Constant Faller - page 2

Okay this is a little of a vent here. We have a resident who loves to live on the floor. Falls and climbs on the floor more than he is in his chair. We've tried alot.. wheel chair alarms, bed... Read More

  1. by   canoehead
    How about a rocking chair? |Lots of movement and less risk.
  2. by   NursePatsy
    Can a pattern of the falls be determined? Such as the times of each fall, where the falls happen etc.
    My facility recently dealt with a similiar situation involving a frequent faller that is also a hospice patient - with 75% of the falls occuring between 4pm - 6pm (determined through tracking). We tried everything imaginable. As our last resort, Social Services arranged for family members to be present at the high risk time until hospice can find a volunteer. The family is very supportive. so far, so good.

    I have also heard of other facilities using Adirondeck chairs. My facility considers this type of chair to be a restraint, so I'm not sure how other facilities get away with it?

    Hope this helps
  3. by   ktwlpn
    Originally posted by NursePatsy
    Can a pattern of the falls be determined? Such as the times of each fall, where the falls happen etc.
    My facility recently dealt with a similiar situation involving a frequent faller that is also a hospice patient - with 75% of the falls occuring between 4pm - 6pm (determined through tracking). We tried everything imaginable. As our last resort, Social Services arranged for family members to be present at the high risk time until hospice can find a volunteer. The family is very supportive. so far, so good.

    I have also heard of other facilities using Adirondeck chairs. My facility considers this type of chair to be a restraint, so I'm not sure how other facilities get away with it?

    Hope this helps
    The residents can get out of the adirondack type low chairs(theoretically ,at least-or the chairs slow them down long enough to enable staff to reach them before they fall over) so they are not considered a restraint here-any device that the resident can get out of or unfasten is not a restraint(lap buddies,low chairs) We were citied due to a resident with over a dozen falls in a day-the facility had to provide 1 to 1 care to keep her safe...According to the state dept of health when you admit a resident you are agreeing to give them the care they require-not having enough staff was no excuse for them....
  4. by   CoffeeRTC
    ktwlpn
    sounds like my guy. He's settled down a little bit. Right now he's in a wheel chair with a seat alarm and lap buddy. He's able to remove the lap buddy, but at least its slowing him down a little. I like the addirondeck chair idea.
  5. by   boxermom
    He sounds like he needs a restraint, after you do all your supporting documentation. He needs to walk and tire himself out, and be toileted, repositioned and fed and given fluids and everything else, like labs done before you do a restraint. He needs hip pads to decrease the risk of injuries if he falls. He needs either his family to be of assistance to staff when he's busy or he needs to be transferred to a different facility if you aren't able to keep him safe. You sound like a great nurse, your administations sounds like they aren't in the real world.
  6. by   Monica RN,BSN
    Reply to comment " make an incident report each and every time and state the reason as lack of proper staffing and management has been notified" I will agree to make an incident each and every time, but in our facility if a nurse would have written the cause of fall was due to lack of proper staffing the nurse would have to rewrite the report. That information would never be allowed in an incident report. I would suggest making a separate letter to administration stating the unsafe practice and liability involved, go above the administrator if you have too. And if all else fails make an annonymous phone call to the ombudsman or elder affairs people who handle nusing home complaints. This will prompt an investigation on the facility and then management will have to listen!!
  7. by   blueeyes827
    Our facility works very hard on preventing falls and still have a few who just are very persistant so we must be creative. We have a fall form to fill out after each fall............the nurse on the floor immediately so we can see what was found when the resident fell such as: were the alarms attached and working, all safety equipment in place, ask the resident what they were trying to do ( it is amazing that some of our demented residents are consistant with their response), do they need toileting, when did the eat last, last meds given. The unit manager then does a chart review and requests med review by pharmacy. PT/OT screens for least restrictive measure and begins treatment for strenghtening.

    Things we have tried:
    merry walker............but they can be dangerous if the resident climbs out of them.
    aggressive toileting programs,
    snacks,
    changing med times
    reducing or changing meds
    using bolsters on the bed
    low beds
    various alarms
    activities
    restorative program---a must
    family input

    We meet weekly with a fall committee with a respresentative from all departments to come up with creative solutions.
  8. by   deadend
    I am concerned about frequent falls also we have tried everything however it appears that the staff are desensitized to fall incidents (even the nurses) we do have a new QA person however she is just getting to know the facility, supervisors on each shift are to review the incidents reports including myself however one stubborn supervisior does not seem to get it right and wants to dump all the fall investigation on me ADON what are my liabilities in regards to fall investigations? does anyone out there know how I can protect myself some of the documentation on the falls incident report is horrifying please help
  9. by   blueeyes827
    In our facility we had a lot of nurses who did not want to follow procedure post fall. We made up education forms. We spent a lot of time educationing them. I always keep a copy of the education form and the DON keeps the original. She logs them and then they go to the employee file. We also had inservices to educate CENA's and all other staff members. We taught them that no one can go by a room with an alarm ringing. We also taught them how to use all equipment. It sounds like you do not have a team approach and your survey team will see that on survey. We also super glued are alarms to the on position and the loudest sound. Education forms have helped the most, unfortunately there are some who need to be written up. This has to be consistant across the board. Good luck
  10. by   Nursie30
    We have stated the falling leaf program, had all staff sign a protocol of at risk residents, any resident that scored higher than 10 on fall risk assmt was placed on this list, first one down, last one up, helmets, siderails down, low bed, mattress on floor, pressure mat on floor, safety alarms, velcro restraints, lap buddies, all evaluated for effectiveness through OT for positioning device and which is the least restrictive for that resident, staff education is very important, drilling it into their heads, but falls have decreased dramatically since implementing this program (no longer work there, can't say about since I left last week, but it was working)

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