Rehabilitation facilities are responsible for the care and well-being of patients who, by and large, have an elevated risk of falling. As such, the importance of bathroom safety at these facilities should not be underestimated.
The article at hand focuses on practical safety improvements that rehabilitation hospitals, long-term care hospitals, specialty hospitals, and other facilities offering inpatient rehabilitation and post-acute care can make to protect patients in the bathroom.
Ambulation, transportation, and transfer activities involving high fall risk patients already present appreciable safety challenges. Bathroom settings can compound these challenges by adding unique environmental constraints along with a need to perform time-sensitive tasks (e.g., using the toilet, showering, undressing/dressing).
When evaluating their facility’s current patient safety program, leadership should seek to identify any existing shortcomings and look for ways in which to optimize the functional design elements of the facility’s bathrooms and/or strengthen bathroom-related protocols.
Informed by a thorough fall risk assessment, an individualized bathroom safety plan should be tailored to support the patient’s unique capabilities and needs. This bathroom safety plan is a key component of the individual patient’s more comprehensive fall safety plan.
Individualized bathroom safety plans should indicate the patient-specific measures to be implemented, detailing applicable procedures, assistive equipment/devices, and schedules (e.g., toileting, showering, rounding). As part of the patient’s broader fall safety plan, the bathroom safety plan should be kept up to date and follow the patient throughout their healthcare journey.
Here are several ways that rehab facilities can address bathroom safety issues:
Supervised/assisted toileting is a fundamental safety measure to help safeguard fall risk patients. The implementation of individualized toileting schedules in concert with regular rounding can help reduce problems associated with urgency or incontinence.
Devices such as raised toilet seats and toilet safety frames can facilitate toileting, as can a bathroom design that provides sufficient space around the toilet. Placement of toilet paper holders for ease of access is another basic design consideration.
Technology solutions for safety include pressure-sensitive, wireless toilet seat sensors that alert nurses when a patient is attempting an unassisted toilet seat exit. Similarly, wireless or wired chair sensors are available that alert nurses when a patient is attempting an unassisted chair exit, possibly with the intent of heading to the bathroom. Meanwhile, self-releasing belt sensors for chairs and beds are designed to give nurses extra time to reach a patient attempting to exit a chair or bed without help ― and can serve as a reminder for the patient to seek assistance.
Items such as walk-in tubs, roll-in showers, shower chairs and benches, nonslip mats and decals, and handheld showerheads can help improve safety and ease of use.
Grab bars and handrails near toilets, showers, and bathtubs can help improve bathroom safety, provided they are placed properly, installed securely, and made of appropriate materials.
Nonslip flooring materials, along with regular maintenance and cleaning, can help prevent patients and caregivers from slipping in the bathroom.
Bathroom lighting should not only be adequate but adjustable; all shadows and glare should be eliminated. Motion-sensor lights can be installed for use at night.
Depending on patient needs, assistive devices/equipment such as bath lifts and transfer benches can improve bathroom safety. Gait belts and transfer belts may also prove helpful. Note that when used correctly, gait belts and transfer belts can help reduce the risk of injury to caregivers.
Brightly colored items such as bracelets, socks with skid-resistant treads, and blankets can help staff visually identify high fall risk patients.
Clear communication is critical for patient safety in the bathroom. Patient fall risk information should be shared consistently amongst all staff members caring for the patient, especially during handoffs.
Staff should be trained on the proper use of safety devices/equipment for the bathroom and made aware of potential safety risks and how to avoid them. Open communication with leadership about safety concerns should be encouraged as a means of initiating improvements.
It is also important for patients and their families to receive education on applicable bathroom safety practices both during and after a stay in the rehab facility.
There are many ways to improve bathroom safety in rehabilitation hospitals, long-term care hospitals, specialty hospitals, and other facilities that offer inpatient rehabilitation and post-acute care. Enacting bathroom safety measures such as those discussed in this article relies on a commitment by leadership and staff to adopt a proactive approach and work together to better protect their patients.
Contact us to learn more about improving bathroom safety in your rehabilitation facility!