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Nurses Implement Best Practices to Prevent Falls Among Patients with Brain Injury

Recognizing the high risk of falls among brain-injured patients, Shepherd Center takes steps that significantly reduce falls.

Patients in the acute rehabilitation phase of recovery from a brain injury are at a high risk of falls, largely because of physical limitations and cognitive impairments. But some prevention strategies implemented at Shepherd Center have proven successful in reducing fall rates significantly in this setting.

Falls among these patients can occur because patients experience weakness, confusion, impulsivity, impaired safety awareness, and poor judgment and reasoning. They may also have uncontrollable spasms or movements that increase the risk of sliding out of a bed or a chair. Also, assisted falls may occur when a patient with limitations is learning new ways of moving and attempting to rebuild strength and endurance.

Strategies to prevent falls among these patients can be simple, but effective. Shepherd Center uses bed alarms on all brain-injured patients, seatbelt alarms, one-on-one attendants and frequent rounding on patients. Also, leadership engages staff members in maintaining a culture that recognizes the high risk of falls requires a high sense of urgency in responding to alarms, and that safety has to be more important than privacy for the brain-injured patient.

In a new 10-minute podcast from Shepherd Center Radio, Brain Injury Unit nursing manager Gail Greene, RN, BSN, CRRN, explains how Shepherd Center uses an interdisciplinary, collaborative approach to teaching and reinforcing the use of these strategies. The podcast is available as a download on this page or at Shepherd Center Radio.

Greene has been the nursing unit manager of the Acquired Brain Injury Program at Shepherd Center since 2007. She has practiced nursing for 39 years and has been a rehabilitation nurse since 1994 and a nursing manager since 2000. Greene is a graduate of the University of Pittsburgh, School of Nursing and earned her Certification in Rehabilitation Nursing (CRN) in 1998.

For more information on fall prevention, brain injury causes, and other patient and healthcare professional education topics, visit

About Shepherd Center

Shepherd Center provides world-class clinical care, research, and family support for people experiencing the most complex conditions, including spinal cord and brain injuries, multi-trauma, traumatic amputations, stroke, multiple sclerosis, and pain. An elite center recognized as both Spinal Cord Injury and Traumatic Brain Injury Model Systems, Shepherd Center is ranked by U.S. News as one of the nation’s top hospitals for rehabilitation. Shepherd Center treats thousands of patients annually with unmatched expertise and unwavering compassion to help them begin again.