IDPH has cited and fined Auburn Rehab & Healthcare Center nursing home after a resident there fell and suffered a fractured hip.
There are a handful of factors which make a resident a fall risk. One factor is some form of musculoskeletal weakness or dysfunction. Another is that the resident has some form of dementia or confusion. There are a number of other factors such as poor safety awareness, medication usage, incontinence, and so forth. However, the key issues are (1) musculoskeletal dysfunction because this is what leads to a fall from a physiological standpoint and (2) dementia/confusion because this leads to the resident failing to follow safety instructions or get assistance.
Once a resident is assessed as being a fall risk, a fall prevention care plan must be developed. One of the standard parts of most well-developed care plans is to anticipate resident needs. Why? Because when a resident needs something and doesn’t have it on hand, they are likely to get up on their own, especially if the facility is one where the staff has a dodgy reputation for responding in a timely fashion. For example, if a resident is seated in a chair and wants a blanket, a book, the remote for the TV or whatever, and if it is not on hand, they may just go to get it with the potential for disaster all the way.
In order to effectively, anticipate the resident’s needs, the staff must be able to effectively communicate with the resident or determine what those needs are.
The resident at issue was one with whom there was a language barrier between the staff and the resident. The resident was recognized as a fall risk due to long term and short term residents and needing the assist of two staff with transfers. On the night of this nursing home fall, the resident was found out of bed on three different occasions. There was no attempt at toileting the resident while At 5:15 a.m., the resident was found on the floor on the bathroom. She reported to her son that she got up and made it to the bathroom on her own and was getting up from toilet when she lost her balance and fell. The resident was brought to the emergency room where she was diagnosed with a fractured hip.
This was a highly preventable fall. This was a resident who was recognized as a fall risk given her memory deficits and her mobility issues. She was demonstrating some degree of restlessness as shown by the fact that she was seen out of bed on three different occasions that night. With that in mind, increased rounding was called for and making sure that her needs were addressed was called for but was not done.
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