support the affected side because the patient

 will tend to lean to this side. Use pillows tosupport the hemiplegic patient's affected side toprevent slumping in the wheelchair.

Before moving and / or positioning a client inbed, identify what the nurse should first assessfor.  Muscle strength (legs and upper arms)   Joint mobility and contracture formation  Paralysis or paresis (spastic or flaccid)  Orthostatic hypotension   Activity tolerance  Presence of pain   Vital signs

Keep in mind when transferring a client withone sided weakness:

  Inspect and identify any sources of pain at any 

of the joints.  Having more than one nurse while moving the

client would be ideal.  Use good body mechanics during the transfer to

prevent injury.

Don'ts

  Don't let the patient wear slippers or shoes without nonslip soles.

  Don't leave the wheelchair's footrests down

because they'll interfere with the transfer.  Don't change the patient's position quickly 

because his cardiovascular system may not havetime to adjust to postural changes.

  Don't stretch your back at any time during thetransfer.

Prevention a Possible Fall Transferring a Client with One

Sided Weakness

Transferring a Client with One

Sided Weakness

 Assessment of someone who falls

 The following should apply to all clients who fall. This should incorporate a good history of exactly  what happened (If possible get collaborationfrom a witness).

   Was it tripping over something or loss of balance?

   Was there loss of consciousness?  Is there a history of any previous falls?   As always in the elderly, note drug history.  Past medical history is important in assessing 

risk of falls and injury.  Home assessment can be very instructive in

diagnosis, risk assessment and fallsprevention. It can identify environmental

factors.

 With the answers to these questionsprevention of a fall is greatly improved, by using appropriate interventions.