How do you manage "fall precautions" in your ED?

Specialties Emergency

Published

Our unit is trying to find a way to identify patients at risk of falls in the ED. Our P&P dictates that the Morse scale is used on admitted patients, but we're working to write a P&P for the ED, and to implement appropriate documentation. The manager really wants to avoid the Morse scale as it is too cumbersome for the ED, but we're having trouble coming up with something simple.

Wondering how other ED's handle this. Any ideas are much appreciated!

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

We have a fall risk assessment tool that is built into our PICIS/ED PulseCheck software. Before that we had a page-long form we had to complete on each patient that was similar to the Morse scale as I've seen it. It wasn't too bad -- it only took a minute to complete, but it was just another darn piece of paper! LOL.

the hospital i go to the er has a policy that all patients have the rail up on all beds. not all nurses follow it for all paitents. many nurses do not put it up on me since it is a childrens hosptial and they assume i can handle myself

Lunah--does your program give them a score based on answers chosen by the nurse(like the morse scale)? thanks!

lpnstudent--we've been joking that all pediatric patients are high risk because of the question: history of falls?

Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.
Lunah--does your program give them a score based on answers chosen by the nurse(like the morse scale)? thanks!

Yep! Above a certain score, we flag them as a fall risk -- we have an orange flag that we can attach to the bed's IV pole to signify that the patient is a fall risk.

Specializes in ER.

ALL ER patients are at high risk for falls until observed walking steadily. If they get a sedating med they return to high risk again...until observed walking steadily. Make it policy and avoid another page of paperwork, but remember to chart your observations of whether they can walk or not.

Canoehead--yes, I was thinking of something like that. Sort of charting-by-exception--they're assumed to be a risk unless they are a&ox4 and have a steady gait.

Thanks for your response.

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