Key Takeaways
- Falls are the leading cause of injury in healthcare - many are preventable
- Risk factors include age >65, confusion, medications, mobility issues, and environmental hazards
- Keep beds in lowest position, call lights within reach, and pathways clear
- If a patient falls, stay calm, call for help, and do NOT try to catch them
- Document all falls and complete an incident report
Last updated: January 2026
Fall Prevention
Falls are one of the most common and serious safety concerns in healthcare facilities. CNAs play a critical role in identifying fall risks and implementing prevention strategies.
Why Falls Matter
- Falls are the leading cause of injury in healthcare settings
- 30-50% of falls result in injury
- Consequences include fractures, head injuries, and death
- Falls increase length of stay and healthcare costs
- Many falls are preventable
Fall Risk Factors
| Category | Risk Factors |
|---|---|
| Patient factors | Age >65, history of falls, confusion, weakness, incontinence |
| Medication effects | Sedatives, diuretics, blood pressure meds, pain medications |
| Mobility issues | Unsteady gait, need for assistive devices, paralysis |
| Sensory deficits | Vision or hearing impairment |
| Environmental | Wet floors, clutter, poor lighting, unfamiliar surroundings |
| Medical conditions | Dementia, stroke, Parkinson's, diabetes, osteoporosis |
Fall Risk Assessment
Patients are assessed for fall risk upon admission and regularly after:
| Assessment Component | What to Look For |
|---|---|
| Fall history | Previous falls, circumstances |
| Mobility | Gait, balance, assistive device use |
| Mental status | Confusion, impaired judgment |
| Medications | High-risk medications |
| Elimination | Frequency, incontinence, urgency |
| Environment | Room hazards, lighting |
Prevention Strategies
Patient-Centered Interventions:
| Strategy | Action |
|---|---|
| Call light access | Within reach at ALL times |
| Bed positioning | Lowest position, wheels locked |
| Side rails | Per care plan (can be entrapment risk) |
| Non-slip footwear | Proper shoes or gripper socks |
| Assistive devices | Walker, cane within reach |
| Toileting schedule | Anticipate bathroom needs |
| Adequate lighting | Night lights, clear pathways |
| Personal items | Within reach (glasses, phone) |
Environmental Safety:
| Area | Safety Measures |
|---|---|
| Room | Clutter-free, clear pathway to bathroom |
| Bathroom | Grab bars, non-slip mats, call light accessible |
| Hallways | Handrails, clear of obstacles |
| Floors | Dry, clean, no throw rugs |
| Lighting | Adequate, especially at night |
Bed and Chair Safety
Bed safety:
- Keep bed in lowest position when not providing care
- Lock wheels
- Use side rails per care plan
- Place call light within reach
Chair safety:
- Use chairs with arms for support
- Lock wheelchair brakes
- Ensure feet touch floor or footrests
- Never leave patient in unstable position
Responding to a Fall
If a patient falls, do NOT try to catch them - you could both be injured:
| Step | Action |
|---|---|
| 1 | Stay calm - Don't panic |
| 2 | Call for help - Use call light or shout |
| 3 | Protect the head - If patient is falling, guide them down |
| 4 | Don't move patient - Wait for assessment |
| 5 | Stay with patient - Reassure them |
| 6 | Note details - What happened, where, how |
| 7 | Wait for nurse - RN will assess for injuries |
| 8 | Document - Complete incident report |
After a Fall
| Action | Purpose |
|---|---|
| Nurse assessment | Check for injuries |
| Vital signs | May indicate shock |
| Head injury monitoring | Watch for changes in consciousness |
| Incident report | Legal documentation |
| Fall risk reassessment | Update prevention plan |
| Communication | Notify family per policy |
High-Risk Times for Falls
Pay extra attention during:
- Night shift - Patients may be disoriented
- After sedating medications - Increased fall risk
- Toileting - Common time for falls
- Getting out of bed - First standing is risky
- New admission - Unfamiliar environment
CNA Role in Fall Prevention
| Responsibility | Actions |
|---|---|
| Assessment | Report changes in mobility, cognition, or risk |
| Prevention | Implement safety measures consistently |
| Response | Know what to do when falls occur |
| Communication | Report concerns immediately |
| Documentation | Accurate recording of fall events |
Test Your Knowledge
What is the FIRST action if you see a patient falling?
A
B
C
D
Test Your Knowledge
Where should the bed be positioned when not providing care?
A
B
C
D
Test Your Knowledge
Which is a common risk factor for falls?
A
B
C
D