Patient demands fall precaution sign be taken down

[FireStarterRN, BSN, RN]

I had a really nice patient today, who naturally was on fall precautions, since if you score 6 or more on the checklist, you get a yellow bracelet, yellow rectangle on the chart, yellow fall precaution sign outside the door, plus a round yellow sticker on the Kardex.

Of course, filling out the fall precaution checklist is another 'important' bit of charting done each shift that really makes a difference for our patients!!! Thanks to documentation like this, America is a better, safer place. Busy nurses really find the fall assessment worksheet an invaluable tool that they don't know how they ever got through the day without!

My patient, however, thought it was ridiculous that she was being told to call a nurse to go to the bathroom. She felt like having a sign outside her door, for all the world to see, was embarrassing. :imbar She told us, and she told her doctor, that we should use some common sense here. She told me that she has her cane, and she is perfectly capable of being careful in going to the bathroom, and she demanded that that sign be taken down!

Do ya think we should have gotten a mental health eval???

[TopazLover, BSN, RN]

IMO. No, just document clearly that you did patient teaching and it was clearly understood. I have often wondered about HIPAA and those signs. It does not take a mental genius to know what they mean. Some people are bothered by that label.

Can you negotiate with her? She allows you to assist her and she gets the signs down? What does the MD think. Will he chart that she is capable in spite of the score?

Just random thoughts.

[Valerie Salva, BSN, RN]

Maybe mgmt should ask risk mgmt about the liability involved in removing the sign.

[canoehead, BSN, RN]

Take the sign down if she agrees to call someone to stand by when she gets up. Patients can refuse treatment, and it sounds like she's refused with knowledge of the risks. You can still keep a close eye on her, with or without the sign.

[noc4senuf]

If she refuses to have it in pace, it needs to come down. THat is her right. Just document that it was explained to her the reasons for having it and make sure you care plan for it.

[RNsRWe, ASN, RN]

Or, you can do what we do: EVERYONE on our unit has a yellow Fall Risk sign outside their door! No discrimination: we just expect everyone on our unit to tumble at some time or another...

[GrumpyRN63, ADN, RN]

I had a patient who wanted her Contact precautions sign removed- it violated her HIPPA rights--- what say you ?

[RNsRWe, ASN, RN]

I had a patient who wanted her Contact precautions sign removed- it violated her HIPPA rights--- what say you ?

I'd say that the sign ensured she was cared for properly, and protected the hospital staff as well, so forget about removing it. It's not like there's a big sign that says "Mrs. Jones, 123 Marigold Lane, is in here and has Cooties"!

Besides, there'd be an isolation cart outside her room, and any guests visiting her would have to be warned to gown and glove up, so...what does she expect?

In our hospital, she certainly has the right to NOT be on isolation--if she is also leaving AMA, of course. If she's staying, she's taking it as it comes.

[Jolie, BSN]

It is a ridiculous contradiction: we aren't to disclose PHI to anyone without a "need to know", then we plaster signs and bracelets everywhere. I don't blame the patient for insisting the sign be removed from the door. Next thing we know, JCAHO will decide that fall risk signs violate patient privacy and require an individual sitter instead.

[ZooMommyRN, ADN, RN]

Does the yellow sign on the door specificaly say fall risks? We had similar issues so we now have a small magnet strip that is yellow with shooting stars so when turned on their side they are falling stars I also found that explaining to the pt that they are at an increased risk for balance problems due to meds or dx (even tho some are just plain unsteady to begin with) rather than saying they are at risk for falls kinda gets through a little better, especially with the spitfire indepenent older pts

[FireStarterRN, BSN, RN]

We just took the sign down and documented her request. She agreed to keep the bracelet on, but said she planned to use the BR independently.

[BrnEyedGirl, BSN, MSN, RN, APRN]

Ok,..if the sign comes down,.yes the staff on the floor can still watch her,.but what about lab, radiology, RT, PT etc? What about the staff that was off the first three days of her admit? AND if she falls, with our new rules,.Medicare won't pay to fix the broken hip, the resulting pneumonia, DVT etc! Does administration want us to be ultra sensitive, politically correct and do everything to make the pt happy or do they want us to keep our pts safe?

They force us to do the fall risk assessment, they make the rules for the signs, they teach us what precautions to take for those at high risk for falls, but if the pt doesn't' like it, it isn't so important anymore? When did the pt become better at managing their own health than the professionals who are highly trained to do it? Why even place people in the hospital if they are only going to agree to part of their care? Why don't we just skip the docs all together and let the pts decide which labs to draw, which meds they want to take and which CT/MRI/Xray etc they want?

I'm all for pts being involved in their health care. They should be able to make informed decisions and understand the "why's and what for's" but if you don't trust your health care provider enough to do what he/she recommends then get a new doc or stay at home!