What do you do to prevent falls?

[carebear01, BSN, RN]

I work on a med/surg unit with a diverse population. Last month we had four falls We use bed alarms, yellow socks, fall armbands and fall alert signs. Something is not working. The bed alarms are not used 100% of the time. Sometimes they do not work or someone may forget to set the alarm. I have volunteered to do research to figure out what we need to do to change this problem. What does your unit to do prevent falls? Any advice would be appreciated

[makes needs known]

We have alot of paperwork to fill out and even our cna's have to contribute to it. This and the fact that people with broken hips require more work and have many more health problems than before they fell has made us run when we hear an alarm. An I&A report details the circumstance makes create a plan so that particular resident doesn't fall like that again. Did they fall trying to get into bed? We offer to help them lay down. Did they fall leaning over to get something?, We put all their things where they need it. Did fall trying to take them self to BR? We offer toilet freq. and monitor for UTI. Every person every fall has a different reason. Anticipating needs helps, but we still have falls, humans like to move.

[nursekimmi]

:nurse:I'm the PCA where I work...we just monitor, monitor, monitor....do you have nursing assistants on your unit? This is what I do all night long...good luck with the research!:heartbeat

[NurseLoveJoy88, ASN, RN]

this is a great question. i work with alzheimers pts. and we have 2-3 falls a week. im dying to know what else can be done to prevent them. paperwork i dont care about, i just want my little residents to be safe.

[cakegirl]

In my unit the use of alarms at all times is a must for patients that are fall risks. We go around at the start of each shift and make sure they are both plugged in and in good working condition. Extras are always available to immediately replace a non- working alarm. We also began an education program for all staff members, even those non medical personal. Such as cleaning crew to be alert an aware of what patients are doing when they are in the vicinity of their rooms. All of our staff have been trained on fall prevention so it's not just the CNAs or nurses job. A good toileting scedule is also helpful. I'm happy to say we have seen a reduction in falls on all three floors of my facility since Jan. I think consistancy is the key. I know everyone is always really busy but the time lost when a pt has a fall is far greater than taking a few minutes here and there for preventative measures. I hope this is helpful!

[makes needs known]

Paperwork helps to formulate a plan to prevent falls. We have people who roll out of bed several times a week. We put them in ultra- low beds and put mattresses around bed. Now when they roll onto extra mattress it is care planned to not be a fall. The extra mattress is considered part of their bed.

[mamamerlee, LPN]

When visiting my MIL in the NH, I noticed some pt's only had mattresses on the floor, no actual bed at all. There were a few of these, so I assumed it was a fall prevention technique. You may need permission from the POA to do this, as it may seem punitive to some people.

[loriangel14, RN]

We have beds that lower right to the floor and we use the mattresses on the floor around the bed occassionally. We use seatbelts on wheelchairs,trays on geri chairs and very frequent monitoring for the three Ps -pain, positioning and potty.

[sassy_cassie]

We have some lowbeds that are great they go about 18inches off of the floor, but can be raised when I want them to be. Then we have pads that go on the floor, so if they roll out they don't get hurt. They have an alarm in them, but it seems they either go off everytime the pt's turn or 5min after they get out of bed. If the pt has family you can always ask them to stay with the pt's at the times they are the most restless or all the time. Sometimes I bring the pt out to the desk, so who ever is charting or the unit sec can monitor them while doing other work.

[classicdame, MSN, EdD]

hourly rounding?

[ayla2004, ASN, RN]

hourly rounding we look at possiens and clutter toileting and drinks.

commode taging(a pt on a commode must always be monitored by a staff member we can step outside a privacy curtain)

safety crosses.

we have had good sucess however some pt with impulse control wont wait to be assited and try to stand unaided a pt of mine has.

[JDZ344]

As a HCA in England- We have low beds that go to the floor, almost, which we use with "fall mats" to minimise injury. Bed rails if indicated.

For prevention- 1/2 hourly or more frequent rounds (this is easier in the UK because we have open wards with 4 to 8 people to an area), with an activity chart where you state what the person was doing at that time- e.g "Sleeping" or "Walking around bed area" etc.

Make sure everyone has a call light, water and tissues, etc in reach and nobody ambulates without shoes.

For those really at high risk, we get a 1:1 person to stay with them at all times.