Hops requiring nurses sign no Falling contract, Is this legal???

[psmith118]

My acute care facility is requiring nurses to sign a no fall policy with each patient. The patient is stating they will not fall and the nurse is stating she/he will do everything they can to help their patient not to fall. Is this legal and if a patient does fall and gets hurt or even dies, would the responsibility fall on solely on the nurse? I don't like this one bit. Esp on a fast paced med/surg unit where you are always busy.

Any thought???

[ottersloveoysters]

My thought: maintaining a safe environment for patients is part of my responsibility as a Registered Nurse so there is no need to sign any sort of contract about this.

[dawniepoo]

It's just another task that is piled up on the nurses, having to worry about agreements. ugh!

[NurseGirl525, ASN, RN]

This is not a contract. I think the OP is blowing this way out of proportion. We have family or patient if they are capable, to sign a safety agreement. I'm sure what the OP is describing here is similar. It's just the nurse and patient going over safety precautions that are put in place.

Falls still happen. People still try to get out of bed. Things happen. Get malpractice and it shouldn't be a worry.

[RiskManager]

https://intermountainhealthcare.org/ext/Dcmnt?ncid=521548969 Here is the agreement used by Intermountain

Eliminating Falls - Hospital Quality Institute The sample agreement is at number four

http://www.carondelethealth.org/media/carondelethealth/documents/5812_15896_SJ%20Patient%20Fall%20Prevention-Clean%20Policy.pdf Carondolet fall policy

https://www.americannursetoday.com/wp-content/uploads/2016/09/POSEY-Contract.pdf Another agreement

Fall prevention: A contract with patients and families - American Nurse Today Journal article

I would hope that the typical inpatient nurse would be in favor of these efforts to prevent patient falls.

[taivin]

I wouldn't go all crazy with this. It all depends on the language. You say it says that the nurse will do everything they can to prevent falls. Does it actually say that you would be personally responsible if they fall. As someone said earlier, it's to highlight falls and how dangerous they are to the patient's well being.

People fall at home, but when they get to a hospital they don't think about it. Actually pretty clever if you ask me. This also puts a major focus on fall p/p. It might not be the first thing you think about when admitting a patient, tough there is a fall evaluation tool in the admission kit (should be).

This would also fall under the heading of your job description and the state's Nurses Practice Act. I'm curious, has there been many falls in your unit? If you think about it, you already sign for the fall risks when doing the fall risk assessment tool upon admission. But that doesn't really register with the patients.

A fall is considered a "never event"; as in it's not suppose to happen. Interesting link below... CMS is on everyone's back to implement extra policies for the never events.

I'm predicting the same thing will happen with bedsores, and than the skies the limit. Your jacket should be chock full of agreements that simply point out your job.

Hospital-Based Fall Program Measurement and Improvement in High Reliability Organizations

[Buyer beware, BSN]

Only have patients sign "no falling contract" if on orthopedic floor and/or are demented elderly clientele and you are understaffed; and/or, if need be, also binding arbitration.

*( for convenience, these documents can be innocuously thrown in with the hospital corporation mission statement)

Because, in reality, we all know how "slip and fall" happy this patient population can be.

Bombastic Bushkin RN Esq.

Risk Management

[Susie2310]

Only have patients sign "no falling contract" if on orthopedic floor and/or are demented elderly clientele and you are understaffed; and/or, if need be, also binding arbitration.

*( for convenience, these documents can be innocuously thrown in with the hospital corporation mission statement)

Because, in reality, we all know how "slip and fall" happy this patient population can be.

Bombastic Bushkin RN Esq.

Risk Management

Sarcasm here . . . This important agreement should be included in the admission paperwork and posted on the facility web site under "Patient responsibilities when receiving care: This is your agreement with our facility. No matter how sick/infirm/incompetent/under the influence of medications you are and irrespective of what procedures/treatment you have undergone, this agreement binds you to ensuring you use the call bell to summon assistance before trying to get up/get out of bed, and to waiting for a staff person to assist you. You are responsible for any injuries you incur as a result of not following this policy." Just to be clear, I am expressing sarcasm at this absurd concept of making the patient responsible for their safety while hospitalized.

[Julius Seizure]

It wouldn't worry me liability-wise as a nurse, but it does seem kind of like one more silly form to waste paper on. I guess unless it protects the hospital from those patients who get up without assistance when they shouldn't. Proof that they had been told not to?

Otherwise...

"Here, sign this form promising that you won't fall"

Next, should we make one where they promise not to die?

[AutumnApple]

In reading the original post, it says nothing about a contract. It states 'policy'. It seems to me that a specific policy has simply been highlighted as being amongst the most important to bring awareness to patients' responsibilities to help keep themselves free from injury....kinda like a 'you have to help me help you' type deal.

If the patient still falls and all safeguards have been implemented, the RN cannot be held responsible if she has other patients to tend to as well. The patient didn't uphold his/her responsibility such as calling for help and waiting for that help to arrive before attempting to get up.

In short, that form is to let the patient know that we have expectations of them, too. That's how I would interpret that policy.

Yes. It's obviously a "behavior contract" or "treatment plan contract". Not a legal or binding contract.

Admin/management are most likely using it to open the conversation of safety between the pt and nurse.

[Shanua]

The hospital I work at is starting something like this. It's not a binding contract but something to show that we've educated on the fall risks and put the patient on fall precautions. AMS patients can have family member sign. It's more to raise awareness and there is a huge push to decrease falls. It's starting October 1st so I'm not really sure of all the details. In no way is it a contract that will reflective negatively on the nurse if she has a fall. It's not legally binding to fall back on patient either.

[Susie2310]

The hospital I work at is starting something like this. It's not a binding contract but something to show that we've educated on the fall risks and put the patient on fall precautions. AMS patients can have family member sign. It's more to raise awareness and there is a huge push to decrease falls. It's starting October 1st so I'm not really sure of all the details. In no way is it a contract that will reflective negatively on the nurse if she has a fall. It's not legally binding to fall back on patient either.

Don't you already chart that you have assessed for fall risks and implemented fall precautions, and that you have educated the patient on this? Isn't your documentation in the patient's medical record? Are staff physically checking on the patient's safety frequently? Is it possible that the assessments/patient education are not being done and fall precautions are not being implemented, hence Management's need to involve the patient further?

[OwlNation]

It reminds me of having a patient contract for safety if they are suicidal. CYA and awareness type of purpose.