I got a call from the 11-7 nurse supervisor last night saying that I didn't report a fall. I was wondering what's your facility's description of a fall? I didn't report the fall because my resident who to my perception didn't fell, she 'almost fell'. Resident was already at the edge of her wheelchair when I caught it and we eventually ended up on the floor with her knees touching the floor. She is 260 pounds and I'm only 110 and 5 foot tall, trying to stand the resident all by myself was impossible. She was holding the edge of her bed so tight that I can't even stand her up. I was there for 5 minutes and thank God that my aide passed by and called another aide to help her put to bed. Now, the said CNA told the 11-7 shift (she worked a double that night) that she wants to go home at the middle of her shift because her back hurts because this said resident fell.
Bottom line is: In your point of view, do you think that my resident fell and that it requires to be reported?
In my facility it would be considered a fall too. Even if they are lowered to the floor it is a fall. I look at this way. An incident report is used to revise the care plan and find ways to prevent it from happening again. So you would want to find ways to prevent that near fall and hopefully prevent a real fall.
Yes...In my place that should warrent an incident report. I think we need to come up with other names for these things...they really aren't falls. To me a fall is when the resident is not being assisted and unintentionally drops or falls to the floor.
I had a similar incident that happened a month ago with a different resident and told the nurse supervisor about it and the incoming nurse. None of them told me to make an IR so I was under the impression that when this happened, it shouldn't be written down. Now, I realize that you don't really learn everything upon orientation. It's a case-to-case basis and everyday I'm learning. Sucks that I have to go through things like this before I learn.
I've been told "we're not going to do an incident report" on "this" [lowering a pt to the floor, or someone on their knees, as you described] and gotten the impression that the supervisor instructing me does not want another IR on her shift. In some facilities, IRs are broken down into categories - fall, "near fall," etc... if "near fall" is an option right on the IR, I'd take that as a sign that a near fall should be documented in an incident report. It really isn't clear, like you said, and I've started going straight to the DON to clarify these things. If you get your info from the DON, no one is gonna tell you you're wrong.
What the OP has described is called an assisted fall at my facility. It is not safe to keep a resident from falling while they are falling, so the OP was safe by lowering the resident to the floor. Thus is an "assisted" fall. We document this and do an incident report.
I had a similar incident that happened a month ago with a different resident and told the nurse supervisor about it and the incoming nurse. None of them told me to make an IR so I was under the impression that when this happened, it shouldn't be written down. Now, I realize that you don't really learn everything upon orientation. It's a case-to-case basis and everyday I'm learning. Sucks that I have to go through things like this before I learn.
Write them all up. The reason this became an incident is because the aide is claiming injury.
Cover your butt, and not because of possible slaps.
Specializes in LTC,Hospice/palliative care,acute care.
Once the resident is on the floor, it's a fall. Has to be reported and usually only an RN can assess and say ok get them up. At my LTC facility we have to lift with an actual lift when this happens.
Wow! We would have to pass out pillows and blankets if we had to wait for an RN to assess.
I was taught the definition of a fall is when the resident ends up in a place they would not normally be!
IN our facility the resident cannot be moved until they are assessed by a nurse, but it doesn't have to be an RN, an LPN can do it. We only have RN's on day shift.
NYS requires and RN assessment before the person is moved. True PITA. I stand there and cosign what the LPN with 30 years more experience than I have wrote.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Just curious about--- why did she fall? Was she stable enough normally that you felt it was safe to transfer a 260 lb woman by yourself? Heck I would imagine you would have been the one that had a bad back from attempting to stand up an obese lady for 5 minutes to prevent her from falling all the way to the floor! Ouch!
Specializes in OB, Peds, Med Surg and Geriatric Nsg.
Just curious about--- why did she fall? Was she stable enough normally that you felt it was safe to transfer a 260 lb woman by yourself? Heck I would imagine you would have been the one that had a bad back from attempting to stand up an obese lady for 5 minutes to prevent her from falling all the way to the floor! Ouch!
It was already 2200 when the incident happened. I'm surprised to see why resident is still up on her wheelchair and not on bed. Ambien was given at 2100, so I'm pretty sure that the pill probably kicked in already thats why resident is ringing her call bell. Being a new nurse who makes sure nobody falls on my shift, I took a peek at resident's room, only to see that she was at the edge of her wheelchair, leaning forward holding firmly on the side if the bed. Came in and assisted patient to let go of the bed and to stop leaning only to find out that she is on her way to fall. Assisted the patient with the much strength that I have and held her in that way she wouldn't slam her legs on the floor. Thank God her call light was still on and when an aide passed by, they helped me put her back to bed. When I explained my case to my director, she was wondering why resident was still up by that time and why did the chair alarm didn't sound which happens to be aides fault for not checking that alarm wasn't turned on.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Sounds like you walked by in time to prevent it from being much worse than it turned out to be. Ambien sure does kick butt for such a little white pill, too. Thanks for your reply.:)
, most residents should be IN BED before they receive Ambien.
kcochrane
1,465 Posts
In my facility it would be considered a fall too. Even if they are lowered to the floor it is a fall. I look at this way. An incident report is used to revise the care plan and find ways to prevent it from happening again. So you would want to find ways to prevent that near fall and hopefully prevent a real fall.