Quote from Let's help out
I know many may want to "file" this question under the "duhhhhhhh, column of basic nursing" but I would like info on the protocol and proceedures of nursing care after a pt falls. Please share how and what your response is. How do you handle falls? What exactly do you do? Also, what are the roles of the CNA's re: pt falls? We had a CNA say, (after she found pt and assisted nurses returning her to bed), that she didn't know she was to do VS on fall pt. Which was pretty much throwing the nurse, not to mention the pt, under the bus. Don't CNA"s learn how to monitor pt p fall in school these days? I realize ea facility is "supposed" to have available policy and proceedure manuals. I've been on a "Where's Waldo?" hunt in my facility to find them. Why aren't the manuals online? Maybe they are properiortory (sp) information . I have heard they may be locked up in the DON's ofc. Which doesnt help PMs and noc nurses. Also, do I dare mention the politics of "what constitutes a fall" some use the term "slid out of bed" how does that work? How to evaluate what is a fall and what is a slide? Thank You Nurses
Best practice guidelines: any change in elevation is a fall, nueros on all unwitnessed fall (doesn't matter what the resident tells you, do nueros), don't touch resident without nurse assessment especially for new pain, decreased ROM all joints. C.N.A's work under the license of the nurses, nurses must train and educate, I wouldn't expect the aides to do anything accept leave the resident on the floor, get the nurse and proceed from there and fill out their portion of the incident report. If you train them, they will learn to get the vitals at the scene, but safety comes first before vitals, and if the fall is a repeat offender, initiate tab or pressure alarm asap or move closer to nursing station. There is no reason a nurse can't get the vitals either. Ask for and make referral to PT for fall evaluation, chart, put on alert, call MD and family and DON/Administrator. Look for abuse/neglect: was the patient too close to the edge of the bed, slid out of bed, speciality mattress deflated and patient slid, bed NOT in low position, etc. Train your CNA's not to leave w/c's next to bed of folks who WILL try to climb back out of bed, keep the busy fallers UP as long as possible and entertained, so that when they DO go to bed, they go to sleep.
Note on the comment "Locked up in the DON" office. This is such a bizarre statement, I have heard it over and over at my building. The ONLY thing I have in my DON office is the filled out incident reports, and ONE policy and procedures manual and ONE purple book for SNF guidelines. THESE are ALL available at each nurses station, easily visible in the chart racks.
WHAT is this about? WHY do nurses persist in passive-aggressive "I don't know" "I don't have time" attitudes that ultimately HURT them? MEMO to all nurses: IF one really think the DON has all the vital books locked up in her/his office then for HEAVEN"S SAKE go see her/him during office hours and ASK for them. (and CALL in the off hours to find out from the DON where the books are located.
Seriously, CALL the DON, the Administrator, the owner, the corporate nurse, the MD. TELL the DON what these other nurses are saying and CALL the Staff Development nurse so she/he can schedule an immediate inservice for those NOT in the know.