[Elektra6]

All of a sudden I have been writing up loads of incident reports for bruises, skin tears and falls. Is this what goes on in LTC? Or shouldn't I have this many? I have been working here for 9 months and all of a sudden some residents have become more combative and are racking up the injuries! Would like some feedback about your experiences with incidents.

Thanks!

[msnursekim]

You say, all of a sudden , you have more combative residents racking up tears and bruises? My first instinct as a 28 year veteran lpn is that you have a new employee that is agitating or abusing these residents. think about your nursing environment...what has changed from when you first started there compared to now? Think cause and effect...something has triggered these residents to become combative now, which we all know leads to tears and bruises.

[suebird3]

Is there any change of routine, or meds?

Suebird

[Elektra6]

It is a mixed dementia/non dementia ward. Two of my residents seem to be deteriorating mentally (dementia) and have become combative lately. Ruled out physical problems, but working on the psych ones, try this, try that. I was really wondering do other LTCs have this many incidents? Do you have 10+ a week? I'm starting to feel rotten about this. I have even been assisting with PM care with the combative ones trying to prevent any problems. Our nurse's aides are great and have been working there for many years so I don't feel it's them. They feel horrible when something happens to their residents.

[msnursekim]

Unfortunately, in LTC it seems we have cycles or runs of falls, deaths, incident reports, etc. I think it just goes along with LTC...but 10 incident reports a week does seem like a lot but it also depends on how many residents you have declining at one time. As you said, you do have several in this process so seems like it would be logical to expect more incidents. Hang in there...as the old saying goes,"...this too shall pass." Thank goodness you have caring CNA's. Treasure them because they are hard to come by in this day and age. Have you asked the aides what they think could be causing the problem? Many nurses overlook the aides as an input but they are really a goldmine for information on residents.

[suebird3]

Don't discount the Full Moon....I mean it! I swear our 'pleasantly confused' patients go gung-ho about then. And yes, some Full Moons are worse than others.

The aides are good resources. Good idea!

[marjoriemac]

I have seen periods when fals occur regualrly and skin tears. Sometimes staff education helps as they may be unintentionally too rough when dressing people etc. However I do believe there are times when risk is a part of a residents life which they are entitled to. We cannot wrap them up in cotton wool and can only ensure that we have done our duty in educating them, removing any physical dangers and documenting everything. Unfortunately sometimes people do partake in risky behaviour because they crave attention however and it is a sad state that people who are deprived of human contact will do anything to gain some. Keep a close eye on your reports and if they point to one carers involvement, or one scenario or one area - act on it. If they are all different, it may just be a natural part lifes risks!

[Patti 2nd gen RN]

Yes to msnursekim!!! Our aides are invaluable, and have an understanding of patients that often gets overlooked--validate them by asking for their input whenever you can!!!They have a huge, and dirty job for little more than McDonald's money--the reason the good ones stay is mostly that they care. But--as to 'runs' of incident reports--don't get too nuts about it--we get 'runs' of trach admissions, 'runs' of dementia patients, 'runs' of GT's--and right now we are getting renovated--the change in scheduele in getting some of the patients quite restless. Remeber, health care facilities are not motels--stuff happens.

[hptogram]

I'll go weeks without anyone falling on my shift, then all of a sudden I'll find three people on the floor. I think it does run in cycles.

[Dixiecup]

I do the monthly report for our incidents. On average we have between 20 and 40 per month.