Patient Falls in Acute Care Setting

PhantomRN · Jan 4, 2002

I read this post several times and I still can think of nothing very nice to say as a reply, as we all know the reason people fall is because management won't change the staff matrix to allow for safe care.

MiniRNC · Jan 5, 2002

LOL...Thanks PhantomRN. I'd love to be able to end this project he so nicely chose me for with that advice. Especially since I just heard at work that the DON is getting on our fairly new NM about the budget (of course due to staffing). I kind of thought that was coming. Now I'm waiting for it to come to me & the other 2 charge nurses . Guess I'll save that comment for another project. :)

babsRN · Jan 16, 2002

All kidding about staffing aside...we've had a pretty successful "watchful eye" program, where the room door, chart, patient armband is all color coded to identify the patient as a high risk for fall. We've have recently tightened the screen we use on admission to kick folks into the program that we were missing in the past. We also use a fair number of sitters to keep restraints(sorry, didn't means to use a bad word) out of the med surg areas. The down side of sitters is that in our facility they come out of your staffing matrix...not good when explaining poor productivity. Also not good when you're tightly staffed to begin with, then pull people off the floor to sit. Let me know if I can be of further help...b

askater · Jan 16, 2002

I've dealt with falls.

My first facility did not have patient sitter's. The staffing was minimal. There were many fall incident's.

Second institution had sitter's. A lot less fall incident's noted. Staffing comparable.

Slowone · Jan 17, 2002

Personal Alarms can help if you can get to the pt. quicky enough after hearing it go off.

Otherwise, consistant assessments of risk level for falls. Initial assessment done on admit then repeat Q 24hours/PRN.

Assessment of amount of narcotics/psycotropics used.

Just a few thoughts for ya.

Good luck, this will forever be a problem unfortunately. If you come up with 'The answer" let us know! :)

crrnmanager · Feb 16, 2002

I have been looking at falls on a monthly bases, just at the numbers. Last month I started looking at falls from a different direction. What time did the fall occur? Ususally at shift change and right after meals when patients need to go to the bathroom. Did the day of the week make a difference. 36% of all the falls were on Sunday's. I am going to continue to trend this for the next few months. My orginial thought was that the falls came mostly during lunch and break time for the staff when there was less staff on the floors. Does not seem to be true. Any one wanting a copy of my fall assessment let me know. [email protected]

live4today, RN · Feb 17, 2002

If restraints, bed alarms, and siderails are no longer permitted as safety devices, then allow me to suggest hospitals pay to lay a gymnastic type "bouncy" carpet in the patients rooms, and make beds that are capable of being lowered to within two feet of the floor. Then, if a patient falls out of bed, they won't suffer a severe injury -- just a minor bump to the body. Cost effective? Not initially, but in the long run add up the monies spent on lawsuits, etc., and the savings will outweigh the cost any day. Take this suggestion to the head hauncho at the hospital where you work, and tell him to implement the necessary structural changes that will alleviate the hospitals patient fall statistics that are costing him a pretty penny.