desperate need of info

eak16 · May 17, 2004

do a search on PubMed or CINAHL, ask your school librarian if you do not know how to access these

zacarias, ASN, RN · May 17, 2004

im in desperate need of info on falls in elderly patients. one is what constitutes a fall does walking in a room and finding a patient on the floor concidered a fall if there is no apparent injury. and what type of interventions are out there being used to prevent falls ?

I would say that walking in a room and finding a patient on the floor is considered a fall no matter injuries they may or may not have. It still requires an assessment to see if there are any obvious injuries. A fall to the head would necessitate a CT scan also.

There are many methods to reduce falls. For instance on the floor I work on, we have a lot of encephalopathy patients and we opt for "sitters." They are with the patient and help them out with basic care and are instrumental in preventing many falls. Another method is to somehow put a symbol or sign next to their name on the door to alert staff that this person is a fall risk. Then you will be that more diligent in working to prevent a person from falling.

nurseygrrl, LPN · May 17, 2004

I can tell you what we do in our facility.

First off, if a patient is found on the floor and there was no one to witness it, (this is reminding me of a tree falling in the forest :chuckle ) we call it FOF for found on floor. This counts as a fall because when in doubt, it's counted.

As for prevention there are many things out there. We have a program for our frequent fallers where a team meets and discusses individualized prevention techniques for each patient. We have personal alarms, underseat alarms for WC bound patients, bed alarms. Floor mats for pts. who fall out of bed to prevent injury. We also put a little sticker on the back of their WC or give them a pin that shows staff, in a discreet manner, that the resident is a frequent faller and then they know to watch them more carefully.

We also put pts. on a toileting program if it seems they fall in or on their way to, the bathroom. If we go in and take them to the BR every 2 hours or so, they are less likely to try and go on their own .We will also get pts. OOB earlier so they can be monitored instead of having them lie awake in bed and trying to climb out on their own.

elkpark · May 18, 2004

Whatever facility you work for should have a policy & procedure that define what a fall is, and how to treat situations where you find someone on the floor without having actually witnessed them falling. Most facilities do consider that to be a fall (erring on the side of caution ... :) )

The facility should also have a policy & procedure for a fall risk protocol (or whatever they choose to call it), which would identify the process by which the facility identifies patients at higher risk of falls and interventions to be used with those patients to attempt to keep them safe. All of the suggestions may by the other posters are good ones that you often see in these protocols. Another common intervention is to place the fall risk people in rooms as close to the nursing station as possible, and communicate to all nursing staff which patients are at high risk for falls so that all can work together to keep an eye on them and keep them safe.

If you are working for a facility which does not have specific policies and procedures that address these issues, you may want to bring that up with administration as something that needs to be addressed. I work as a surveyor/inspector of hospitals for my state and for the feds, and we often investigate complaints that involve patient falls. The facility may not get in trouble if they took reasonable steps to keep the patient safe but the patient fell anyway, but it will definitely get in trouble if it does not have an established policy/procedure for identifying patients at higher risk of falls and taking steps to reduce the risk of falls (or if it has such a policy/procedure but staff failed to implement it).