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!
My facility has a bed alarm that says, "Stop, your nurse has been notified....". That made matters worse the very first time the alarm was triggered. One of our elderly patients swore there was someone in her room for the rest of the night and commenced to demanding that she be placed in a room to herself (which she already was). Aside from that and the flags, armbands, and "Call! Don't fall!" signs, we have the double-sided, one-size slipper socks that our petite patients walk right out of, and our larger patients wear as tourniquets around their ankles. In other words, our staff runs for the entire 12-hour shift.
Specializes in Critical Care; Cardiac; Professional Development.
We order low beds for high fall risk patients. They come with padding for the floor, which mostly serves as a way to topple over the bedside table or for the nurse herself to trip and fall on. But apparently by some governing body standards (not sure which one) if a patient is in a low bed and then is found on the floor it counts as a "roll" not a "fall". Rolls are acceptable it seems.
We use bed alarms as well and we are allowed to use restraints in our facility. We also get sitters sometimes and we don't hesitate to call family members to tell them we need them to come help with their loved one. We actually have a superb track record for no falls.
Pretty much everyone has hit every "intervention" my hospital requires us to do except one: make doubly certain that you place a yellow falls sticker on the front of the patient's chart. Because that sticker is going to do a lot of good. We have a chart auditor that rolls in early (I'm nightshift) and this is one of her petpeeves...she'll have a conniption fit if a person is high risk and doesn't have a stupid yellow sticker on their chart!
My fav (read: sarcasm) are the confused patients that are still cognisant enough to figure out how to maneuver themselves in order to turn off the bed alarm without tripping the alarm first!! I'm pretty sure in their minds that this is just some grand game.
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.
We've had a huge increase in falls lately and we all respond promptly to bed alarms. Most of these falls were with prompt response to bed alarm. I think staffing is another huge piece of the puzzle. If everyone is in a room helping another patient, falls are going to happen. We use landing strips next to the bed for known falls patients. We do bedside rounding at change of shift, use signs, red socks, etc. I think basically none of it works. 1:1 sit works but for safety sits, we never get coverage. So then we work short staffed on the floor and other patients are more likely to fall!
Specializes in ED, Med-Surg, Psych, Oncology, Hospice.
In our facility falls are inevitable. At night we have 2 nurses and 2 CNAs and 70 residents. Tell me, how do we cover 5 hallways all the time and make sure our people aren't falling? Alarms are being phazed out .... we have 3 only. If my aid and I are doing a complete bed change down hallway "A" there is no way we can know what is happening on Hallway "B". And because it is a privately owned, for profit NH nothing is going to change. Their claim is staffing is adequate and that's that.
Not my facility policy, but my own; I tell my patients what a pain the rear it is to fill out fall paperwork, that I'll get in trouble if they fall, and that they will have to be interviewed by multiple people, all wanting to know what happened.
Policy is: move worst fall risks close to the nurses' station, yellow band, yellow sign on door, bed alarm, chair pad alarm, write the fall score on the patient's white board in their room, along with what it takes for them to safely ambulate (for other RNs or Techs who come in to help them); "Fall Score, 55. Up with assist X1, gait belt and walker" We have managed to cut our falls significantly over the last year.
nothing works... the closest success was the bed alarm... even then,when a bed alarm goes off, nobody answers it if UNLESS THEIR own pt has a bed alarm. teamwork (sarcasm). 1:1 is the only way to go.
We put on yellow socks, yellow arm band, and a light on above their room- as well as reading the room number in huddle. Bed alarms are utilized as appropriate.
This all is totally ineffective as most of our falls are from patients that aren't even deemed fall risks!! One lady walked the halls alone but was given ambien which made her confused and she fell.. Another was a 25 year old who tripped over her own feet with the nurse in the room.. Another was bleeding internally and passed out post op.
We use bed alarms as well and we are allowed to use restraints in our facility. We also get sitters sometimes and we don't hesitate to call family members to tell them we need them to come help with their loved one. We actually have a superb track record for no falls.
THIS ^ is why you all have a good record. we rarely get sitters( much less techs), family is rarely involved ( caretaker fatigue i believe),and rarely get orders for restraints. There is usually not enough staff to make sure the pt who does have a restraint isn't hanging themselves from from it.
Falls are inevitable. In our setting, most of our falls occurred with unattended elderly patients in the bathroom, or getting dressed. You gotta stay with em!!
wooh, BSN, RN
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And after their next assessment are liver enzymes ordered to check why they're suddenly jaundiced?