Identify cognitive or physical deficits of the patient that may increase potential of falling in a particular environment Identifi behaviors

and factors that affect risk of falls Review history of falls with patient and family Identify characteristics of environment that may increase potential for falls (slippery floors and open stairways) Monitor gait,balance, and fatigue level with ambulation Ask patient for perception of balance, as appropriate Share with patient observations about gait and movement Suggest changes in gait to patient oach patient to adapt to suggested gait modifications Assist unsteady individual with ambulation !rovide assistive devices (cane and walker) to steady gait "ncourage patient to use cane or walker, as appropriate Mantain assistive devices in good working order #ock wheels of wheelchair, bed, gumey during transfer of patient !lace articles within easy reach of the patient Instruct patient about use cane or walker, as appropriate $each patient how to fall as to minimi%e in&ury !ost signs to remind patient to call for help when getting out of bed, as appropriate Monitor ability to transfer from bed to chair and vice versa 'se proper techni(ue to transfer patient to and from wheekhair, bed, toilet, and so on !rovide elevated toilet seat for easy transfer !rovide chairs of proper height, with backrests and armrests for easy transfer !rovide bed mattress with firm edges for easy transfer 'se side rails of appropriate length and height to prevent falls from bed, as needed !lace a mechanical bed in lowest position !rovide a sleeping surface close to the floor, as needed !rovide seating on bean bag chair to limit mobility, as appropriate

!lace a foam wedge in seat of chair to prevent patient from arising, as appropriate 'se partially)filled water mattress on bed to limit mobility, as appropriate !rovide the dependent patient with a means of summoning help (bell or call light) when caregiver is not present Answer call light immediately Assist with toileting at fre(uent, scheduled intervals 'se a bed alarm to alert caretaker that individual is getting out of bed, as appropriate

!ain management Aktivities* !erform a comprehensive assessment of pain to include lacation, characteristics, onset+duration, fre(uency, (uality, intensity or severity of pain, and precipitating factors ,bserve for nonverbal oues of discomfort, especially in those unable to communicate effecively Assure patient attentive analgecic care 'se therapeutic communication strategies to acknowledge the pain e-perience and covery acceptence of the patient.s response to pain "-plore patient.s knowledge and beliefs about pain onsider cultural influences on pain response /etermine the impact of the pain e-perience on (uality of life (sleep, activity, cognition, mood relationships, performance of &ob, and role responsibilities) "-plore with patient factors that impove + wosen pain "valuate past e-periences with pain to include individual or family history of chronic pain or resulting disability, as appropriate "valuate with the patient and the health care team, the effectiveness of past pain control measurethat have been used Assist patient and family to seek and provide support 'tili%er a developmentally appropriate assessment methodnthat allows for monitoring of charge in pain that will assist in identifying actual and potential precipitaring factors /etermine the needed fre(uency of making an assessment of patient comfort and implement monitoring plan !rovide information about the pain, such as causes of the pain, how long itwill last, and antipated discomfrts from procedures

ontrol environmental factors that may influence the patiens response to discofort Reduce or eliminate factors that precipitate or increase the pain e-perience onsider the patients willingness to practicipate, ability to participate, preference, support of significant others for method and contraindications when selecting a plan relief startegy Select and implement a variety of measures $each principless of pain management onsider type and source of pain when selecting pain relief strategy "ncourage patient to monitor own pain and to intervence appropriately $each the use of nonpharmacological techni(ues "-plore patients current use of pharmacological methods of pain relief $each about pharmacological methods of pain relief "ncourage patient to use ade(uate pain medication