How does your facility help prevent patient falls?

barlowjb · Feb 5, 2010

Try to determine if the pt is in pain. Try distraction (TV, radio, folding towels), bed alarms, chair alarms, sitters, bringing pts closer to the nurses station, wrist and/or vest restraints (last resort). In situations where one particular pt is prone to falls and keep getting up, all the nurses and CNAs pitch in to keep an eye on that pt. In cases where I have a particular CNA assigned to my pts, if I have one that is prone to falls and need close monitoring I may take over the cna responsibilities for other pts and ask the CNA to stay with the pt for a little while.

I had an elderly Alzheimer's pt once that kept getting out of bed. We finally got him out of bed and put him in a chair to sit and monitored him. I discovered that I had less problem with him in the chair than in bed. Later found out from his family that he had not slept in a bed for years and had always slept in a recliner. Later when we put him back to bed we made sure that the head of the bed was elevated enough to provide a similar feeling to being in a recliner - it actually helped. Sometimes turning the light off in the pt's room may reduce stimulation and help the pt sleep/rest. On the flip side some pts may not be used to the dark.

Try to determine the underlying reason why they continue to try to get up by themselves etc. Does the pt need to void? has the pt voided already and is just wet? Could it be that the pt is SOB and needs to sit up in a chair, or is the pt experiencing soreness on the buttock from lying in one position for too long. Does the pt need to put home clothes on because of feeling uncomfortable in hospital clothing? Is the pt bored and just need to leave the room for a little while: we once took a pt out of restraints and allowed him to travel up and down the hallway in his wheelchair by himself (he was monitored of course) and it worked.

We had one pt who kept trying to get up almost falling each time because she wanted to reach her purse, so some pts may need to have their belongings closer. On the flip side (I've seen this happen once) - a pt kept trying to get out of bed (just had a knee replacement) to reach her purse - we later discovered that she kept trying to reach some barbiturates in her purse, after the discovery they locked her purse up until discharge.

Some pts try to get up by themselves because they don't like to "bother people". For these pts teaching and reinforcement is very important, especially if they are taking medications which can cause drowziness or drop in BP. Reinforce that certain pts ask for help before getting up by themselves and when they get up teach them to sit on the side of the bed for a few minutes before getting up, in order to allow their BP to compensate for positional changes.

Hope this help answer what you are looking for

Best wishes