Is a fall occurrence of "zero" possible?

[nursidosis]

Its every facilities goal to have no falls occur each month. But, is it possible? Most of you are probably thinking, no it is not. I disagree. It is possible. It is possible if certain areas of need are met. It takes a team effort that goes beyond the techs and nurses on the floor. Why is preventing falls such a big deal? Because falls cause injury to our patients, injuries to our patients lengthen their hospital stay, and if a fall with an injury occurs the hospital is now financially responsible for the patients care from there on even after discharge and long term care if needed. Here are good ideas you can take to your team at work and utilize to help your fall problem.

• Every bed has the alarm turned on. Even if the patient is ambulatory. It seems silly. But is the extra 2 minutes taken out of the day to help the patient who can walk on their own go to the bathroom and help them with their IV pole or make sure they have anti slip footwear on a big deal if it prevents a fall?
  
• Anti-slip footwear
  
• facilities like to go cheap and place a yellow arm band on the patient. No one who is not a floor personnel really notices them. How about yellow anti-slip footwear or gown? its more noticeable so that PT or the speech therapist who helps your patient to the bathroom can really notice that patient is a high fall risk patient.
  
• Frequent rounding! we are busy, i know. Take turns with your tech every so often to check on your patient.
  
• Change your call bell alarms. We all fall victim to alarm fatigue. If we have a new noise to learn we can subconsciously pay more attention to that alarm.
  
• Educate your patient about falls and that your floor is adamant about not having them. Encouraging them to use the call bell every time they need to get up can make a difference.
  

I know that proper staffing is the biggest problem with preventing falls. The fact is we have no control over that. We have to make do with what we have and what we have access to. Preventing falls needs to start from management down. Its a long boring process. But one fall is financially crippling and we need our jobs. We need money to staff and maybe one day be properly staffed. One fall can be more costly than a MD's yearly salary. Now imagine having 1-3 a month in most facilities. I hope this can help some of you and I encourage all of you to add some more of your ideas and best practices in the comments below.

Thank you for your support on Instagram. Look me up @nursidosis and follow for nursing education and humor.

Your fellow nurse,

Frank Trujillo

[LoveRNBSN]

There's nothing wrong with aiming for no falls but things out of a nurse's control happen unfortunately. The key is that you take the proper steps to prevent sentinel events from happening as much as possible. I remember a friend once told me that patients would purposely throw themselves to the ground so they could stay in the hospital longer and it would count as a fall event. So I mean, unfortunately, sometimes patients do things they should not be doing and it counts against the unit but nevertheless we have to aim for 0 as much as possible.

[LPNtoRNin2016OH, LPN]

We do not use alarms of any type at my facility -- I would say for a LTC/SNF of 50 residents, we usually only 1-2 falls/month, if that.

[NotAllWhoWandeRN, ASN, RN]

The only sure-fire way to prevent *all* falls is to get rid of gravity.

Since anti-gravity remains in the realm of undiscovered physics and engineering - and since the ISS doesn't have any open beds - no, the goal of No Falls is unattainable on a sustained basis.

Don't be silly! The only way to eliminate all patient falls is to get rid of all patients.

[NotAllWhoWandeRN, ASN, RN]

Some patients are fully alert and oriented and don't give a crap if you think they're a fall risk. I had one fellow who set off his alarms on purpose because he knew he would have staff in his room faster than using his call light.

[LoveRNBSN]

Some patients are fully alert and oriented and don't give a crap if you think they're a fall risk. I had one fellow who set off his alarms on purpose because he knew he would have staff in his room faster than using his call light.

Yup, have personally seen that happen as well. So what did ya'll do to deal with the situation?

[Nursynursenurse, ADN, RN]

We do not use alarms of any type at my facility -- I would say for a LTC/SNF of 50 residents, we usually only 1-2 falls/month, if that.

Thats impressive. We have about 130 beds and have falls daily to every other day, usually the same few residents over and over again.

[MHunterRRT]

Falls will happen regardless. A lot of the RNs and CNAs I work with are very busy, so I have no problem assissting a patient to the restroom after I have been in for their therapies or even if I'm just passing through the unit. I'd rather take a few extra minutes with my patient, then run the risk of them falling on the way to the restroom because they got tired of waiting for the nurse or the aide.