How does your facility prevent falls?

BahoRN · May 4, 2014

I've you're overhauling or adding content to your current policy, you really should be reading the latest evidence-based research regarding this topic. That is where you will find the best and most effective interventions organizations can use. Best form is to have policies related to the research, not upon what others say they may or may not be doing.

Wrench Party · May 4, 2014

All kinds of fun ways:

1) yellow wristband and socks with traction for falls risk patients.

2) Picture of a leaf on the door for those who have fallen in the hospital

3) OT/PT will include in their assessment whether pt should have access to bedside commode, raised toilet, etc.

4) Pt education on calling for us. Most of mine are pretty good about calling for help, especially when they realize they're attached

to several IV pumps, O2, cardiac monitor hardwire, etc.

martymoose, BSN, RN · May 4, 2014

Hmm, how do we prevent falls? We end up having the nurse 1:1 the patient the whole shift and his/her other patients suffer as a result.

Cause heaven knows we can't restrain them in any way- yet they won't stay put.

No win situation unless facility wants to hire babysitters.

Yes, this subject burns me to no end.

Bands on those pts don't stop them. Cute signs on the door don't stop them. Low beds don't stop them. Bed alarms are useless if you can't get there in time to catch them.Toileting them q 1 hr doesn't stop them.

Only thing that stops them is to physically tell them to get back in bed.You can ask all you want" Do you need something; why are you getting up " Their answer "I don't know" or "I'm going home" You can redirect until you are blue in the face.

I'd love to see evidence based practice of implementing babysitters for these people. Awww, but then the hospital will lose money

sunnyshine1989 · May 29, 2014

1. yellow sign on the door that says Fall Precautions

2. yellow band on

3. yellow gown

4. bed alarms. ours have 3 settings from least sensitive to most sensitive

When a bed alarm goes off everyone that is available runs to that patients room. We do have times, when all else fails, that we have to be with them in the room one on one. We do have in our policy the allowance for sitters. But, we never are allowed to have them. Have to jump through a million hoops to get one. It has been my experience that sitters take their title seriously. They just sit and watch the patient get out of the bed and do nothing.

Restraints are always the last resort.

Hope this helps.

imintrouble, BSN, RN · May 29, 2014

Hmm, how do we prevent falls? We end up having the nurse 1:1 the patient the whole shift and his/her other patients suffer as a result.
Cause heaven knows we can't restrain them in any way- yet they won't stay put.
No win situation unless facility wants to hire babysitters.
Yes, this subject burns me to no end.
Bands on those pts don't stop them. Cute signs on the door don't stop them. Low beds don't stop them. Bed alarms are useless if you can't get there in time to catch them.Toileting them q 1 hr doesn't stop them.
Only thing that stops them is to physically tell them to get back in bed.You can ask all you want" Do you need something; why are you getting up " Their answer "I don't know" or "I'm going home" You can redirect until you are blue in the face.
I'd love to see evidence based practice of implementing babysitters for these people. Awww, but then the hospital will lose money

I agree with the above 100%.

You can keep the cute signs, the colors, the alarms, and the alert on the Kardex. The nurse knows 5 minutes after he/she's assessed the patient, if there's going to be a problem with falls. Sometimes there's sundowners, or other conditions that don't manifest immediately, but generally a fall risk is evident on admit.

All the "props" used for fall alerts, are simply protection from litigation. Protection for the hospital, not the nurse. Any falls that happen on any given shift have to be the fault of the nursing staff for not paying adequate attention to the "props".

Muser69 · May 29, 2014

We don't. Despite all the attempts to prevent. The door signs are the silliest. Are they supposed to grab the sign on the way down to the floor?

annie.rn · May 29, 2014

It has been my experience that sitters take their title seriously. They just sit and watch the patient get out of the bed and do nothing.

Ha, ha! Love it.

amoLucia · May 29, 2014

We don't. Despite all the attempts to prevent. The door signs are the silliest. Are they supposed to grab the sign on the way down to the floor?

This one made me laugh out loud! So true!

dudette10, MSN, RN · Jun 3, 2014

I'm as cynical as the rest of you on the signs and arm bands when almost everyone is a fall risk. However, if you have a fall and the sign wasn't on the door or the fall band wasn't on, the nurse is blamed for the fall. Bed alarms do work, as long as the nurses answer them. We do, and watch the CNAs stroll past the alarm as we are running to it.

martymoose, BSN, RN · Jun 3, 2014

the nurse is blamed for the fall. .

we're blamed either way....

Cuddleswithpuddles · Jun 8, 2014

At my hospital, everyone is on fall precautions. Everyone. This was a result of nurses realizing that it is better to CYA than to be blamed for not implementing fall precautions on the rare one that got away. Everyone gets yellow tag things, every bed has a fall precautions sign etc. It is all just window dressing, really. Prudent nurses and CNAs know who to keep an eye on.

By the way, I heard a short segment on NPR about a bed company that wanted bed alarms that sounded like "Mary Had a Little Lamb" or some other nursery rhyme. They wanted the alarm to be distinct from all other alarms in the hospital. I think I spit out my coffee in the car. I immediately told my coworkers. We had fun coming up with other songs like

"Free Fallin'" by Tom Petty and the Heartbreakers

"Another One Bites The Dust" by Queen