Accidents and hazards exist in every day life, no matter where a person lives. In long-term care, providers have an obligation to provide an environment that is free from accidents and hazards that are within facility control, and to provide assistance and supervision to help prevent accidents as much as possible.
Accidents can be separated into two main types: avoidable and unavoidable
Avoidable accidents are accidents that occurred due to a failure to:
Identify environmental hazards
Assess individual resident risks for accidents
Implement measures to reduce risks as much as possible
Implement interventions in line with resident goals to reduce risk of accident
Monitor the effectiveness of interventions and adjust the care plan as necessary
Unavoidable accidents are accidents that occur despite appropriate facility identification of risk and implementation of interventions.
When thinking of accidents that occur in long-term care, some examples include but are not limited to:
Elopement and/or wandering
A fall is an unplanned or unintentional change in elevation, even if the resident was caught by staff prior to hitting the floor. If a resident is pushed by another resident or gets knocked to the ground by a fire door swinging closed, those do not count as falls because they were caused by external force.
Falls are one of the most common forms of accidents/incidents that occur in long-term care. While all falls are not avoidable, many are avoidable with appropriate monitoring, identification of risk factors and appropriate interventions.
Bruises can sometimes be an indication of abuse, but also can be due to physiological conditions, such as taking blood-thinning medication.
Elopement occurs when a resident who is cognitively impaired or otherwise unsafe to leave the building, exits without staff knowledge and/or proper authorization. This places the resident at risk of injury due to exposure to environmental hazards, such as traffic or extreme weather conditions.
While wandering in itself is not considered to be an accident, when wandering becomes excessive it can place the resident at increased risk for accident due to becoming fatigued or wandering into an unsafe area.
It is important that as caregivers, we always be on the lookout for the potential for accidents to occur. It’s also important that caregivers report accidents that have or are suspected to have occurred. For example, if you are caring for a resident and notice a bruise, you should always report it to a nurse for further assessment and to rule out the possibility of abuse.
When determining interventions for falls or any other accident that has occurred, it is necessary to determine the root cause of said accident. Without determining the root cause, there is a good chance that the intervention put in place as a result of said accident, won’t be effective. If you witness a fall or other accident, make sure to gather as many details of the resident behavior or situation immediately prior to the incident as possible and report to the nurse.