Fall Prevention 13 guidelines
1. Safe physical environment
clear walkways of obstruction
stable furniture
easy access to items a person regularly uses
good contrast lighting helps show details and gives cues to anyone moving in the
room, floors in good repair, use footwear that promotes safe walking
2. Address medication side effects - a pharmacy consultant can review and identify
medications with drug to drug interactions that can impact the risk for falls
3. Promote mobility - exercise routinely; research has demonstrated a positive effect of exercise on reducing fall risk and increasing flexibility
4. All wheelchairs and other assistive devices should be periodically evaluated to
check for loose bolts, worn wheels, and is the device still appropriate for the
individual
5. The height of a bed, chair or toilet is crucial to safe standing, the correct
height facilitates rising by requiring less knee extension
6. Utilization of nonskid slipper socks or nonskid mat placed at the side of the bed
and/or toilet can reduce the likelihood of slipping
7. Securely fastened grab bars in the bathroom near the toilet and bathtub/shower
8. Schedule a yearly eye exam
9. Treatment of foot problems can decrease the risk of falling
10. Place a lamp next to the bed that is easy to turn on, have a night-light so you
can see where you're walking
11. Keep emergency numbers in large print near each phone
12. Slow down do not hurry, if the phone rings and they hang up, if it is important
they will call back.
13. Put a non-slip mat or self stick strips on the floor of the tub or shower
Thirteen Resources
1. "Falls in Older People" by Stephen R.Lord, Catherine Sherrington, Hylton Menz
2. e-Newsletter by Liz Taylor e-newsletter
3. "A Nursing Guide to the Prevention and Management of Falls in Geriatric Patients in Long-term Care Settings" by Deanna L.Gray-Miceli DNSc, Elizabeth Capezuti PhD, RN
4. National Institute on Aging
5. Prevent Falls
6. CDC's "What you can do to Prevent Falls" and "Home Safety Checklist" brochures for older adults
7. CDC Falls Prevention page
8. Center of Excellence for Fall Prevention
9. National Institute on Aging, AgePage: Preventing Falls and Fractures
10. The American Geriatrics society Guideline for the Prevention of Falls in Older Persons
11. Center for Healthy Aging Falls Free Electronic News
12. California Blueprint for Falls Prevention
13. National Safety Council
To read more Thursday Thirteen
Wednesday, September 3, 2008
Fall prevention
I have been gathering and reading articles about fall prevention for the last several weeks. On Thursday Thirteen I will write about resources that are available to prevent falls and things to keep in mind when looking at our homes to make where we live a safe environment. Please visit again on Thursday Thirteen.
Friday, August 29, 2008
Tag you're it.
The rules are: Mention six quirky, yet boring, unspectacular details about yourself. Tag six other bloggers by linking to them. Go to each person’s blog and leave a comment that lets them know they’ve been tagged. If you participate, let the person know who tagged you you’ve posted your quirks!
My six quirky details
1. I like going to bed at 8:30pm and getting up at 6am.
2. When I set the table the knife has to be on the right hand side next to the plate, the spoon next to the knife, the fork has to be on the left side of the plate and I prefer that all the silverware matches.
3. I have to have a table cloth on my dining table.
4. I like to wash my towels and washcloths with bleach.
5. I like my ice tea on the weak side and will add water to the tea at a restaurant (this embarrasses my adult children when they are with me at a restaurant)
6. My favorite snack is sliced fresh strawberries, sliced sharp cheddar cheese stacked on top of Ritz crackers.
My six quirky details
1. I like going to bed at 8:30pm and getting up at 6am.
2. When I set the table the knife has to be on the right hand side next to the plate, the spoon next to the knife, the fork has to be on the left side of the plate and I prefer that all the silverware matches.
3. I have to have a table cloth on my dining table.
4. I like to wash my towels and washcloths with bleach.
5. I like my ice tea on the weak side and will add water to the tea at a restaurant (this embarrasses my adult children when they are with me at a restaurant)
6. My favorite snack is sliced fresh strawberries, sliced sharp cheddar cheese stacked on top of Ritz crackers.
Wednesday, August 27, 2008
Thursday Thirteen Edition #7
Thirteen foods that fight aging
1. Broccoli
2. Cantaloupe
3. Carrots
4. Spinach
5. Sweet Potatoes
6. Brussels sprouts
7. Grapefruit juice
8. Orange juice
9. Papayas
10. Almonds
11. Cabbage
12. Onions
13. Seafood
Congratulations to Jerry & Kandy on the birth of their baby girl this morning!
To read more Thursday Thirteen
1. Broccoli
2. Cantaloupe
3. Carrots
4. Spinach
5. Sweet Potatoes
6. Brussels sprouts
7. Grapefruit juice
8. Orange juice
9. Papayas
10. Almonds
11. Cabbage
12. Onions
13. Seafood
Congratulations to Jerry & Kandy on the birth of their baby girl this morning!
To read more Thursday Thirteen
Monday, August 25, 2008
Summer fun and safe food handling
Residents enjoy a change of pace. Many facilities will host barbecues for residents and their families. Part of the planning needs to include adequate means to keep food hot and cold food such as potato salad cold, along with hand washing stations. Summer is fun and it is important to be safe when it comes to handling food.
Wednesday, August 20, 2008
Thursday Thirteen Edition #6 Suggested steps for an investigation by staff in an Assisted Living Center
13 steps suggested for an Investigation for food borne illness
1. Select a number of residents from the total number of residents who became ill; review their records for documentation of when the symptoms started and when they stopped.
2. Determine the time frame to be investigated.
3. Examine the dishwasher. Is the dishwasher cycle reaching 165 degrees for hot water temperature dishwasher? Is the dishwasher chemical dispensing system dispensing adequate amounts of chemical sanitizer to register adequately on the test strips? Check the dishwasher logs for the time frame being investigated.
4. Are the dishes clean after being processed through the dishwasher?
5. Is the dishwasher operating as it should according to the manufacturer’s directions? If staff are having to manually turn on and off the water to the dishwasher something is not operating correctly.
6. Examine the hand wash sink and the supplies staff use to wash their hands. Is the sink functioning properly? Is there adequate soap and paper towels?
7. Observe the food preparation process used by the cook. Is the cook following safe food rules? Changes gloves between different tasks? Was left over hot food cooled with in the parameters of safe food handling?
8. Are staff properly washing their hands the required length of time and using correct technique? Changing gloves when appropriate?
9. Review the meal menus, the actual food that was served to residents during the time frame being investigated. Was the food obtained from an acceptable food vendor?
10. Review food temperature logs for the dates and food that was served to residents during the time being investigated. Was the food cooked to the correct temperature? Check the thermometer being used; that it is functioning according to manufacturer’s specifications.
11. Review staff schedules for staff that worked and were in contact with the residents or the residents’ food in the sample of residents. Were any of the staff sick and if so what were their symptoms? If staff called in sick what were their symptoms and when did they start?
12. Review the facility’s policies for infection control. Did staff follow the policy? Does the policy/procedure need to be updated?
13. Analysis your collected data and determine follow up action based on the data.
1. Select a number of residents from the total number of residents who became ill; review their records for documentation of when the symptoms started and when they stopped.
2. Determine the time frame to be investigated.
3. Examine the dishwasher. Is the dishwasher cycle reaching 165 degrees for hot water temperature dishwasher? Is the dishwasher chemical dispensing system dispensing adequate amounts of chemical sanitizer to register adequately on the test strips? Check the dishwasher logs for the time frame being investigated.
4. Are the dishes clean after being processed through the dishwasher?
5. Is the dishwasher operating as it should according to the manufacturer’s directions? If staff are having to manually turn on and off the water to the dishwasher something is not operating correctly.
6. Examine the hand wash sink and the supplies staff use to wash their hands. Is the sink functioning properly? Is there adequate soap and paper towels?
7. Observe the food preparation process used by the cook. Is the cook following safe food rules? Changes gloves between different tasks? Was left over hot food cooled with in the parameters of safe food handling?
8. Are staff properly washing their hands the required length of time and using correct technique? Changing gloves when appropriate?
9. Review the meal menus, the actual food that was served to residents during the time frame being investigated. Was the food obtained from an acceptable food vendor?
10. Review food temperature logs for the dates and food that was served to residents during the time being investigated. Was the food cooked to the correct temperature? Check the thermometer being used; that it is functioning according to manufacturer’s specifications.
11. Review staff schedules for staff that worked and were in contact with the residents or the residents’ food in the sample of residents. Were any of the staff sick and if so what were their symptoms? If staff called in sick what were their symptoms and when did they start?
12. Review the facility’s policies for infection control. Did staff follow the policy? Does the policy/procedure need to be updated?
13. Analysis your collected data and determine follow up action based on the data.
Monday, August 18, 2008
Factors that may affect a resident interview
At first glance interviewing a resident or patient about an event would seem simple and straight forward. Interviewing an individual about an event that may have traumatized them, needs to be handled with patience and sensitivity which requires more than simply getting answers to multiple questions. Some things to keep in mind.
1. The individual may be experiencing anger at what happened to them.
2. The individual may feel victimized.
3. The individual may feel embarrassed or ashamed that they allowed this to happen.
4. The individual may be in a state of shock and hasn't realized what happened.
5. The individual may feel the need to protect whoever the perpetrator is.
6. The individual may fear retaliation if they tell someone what happened.
7. The individual may deny the event or blame themselves.
8. The individual may distrust anyone who tries to talk with them about the event.
9. The individual may be confused due to the effect of what happened.
10. The individual may be in pain, physical or emotional.
11. The individual may be experiencing grief over the event, maybe tearful.
12. The individual may be withdrawn.
13. The individual may be unable to relate accurately the facts of the event.
Because of all the above possible factors it is extremely important to write down exactly what the resident/patient/individual states. If you do not understand what the individual says request that they repeat their statement. Do not guess at what they said. Interviewing is a skill and takes practice.
1. The individual may be experiencing anger at what happened to them.
2. The individual may feel victimized.
3. The individual may feel embarrassed or ashamed that they allowed this to happen.
4. The individual may be in a state of shock and hasn't realized what happened.
5. The individual may feel the need to protect whoever the perpetrator is.
6. The individual may fear retaliation if they tell someone what happened.
7. The individual may deny the event or blame themselves.
8. The individual may distrust anyone who tries to talk with them about the event.
9. The individual may be confused due to the effect of what happened.
10. The individual may be in pain, physical or emotional.
11. The individual may be experiencing grief over the event, maybe tearful.
12. The individual may be withdrawn.
13. The individual may be unable to relate accurately the facts of the event.
Because of all the above possible factors it is extremely important to write down exactly what the resident/patient/individual states. If you do not understand what the individual says request that they repeat their statement. Do not guess at what they said. Interviewing is a skill and takes practice.
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