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Part B6 of 8 Improving Safety and Quality of Care Chapter 66 of 75

Falls Prevention in Practice Questions

NMC CBT falls prevention practice: environmental measures, rounding, medication review, learning from falls, and worked scenario answers.

JobLabs Editorial
By JobLabs Editorial · UK healthcare reference editorial team
· · Updated · 2 min read

Recognising who is at risk of falling is only half the job; the other half is doing something about it. This chapter is the practical, safety-culture side of falls: the everyday measures that prevent them, and the learning that follows when one happens.

The environment

Many falls come down to small, fixable hazards. Keeping the call bell and belongings within reach means a patient can summon help instead of reaching or getting up unaided. Good lighting, a clutter-free space, safe non-slip footwear, an appropriate bed height, and easy access to the toilet all remove common triggers. Questions here reward the measure that makes the safe choice easiest: the call bell in reach, not the belongings placed across the room to “encourage movement.”

Meet the need, do not restrain

The recurring scenario is a confused, unsteady patient who keeps trying to get up, usually to reach the toilet. The preventive answer is to anticipate and meet that need, through regular toileting and increased supervision, so the unsafe attempts stop. Restraint, including inappropriate bed rails, is never the answer. It can cause serious harm and does not address why the person is getting up. Neither does simply telling them to stay put, or removing a walking aid, which makes them less safe, not more.

Proactive rounding and medication review

Intentional, or purposeful, rounding is planned regular checks that anticipate needs, toileting, pain, position, essentials to hand, before a patient feels they have to get up alone. It prevents falls by getting ahead of the need. Alongside it, reviewing medicines matters: sedatives and blood pressure lowering drugs cause drowsiness and dizziness that raise falls risk, so they are a target for review.

Learn from every fall

When a fall does happen, the response is not just to record it and move on. A post-fall review looks at what happened and why, so the care plan can be adjusted to prevent the next one. Blaming the patient, or ignoring a fall because there was no injury, wastes the chance to learn, which is the heart of a safety culture. Next: clinical audit and quality improvement. Five falls prevention scenarios first.

Sources & further reading

  1. 1NICE — Falls in older peoplenice.org.uk
  2. 2Royal College of Physicians — FallSafercp.ac.uk
  3. 3NMC — The Codenmc.org.uk
Key takeaway from Falls Prevention in Practice Questions

Frequently asked questions

What environmental measures reduce falls?
Keeping the call bell and belongings within reach, good lighting, a clutter-free space, non-slip safe footwear, an appropriate bed height, and easy access to the toilet. Small environmental changes remove many of the everyday hazards that lead to falls.
What is intentional or purposeful rounding?
Regular, planned checks on patients that anticipate needs such as toileting, pain, position and having essentials to hand. By meeting needs before a patient tries to get up alone, it prevents many falls, especially among those at higher risk.
Is restraint an acceptable way to prevent falls?
No. Restraint, including inappropriate bed rails, can cause serious harm and is not a substitute for prevention. Falls are reduced by addressing the underlying reasons a person is at risk and by supervision, not by restricting them.

Check your understanding

Quick quiz: Falls Prevention in Practice Questions

5questions. Click an answer to see the explanation. Your score is saved on this device only.

  1. 1

    A patient at risk of falling is settled in bed. Which simple measure helps prevent a fall?

  2. 2

    A confused patient keeps getting up to use the toilet and is unsteady. What is a good preventive approach?

  3. 3

    What is the purpose of intentional rounding for falls prevention?

  4. 4

    After a patient falls, what supports future prevention?

  5. 5

    Which medications should prompt review as part of falls prevention?

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