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| No. 20 | 
Mar 27, 2000, 08:37 AM
Like some of the above responses already pointed out, I'll bet staffing is an important contributing factor to these falls. While you'll never be able to eliminate falls entirely, I'll bet you'd notice a significant improvement over the next three months if your staffing of aides were to increase particularly during the hours when most of the falls are occurring. Let's face it, most long-term care facilities are notoriously understaffed....
 | | Advertisement Sponsored Links | | | | No. 21 |
Mar 27, 2000, 07:34 PM
Originally posted by Dayannight:
Like some of the above responses already pointed out, I'll bet staffing is an important contributing factor to these falls. While you'll never be able to eliminate falls entirely, I'll bet you'd notice a significant improvement over the next three months if your staffing of aides were to increase particularly during the hours when most of the falls are occurring. Let's face it, most long-term care facilities are notoriously understaffed....
I have read the postings with great interest and sense that falls are of particular consideration in your organizations, as of course they should be to us all who work in long term care facilities. In Nova Scotia, Canada and generally right across this country, falls in geriatric clients are important challenges we face on a regular and consistent basis and we too search to find means to reduce the numbers and severity of them. There is an acceptance, however, of the right of the client to "risk", and the accompanying question of benefit and burden in deciding on approaches which might be employed in a particular client's case. We not only look at what the options list is in terms of safety measures to "prevent" or "eliminate" falls, we also place great weight on the impact the alternative measure potentially will have on the client's quality of life. There are clients then for whom alternative measures reduce quality of life experience; these clients will not have measures imposed. With congnitively intact clients, discussion has been held with them to outline the potential risk so that they have understanding of the consequences. With cognitively impaired clients, about all we really can provide is more frequent monitoring by the entire care team, and an altering of environmental factors which may be increasing risk potential. Of course family is directly involved.
It is my understanding that legal liability issues are a main consideration and motive in deciding care approaches in America. My question is how far do these very real considerations move the focus away from the client and more toward the meeting of regulations and legal liability concerns?
| | No. 22 |
May 06, 2000, 01:07 AM
I am on a fall prevention team at my facility and I agree with some of the others about looking at what type of drugs they are on especially antianxiety drugs and tranquilizers....if you can work together with a pharmacy consultant you can probably assess and possibly eliminate that certain drug with something else like an antidepressant. Or instead of having that type of drug as a routine med. maybe PRN would even do it. This approach has decreased falls in our facility and also we have to get together with our assistants in order to determine the causes for these falls, if you get to understand the behaviors of the pt. you will likely be able to find the most appropriate intervention because no pt. is the same. Originally posted by little bit:
I am a DNS in a 90 bed long term care facility in Vermont. I am looking for unique ideas as to how to prevent falls. We have tried everything in the book I believe and still have too many falls in my opinion. Some of the things we have tried are tab alarms, checking glasses of the residents who fall, checking their footwear, screening by PT , some residents are then put into a program for strenghtening, those are just a few. We also have a weekly falls team meeting to discuss falls that have happened during the week. Staff attending the meeting are myself, the nurse from the unit comes with the incident report and reads it to the team, other members are PT, Act director, LNA 's . Any new ideas to prevent falls, would be greatly appreciated. I also should mention that our facility has 90 beds, 50 are a combination of short term rehab.. long term care and Palliative, the other unit is 40 beds which is a Dementia Unit where the largest portion of our falls occur.
Thank-you in advance!
| | No. 23 |
May 07, 2000, 10:51 AM
We use fall risk assessments. Those patients that are considered "high risk" are put in rooms closest to the nurses station sometimes. Other times we use bed alarms. These are placed in either the bed or chair that they are sitting in. This has prevented people from sneaking out of their chairs and beds.
| | No. 24 |
May 13, 2000, 09:56 PM
I worked in a facility that utilized pvc pipe framed beds which put the beds pretty close to the floor, making a fall from bed pretty harmless. The theory was, if they are going to fall, make the fall less likely to be injurious. The beds were equiped to have the heads raised if neccessary. Also, we used tab alarms which alerted us of care needs. Toileting needs, pain needs, and rest needs were also addressed on a continual basis. In this facility, no restraints or bed rails were used to prevent falls.
| | No. 25 |
May 14, 2000, 07:15 AM
Hi,
I have a question about these PVC pipe beds. Are they hydraulic? If not, how are staff backs holding out with beds so low to the floor?
My facility purchased hydraulic beds that can raise and lower. They go down to about 15 inches and then there is a mat on the floor, which believe it or not we got from Sam's club for $30, instead of going through a medical supply place. This has reduced the significant injuries, at least the number related to beds. If anyone is interested, I will get the company name. Please e-mail me directly. NA
| | No. 26 |
Jun 03, 2000, 04:40 AM
I am an LVN on an Alzheimer Unit in a long term care facility. To answer you question is there any real true way to prevent falls? This is a continuing happening at our facility we have a 30 bed AD unit and most of falls occur with problems resulting from restraints of different types. We do not allow residents that have a lap buddy to have their wheelchair locked. The biggest help that we have is a 1 to 7 ratio of cna to resident that way they are closely monitored and also the added benefit of having the same familiar face helping them at all times.
Originally posted by Heather27:
Hi.
Falls are always a reasonably traumatic thing for the residents/patients, families, and staff included! We always think, "Could I have done something more to prevent this?" Even if a person doesn't get injured from the fall, it would be wonderful if it never happened at all!!
Of course physical and chemical restraint is ONE way of preventing falls, but the facilities that practice that are, in my opinion, not worth their funding....
We find that certain residents seem to fall in "patterns" if you will...For example...some when they have missed their afternoon "nap"...some when their grandchildren have just visited (? because they are excited/overtired)...some with the classic "sundowning".
The key is to know your residents. I often hear from my staff, "Mrs. X is a fall waiting to happen!" We then take extra care to always know where she is, and try our best to keep things out of her way...make sure she doesn't get agitated...anticipate needs...toilet regularly..make sure she has glasses/dentures/shoes/ "safe" clothing..
I don't think there is any "magic" way of preventing falls completely. Be observant, be careful, and be relaxed. There is nothing like tense staff to rile up residents!!
Good luck!!
Heather
------------------
kim
| | No. 27 |
Jun 07, 2000, 09:35 PM
In North Carolina, we are not allowed to use chemical or physical restraints, therefore we have HAD to come up with alternatives, like the Merry Walkers, Lap Buddies & Velcro Seat Belts. I worked in LTC when we used the physical restraints. Some of these residents could get out of them, no matter what.
I feel the nurses and nursing assistants just have to know their patients, and be always alert for anything.
| | No. 28 |
Jun 14, 2000, 01:11 PM
I don't know the laws in other states but,in Indiana, the residents have "the right to fall and hurt themselves". I have been told by administration I cannot restrain a resident in their wheelchair or their bed because it goes against their rights! Why are we here if we can't protect our residents from injuries from falls? When I asked this,what I thought was a sensible question, I was told the staff's job is to watch these people all the time. Do you believe this? How can you keep tabs on 7o-8o residents,individually, when you have one nurse and two cnas? Some nocs I may have three cnas---someone always calls off.We as nurses are suppose to use our sensible judgement in caring for these people.Not only am I responsible for the resident's safety but,if the cnas don't do their work,I am responsible for that,too!So,am I a glorified babysitter? I feel we should be allowed to do whatever is necessary in order to protect these residents from hurting themselves.Just be sure there is good documentation as to why you used restraints and what restraints were utilized. This is the number one problem in the nursing homes around here. Second is skin breakdown;that's a story in itself!
| | No. 29 |
Jun 15, 2000, 09:46 PM
In Wisconsin we are not to use restraints, the State Surveyors have said I need to reduce the risk of injury, I will never be able to prevent residents from falling. What we have done is purchased special beds, as I have mentioned before. It is not a perfect solution, but it has cut down on injury. NA
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