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Fall Prevention: What Are the 4P’s Approaches?

Asian senior woman patient on wheelchair alone to wait her family

As one becomes older, fall avoidance is a crucial issue to think about. As one ages, physical changes, health issues, and perhaps the drugs used to address those issues increase the likelihood of falling. In fact, falls rank first among the injuries that older people sustain. However, life doesn’t have to be ruled by a fear of falling.

Studies and reports suggest that on an average, 15% of long-term care residents have fallen in the last 30 days, and half of all residents have at least one fall each year. Up to 20% of people who suffer a hip fracture will pass away the year after.


How to Define a Fall?

Any unintended shift in posture that results in the resident ending up on the floor, ground, or another lower level, whether it is observed or not, is a fall.

Purposeful rounding must be implemented for all employees in institutions to help lower the number of falls. This procedure may be utilized for all residents, but it should be concentrated on those newly admitted to the institution and those at a high risk of falling.


Falls in Long-Term Care Facilities

Despite common fall prevention techniques and initiatives, older persons continued to have significant fall rates.

Every healthcare employee will likely come into contact with and treat patients who have a higher risk of falling, given the high occurrence of falls.

Fall risk and preventive techniques should be evaluated following the following events:

  • A relocation into a long-term care facility or inside the home.
  • A modification in one’s health.
  • Modifications to medicine.
  • Falls have occurred in the past or recently.


Each person may require a different approach to preventing falls.

  • In a perfect world, the care staff, residents, and families would collaborate to identify the approaches that each person responds to the most favourably.
  • When examining fall prevention, care goals for each resident should be taken into account.
  • For example, encouraging walking and exercise may be appropriate for one resident but not for another.


Given the high occurrence of falls in older individuals, especially those with cognitive impairment, additional studies are needed to identify and assess the efficacy of different evidence-based strategies for avoiding falls.


To prevent fall, 4P's Approaches needs to be done

Anyone entering a resident room should do so with consideration of the 4 Ps:

  • Pain
  • Position
  • Potty
  • Personal Needs

1. Pain

If you are in pain, how are you doing? Or are you feeling any discomfort?

Schedule a medication visit with the resident or administer one. Notify the nurse or other responsible party who can provide medication for those of you who are unable to do this.

2. Position

Do you need to be rotated or repositioned? Are you comfortable where you are?”

For the resident’s safety and comfort, one needs to pay attention to their location, and make sure the call bells are within their reach. Elevate the patient in bed. Move the pillows. Give additional blankets.

Residents who are susceptible to skin deterioration should be turned. Again, if your job prevents you from carrying out these duties, let someone else know.

3. Potty

If a non-nursing person enquires, they should first ask, “Do you need to use the restroom?” and then alert someone who can help.

“Let’s go to the restroom to check whether you can use it,” should be said in response to a query from the nursing department. (Support the resident in using the restroom.)

4. Personal Needs

Do you need the phone, call light, garbage can, water, or your bedside table moved so that it is within reach? Are there any services or things I can acquire for you? Refill the water pitcher, arrange the bedside table, etc.

In addition:

Execute whatever duties one entered the room to complete:

  • Procedures were ordered by a doctor or provider.
  • Give prescribed care and/or medications.
  • tidy up the space.
  • Take out the garbage.

This approach may be used by different caregivers and members of the care team to assist avoid falls and to create a culture that periodically checks in with the resident and attends to their needs.



In the broader public health sector, the increasing frequency of patient falls across healthcare institutions is becoming a major problem. During their hospital stay, patients frequently fall.

The 4Ps Approach allows the care team as a whole to collaborate. Spend a minute checking in on the residents, attending to any needs that are discovered, or informing personnel of the requirements of the residents.

Our Fall Prevention Program

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