Do you RN's out there think that Root Cause Analysis has changed things? It sounds good. I've heard that JACHO is focusing on "falls" currently. There is so much that goes into patient falls. (No orders for activity level, RN's not having time to assess mobility accurately when it comes to weak patients). I know it almost may sound absurd, but wouldn't we prevent so many falls if we did something like a Braden Scale for Strength/Mobility/Safety Risks. If people scored over a certain level, they would require a Physical Therapist's eval with a PTA plan/care plan, orders, etc. that the attending would have to sign off on? The last hospital I did clinical at had skin care orders that were typed!
I think activity assessments/evals/orders and plans of care are so grossly absent on med/surg floors. Pt's deserve better. I'm not saying every single person that goes to a med/surg floor needs a Physical Therapy eval, but why not a screening tool to find out who does need a Physical Therapy? Let's be real. An RN on a med/floor has no way to do a beginning of the shift assessment for mobility/safety without doing an eyeball/gut feeling/1/2 way guess assessment. And we all know that most new nurse's are completely incapable of an accurate one anyway!
We would be better off putting more money in this area, than spending the money on the lawsuits and rehabilitating patients who fall because no one in the hospital thought it was important enought to assess them properly from the get go.
If anyone has risk managers, friends in JACHO, insurance companies, managers on floors, physical therapists to print this out for in order to get some feedback, I'd love to hear it.
I think the root cause analysis of falls would show it is a negligent system that contributes to falls and that nurses should not end up "taking the fall" for everyone.
Would you like to comment?
