How does your facility prevent falls?

[GoldiesMom]

Hi All-

I was wondering if anyone would be willing to share some tips on fall prevention. Does your facility use a symbol/sign-on-the-door system? What symbol do you use? Does anyone have any clever ideas for remembering to set a bed alarm? I recently joined my hospital's fall prevention committee and am looking for new ideas as we are trying to overhaul our current fall prevention policy. Any ideas would be greatly appreciated!

Thanks

[thenightnurse456]

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

"Problem" by Ariana Grande

[K+MgSO4, BSN]

everyone getting a band etc negates the point of high falls risk pts. they are the patients that need to be discussed in huddles etc so that they are a highlight on everyone's mind.

[applewhitern, BSN, RN]

We use the bed alarms. They have been effective for us, and we rarely have a fall.

[whichone'spink, BSN, RN]

Bed alarms mainly.

[martymoose, BSN, RN]

At my hospital, everyone is on fall precautions. Everyone.

You know, I've notoiced we are doing this more too. pt's hate it , but sorry. Since we are responsible, too bad.People dont get what a big deal a fall is.I tell my pts now that sorry, it's for your safety, and if you fall, that makes you stay in the hospital much longer and could cause you to break a hip. Most acknowlege this.

I mean, even the walkie talkie can trip because they're on pain meds, etc.

It's ironic. can't use restrictive devices, but pts still will lose their freedom of moving about independently. Too Bad. Blame you previous patients who have set this precedent.

[calivianya, BSN, RN]

Speaking of funny bed alarms... we have these fancy brand new electronic touchscreen beds (love them to pieces, really, they are the best thing since sliced bread and they are probably what I am going to miss most about my current job when I leave at the end of the month) that play music and even translate things into other languages. Really. I can push the "are you in pain?" option in Spanish/German/Italian/Vietnamese or one of like 20-something other languages and my patient can shake his head yes or no... we recently had a Spanish-speaking patient on the vent that everyone assumed was delirious because we couldn't get him to follow commands, somebody pushed the "hold up two fingers" option in Spanish, and... he held up two fingers. It was awesome. Love these beds...

Anyway. So, one option for the bed alarms is for it to beep so we can hear, but also say in a pretty, feminine voice, "Hold on, your nurse is coming!" I was sitting at my perch between my two patients' rooms when the bed alarm started to go off one night. I got in right after my patient had sat up and inched his feet close to the edge. He was sitting perfectly still, exclaiming, "My nurse is coming! My nurse is coming!" I lost it. It was so freaking funny that I was doubled over laughing while I was putting his legs back in the bed. Seriously going to miss those beds! Maybe I can somehow sneak these giant, heavy beds out, tie a couple of them to the top of my car, and take them with me for future use...

[BuckyBadgerRN, ASN, RN]

1-3 will do nothing to PREVENT a resident from falling.

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.

[xxMichelleJxx]

I work in a Rehabilitation LTC facility. Residents have ID bands if they are at risk for falls, they also have bed alarms. Residents that are constantly climbing out of bed are usually kept in front of the nurses station in geri-chairs or wheelchairs, or highback chairs. There is safety watch that takes place. A staff member is to sit and watch the residents for 15 min, then someone else comes on. Theres a schedule for safety watch. Obviously when its time for bed, residents are put to bed if they are willing. Sometimes residents are given diversional activities (coloring, arts and crafts, we have trivia questions that the folks from activity come and do with them.)

[BuckyBadgerRN, ASN, RN]

I'm in rehab/STC/LTC. No ID bands (dignity issue, can't call attention to the fall risk clients by a bright yellow band). No alarms except wanderguards. Which have nothing to with falls except letting us know if they are exit seeking in order to fall.

[misstrinad]

Working with dementia pts we tend to have lots of falls. We use quite a few alarms in wc and bed but we have a process to go through to determine if the alarms are appropriate and we have to do trial alarm removals periodically. We have a variety to choose from and pretty much each one makes a slightly different sound so when one goes off I know by sound who it is which is nice. Some pts need a psd so the second they lean forward or roll in bed it goes off and others only need the pressure mat style. We also utilize low bed w fall mat and lap buddy or alarmed Velcro seat belt when appropriate. A few pts just having a seat belt with out an alarm was enough bc it reminded them not to stand up. We do frequent assessments on toileting habits and sleep habits and pain so we can better anticipate their needs.

Consistent regular staff is the biggest factor I've seen in reducing falls. You get unfamiliar staff around that don't know the residents routines and often falls occur.

Some pts need to be on q15 or q30 min checks but I have never found that to be effective for long as staff become complacent and don't perform them bc they are too busy running ragged chasing after their 11 other pts. We also do a specific color dot on their name band but honestly no one pays attention to that and that doesn't help prevent anything.

[CardiacKittyRN]

We have fall risk sign on the door & chart. Pts wear yellow gowns & red, nonslip socks. We have to chart a "fall risk assessment" once a shift on every pt. All of which are useless for preventing falls as previously stated.

I work nights and everyone who is falls risk, is receiving pain medication, or a sleeping pill (very common because all pt have one ordered and we are required to offer unless contraindicated) is reminded to call for assistance before getting up & bed alarm is on. There are 3 settings, I chose based on the pts risk factor.

On our floor you also need a doctor'a order for bathroom privileges & it shows up as an intervention in our Meditech charting. Without it pt must use BSC, urinal, or bedpan depending on which is most appropriate.

[THELIVINGWORST, ASN, RN]

I wish someone could figure this thing out. Alarm fatigue is real and nothing ever gets done because we are always running to answer call lights, phone calls, iv beeps, bed alarms, scd pump disconnections and pulse ox alarms! So frustrating.

People fall because they overestimate their ability to manage the lines and tubes and walk at the same time.