The High Fall Risk Room Set Up

A majority of hospital and nursing home falls, at least in part, are associated with extrinsic or unsafe environmental factors in the patient’s bedroom. Consequently, creating a ‘safe room environment’ for patients at high fall risk is an important component of fall prevention. The following checklist can be used by hospitals and nursing homes to ensure maximum bedroom safety for ‘at-risk’ patients.

Download a printable copy of the
High Fall Risk Room Setup Poster

This reference correlates to the online continuing education course Managing Falls In the Nursing Home: Who, Why, and What Next?.

Place patient in bedroom close to nursing station Allows for closer observation by greater number of staff
Place high risk signage (falling star) in bedroom and on outside of room door Alerts all staff that patient is at fall risk
Place fall prevention storyboard (identified risk factors and interventions) on wall in front of patient's bed Used to increase staff awareness of patient's care plan.

Used as a teaching aide for patients/families in ways to prevent falls
Place bed in low position so that knees are at 90 degrees to floor Bed position provides maximum safe egress
Place side rails down on exit side of bed and two split rails up on non-exit side of bed.

If patient exhibits impaired transfers, place head split rail up on exit side of bed and two split rails up on non-exit side of bed
Protects and directs patient to exit on 'safe side' of bed

Side rail used as 'enabler' (hand-hold) for safe transfers
Place anti-slip strips on floor where patient exits bed Protects patient from slipping on spilled items (urine, feces, blood, water, etc.)
Place over-the-bed table on non-exit side of bed Prevents patient from using table for hand support during transfers
Place sturdy chairs with armrests and seats no higher or lower than 18 inches. Avoid chairs with wheels. Provides maximum support for safe chair egress
Place commode chair next to bed, on exit side of bed for patients with urinary impairment (e.g., incontinence, nocturia) Provides safe option to meet toileting needs
Keep room illuminated during day

Place 'motion-activated' night light by bed and in bathroom
Provides greater visibility

Provides safe pathway to bathroom during night
Place call bell/personal items within reach of patient Patient doesn't have to stretch or exit bed to reach items
IV pole on exit side of bed (tubes/lines not across bed) Prevent lines from being pulled out/patient getting tangled in lines
Bed/chair alarm Alarm provides audible alert when patient is attempting to stand

Alarm utilized as an 'assessment tool' to help identify a patient's pattern of bed or chair exits and supervision needs

Tideiksaar, R. Falls in Older People: Prevention and Management. 4th Edition.
Health Professions Press, Baltimore, MD 2010

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