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???
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...
Yeah, fall precautions annoy me. It's always the patients you DON'T expect to fall that you end up hauling off of the floor. And considering how many times I've fallen at work (yes, I'm clumsy), I should be wearing a sign!
JACHO regs are aomewhat different than those of LTC. In both places the resident/patient has th right to fall. In LTC, as long as it has been thoroughly documented that it was explained to the resident the ramifications of a fall if she did not allow staff to use stickers, arm bands, alarms, etc. and it had been care planned extensively.... the nursing home will not receive a citation since the care plan was followed. It still comes down to their RIGHTS!
So, it's all or nothing? Either patients accept, without question, everything the doctors and nurses say to them, or else they stay home and die? You are saying that patients don't have a right to refuse any aspect of their treatment plan, I see.
I think the problem comes with when they refuse to abide by a part of the plan, then the hospital has to pick up the tab for that refusal.
And there's a balance. There's refusing aspects of care, and there's refusing letting the hospital staff take care of itself. You can refuse to wear an allergy bracelet, but I'm still expected to know you have allergies. You can refuse a DNR bracelet, but I'm still supposed to keep up with who gets CPR and who doesn't.
When I'm next a patient, I'm going to refuse to allow them to do any charting on me, after all, someone might see it and tell my neighbors. After all, the best privacy protection is to not let them write anything about me!
what was triggering the fall risk? had she fallen before? or was is simply because she walked with a cane? i think we need to use a little nsg judegement because labeling someone a 'fall risk'.
many people walk with canes - some are at risk for falls because of it, but some aren't. sounds like this lady knew what her risks were.
haven't you heard? joint commission doesn't allow nursing judgement anymore. it's all about checklists!
Specializes in Telemetry, ICU, Resource Pool, Dialysis.
What was triggering the fall risk? Had she fallen before? Or was is simply because she walked with a cane? I think we need to use a little nsg judegement because labeling someone a 'fall risk'.
Many people walk with canes - some are at risk for falls because of it, but some aren't. Sounds like this lady knew what her risks were.
It all has to do with the Fall Risk Assessment Tool the hospital/institution has chosen to use. The original poster was using ( I think) a tool that was used in the last hospital I worked for. This tool basically put a complete quadriplegic on falls. I'm sorry, how is someone who cannot MOVE AT ALL going to fall out of bed???????????????????????????? Maybe there is something I don't know. Unfortunately, I cannot remember the name of this stupid tool.
The only other tool I have used is the Morse Fall Scale. This scale is much more specific, and really identifies patients who are truly at risk.
What a great thread and great topic- we have been talking about this lately on our unit. How long will it be before all of these bands we are placing on the pts and signs outside of their rooms become HIPPA violations and go the way of the "boards" we used to have.
We used to put the pts allergy right on the front of the chart- right under the name..... seems like a good idea to me- worked for years! Now, on the tape that used to have the allergy written on it, says " Check pts allergy information in the admission data base"----what??
What next?? A sign outside the RSV kid's room saying-"Pts on this unit may or may not have a contageous respiratory illness.... check the chart to find out if you should wear PPE":chuckle
We have changed our fall risk signs house wide to a leaf for this reason. Can't wait to see what they come up with for the Isolation signs! Personally, I think this is just one more thing that makes it harder for healthcare workers to do their jobs:twocents:
Specializes in Vents, Telemetry, Home Care, Home infusion.
Matress low to the floor too..
....So thin a mattress that is causes her pressure ulcer on coccyx, refuses to be turned, shearing forces from dragging herself to side, now stage 4 decub by day of discharge to homecare
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...
We don't use falls precautions signs at all on my unit, actually.
Haven't you heard? Joint Commission doesn't allow nursing judgement anymore. It's all about checklists!
:chuckle :chuckle
Thanks for the laugh!!!
cheers,
PS: I refuse to call them numbskulls "The Joint Commission". It's either "JCAHO" ... or ..... well, a bunch of epithets not fit to print here without violating ToS!!
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! 
wooh, BSN, RN
1 Article; 4,383 Posts
Yeah, fall precautions annoy me. It's always the patients you DON'T expect to fall that you end up hauling off of the floor. And considering how many times I've fallen at work (yes, I'm clumsy), I should be wearing a sign!