Medication – Related falls. Some preventable falls occur when the staff administers medications improperly. This can occur, for example, when a nurse mistakenly gives a resident the wrong dosage of his medication, and the resident falls shortly thereafter. Or, a nurse for whatever reason fails to give a resident her required daily medication, and the resident later falls. Or, a nurse administers a resident his medication knowing that the medication’s side effects include dizziness and weakness, yet there is no supervision provided to the resident who later falls because she was dizzy and weak. All of these falls could have been prevented had the staff followed proper protocol when administering medications.
Infection – Related falls. Many times a preventable fall occurs because of an infection that the patient contracts at the hospital or nursing home. For example, if a patient develops a urinary tract infection that goes unnoticed by the staff (despite its obvious symptoms), then that undiagnosed and untreated urinary tract infection can cause an alteration in the patient’s mental status, which in turn, can result in the patient falling. The fall could have been prevented had the staff timely diagnosed the urinary tract infection and treated it.
Most preventable falls occur because the staff failed to provide adequate supervision of the resident; or the nursing home was understaffed; or the staff was not properly trained. When a fall occurs, the nursing home should call the family and advise them of the fall. Tip: When you are called, ask questions—when did the fall occur; how did it happen; and whether there were any injuries. If possible, visit the resident the same day you are called to see for yourself what the injuries are. Ask the resident how the fall occurred, and ask the caregivers who were on duty at the time how the fall occurred and whether there were any injuries. Tip: If you suspect an injury, insist that the resident be sent to the hospital for x-rays and an evaluation. In our opinion, some nursing homes are reluctant to send a resident to the hospital for an evaluation after a fall because of what the hospital might find—i.e. not just an injury from the fall, but evidence of neglect as well, such as a bedsore; a bad infection; old bruising; an old fracture of unknown origin; dehydration; malnourishment; etc.
Infection is a serious problem in both nursing homes and hospitals. Pneumonia, MRSA and sepsis are all too common. These infections are serious and can be deadly—especially in older residents. Infection occurs when the staff fails to consistently implement proper infection control measures to minimize the risk of infection. For example, if the staff fails to wash their hands between patients, or fails to wear a gown or gloves when necessary, or fails to isolate residents who have infections, then infection will likely spread throughout the facility. Infection can also develop in a bedsore or other wound of the resident, which can seriously compromise the resident’s medical status. An infection in a bedsore, if not timely diagnosed and treated, can spread to the bone (called osteomyelitis), which often results in amputation of a limb, especially if the bedsore becomes gangrenous.
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