Nursing Home Slip and Fall Injuries

NURSING HOME FALL INJURIES AND DEATHS

How serious are nursing home falls?

There are about 1800 fatal falls in U.S. nursing homes each year. A typical 100 bed nursing home reports 100-200 falls with many more going unreported. 10-20% of nursing home falls cause serious injuries including broken hips and head trauma according to the Center for Disease Control: National Center for Injury Prevention and Control. Sadly, one-quarter of all elderly persons who suffer hip fractures die within six months. Fuller GF. Falls in the elderly. American Family Physician. 61(7):2159-68, 2173-4 (2000).

Can nursing home falls be prevented?

Proper intervention can significantly reduce the rate of injuries and deaths due to nursing home falls. A study by Vanderbilt University School of Medicine found that implementing a fall prevention program reduces the risk of falls by 19%. Many of the interventions are low tech and low cost. For example, fixing broken wheelchairs and removing clutter from around the patient's bed helps to prevent falls.

Other effective interventions include:

• Proper assessments of residents to address risk factors and to treat underlying medical conditions.
• Physical therapy, gait training, walking programs, and strength building.
• Environmental modifications including placing grab bars in bathrooms, raising toilet seats, lowering bed heights and installing handrails in hallways.
• Minimizing the use of medications including psychoactive drugs that have side effects that cause dizziness and decreased balance.
• Placing call bells in reach of the resident and training the resident to ask for assistance when getting out of bed.
• Providing enough staff to assist residents in getting out of bed, walking, and toileting
• Training the staff in fall prevention.

How important is the development of a proper care plan to prevent nursing home falls?

Care planning is critical to preventing nursing home injuries. All nursing homes have an obligation to conduct a complete assessment of the patient. Based on the assessment they are required to prepare a “minimum data set” which assesses the patient’s risk of falling. The nursing home must prepare a care plan to address fall prevention. The care plan must be approved by the patient’s physician. A proper care plan should address the use of safety devices, and it should show address the type of assistance the resident needs getting out of bed, walking, and toileting. While it is critical for the nursing home to develop a proper care plan, the care plan is only useful if it is consistently followed. That means the staff must be properly trained and there must be sufficient staffing to carry out the care plan.

Failure to implement and carry out a care plan is negligence and may be the basis for a lawsuit.

Do physical and chemical restraints prevent injuries from falls in nursing homes?

Studies have shown that the routine use of restraints do not necessarily reduce the risk of falls and fall injuries in nursing homes. Restraints limit a resident’s freedom of movement. In addition to the psychological harm inflicted on a resident by restraining him or her, long term use of restraints leads to muscle weakness and further physical deterioration. Federal regulations put in place in 1990 require nursing homes to use restraints only as last resort. Since those regulations went into place most nursing homes have seen a decrease in fall related injuries. Before using restraints, the nursing home should exhaust all other options and interventions.

What are the risk factors for nursing home falls?

Nursing homes are required to assess patients to determine if they are at risk for falling and to develop a care plan to prevent the patient from falling. Risk factors include:

• Weakness and muscle fatigue
• Balance disorders
• Arthritis
• Medications including anti-depressents, sedatives, and narcotics
• Visual impairments

If your loved one suffered injuries or died due to a preventable fall at a nursing home, please contact us at (804) 288-1661 to discuss your legal rights.

Library for Nursing Home Slip and Fall Injuries:

• Court Order Permitting Plaintiffs to Pursue Personal Injury and Wrongful Death Claims Arising Out of a Fall in a Hospital [PDF]   
  Description: In this medical malpractice case, the patient suffered a severe head injury after falling in the hospital. She died approximately one month later. The trial court ruled that the plaintiffs are permitted to pursue both personal injury and wrongful death claims.

Web Resources for Nursing Home Slip and Fall Injuries:

• National Center for Injury Prevention and Control: Preventing fall injuries

  Description: The National Center for Injury Prevention and Control provides a useful toolkit to prevent slip and fall injuries to seniors. The statistics are staggering. The economic costs for fall injuries exceeds $27 billion dollars annually. Of the seniors who fall 20-30% will suffer moderate to severe injuries that limit their function and enjoyment of life.