From the Guidelines
The most effective way to decrease the risk of falls in this elderly hospitalized patient with generalized weakness is to use non-slip socks, as part of a comprehensive approach to fall prevention. This approach should also include a thorough assessment of the patient's risk factors for falls, such as their medical history, medications, and mobility issues. According to the study published in the Annals of Emergency Medicine 1, equipment to prevent falls in the ED should include non-slip floor surfaces and patient gown and hospital clothing that minimize fall risk.
Some key strategies to prevent falls in hospitalized patients include:
- Ensuring proper mobility assistance with physical therapy evaluation and appropriate walking aids
- Establishing environmental safety measures like keeping the bed in a low position, using bed alarms, ensuring adequate lighting, clearing pathways, and placing frequently needed items within reach
- Providing non-skid footwear, such as non-slip socks
- Responding promptly to call lights and implementing scheduled toileting
- Patient and family education about fall prevention strategies
- Addressing specific risk factors like orthostatic hypotension, vision problems, and proper nutrition and hydration
While other interventions, such as exercise and physical therapy, vitamin D supplementation, and home hazard modification, may be effective in preventing falls in community-dwelling older adults, as recommended by the U.S. Preventive Services Task Force 1, the use of non-slip socks is a simple and effective strategy that can be implemented in the hospital setting to reduce the risk of falls.
From the Research
Fall Prevention Strategies
To decrease the risk of falls in an elderly hospitalized patient with generalized weakness, several strategies can be considered:
- Patient Education: Studies have shown that patient education can reduce hospital falls 2, 3. Educating patients about their heightened falls risk and promoting engagement can help prevent falls.
- Non-Slip Socks: Research suggests that non-slip socks can prevent falls among hospitalized patients 4. They represent an adequate alternative to well-fitting rubber-soled footwear.
- Multifactorial Interventions: Multifactorial interventions with multiprofessional input have been shown to be effective in preventing falls in hospitals 5.
- Environmental Modifications: Environmental modifications, such as removing tripping hazards and improving lighting, can also help prevent falls.
Ineffective Strategies
Some strategies have been shown to be ineffective in preventing falls:
- Bed Alarms: There is no evidence that bed alarms reduce falls or injury in the hospital setting 2, 5.
- Soft Wrist Restraints: The use of soft wrist restraints has not been shown to be effective in preventing falls and may even cause harm 6.
- Chair Alarms: Chair alarms have not been associated with significant fall reductions 2.
Recommended Approach
Based on the evidence, a multifactorial approach that includes patient education, non-slip socks, and environmental modifications is likely to be the most effective in preventing falls in an elderly hospitalized patient with generalized weakness.