Patient falls

eternal student · Jun 3, 2001

Hi, I am a nurse practice co ordinator of a rehab unit in Australia. We benchmark our falls rates at below 1%.Mostly it is achievable with a lot of strategies.I think our rate is higher than medical wards too.

Hope it helps.

borednurse · Jun 5, 2001

Hi. About falls at our rehab--new guidelines stress no restraints but I feel bad idea! Too many falls now compared to before. Someone will be sued and I promise it will be the hospital who does. That's all I have to say, thanks.

debross · Jul 5, 2001

We have been able to remain restraint free with no increase in our fall rate. We have also found that the falls we do have have resulted in less injuries than when we used restraints. We found that alot of our falls were toileting related so adhering to toileting schedules I'm sure has helped. We also utilize sitters with high risk patients, as well as bed and chair alarms.

monica f · Jul 5, 2001

Our facility puts a big emphasis on no restraints. We have had an increase in falls,but I think that it is because of the combination of short staffing and no restraints. It also seems that we have a lot of impulsive people who like to get up without help. :eek:

ladybyrd · Jul 18, 2001

Rehab patients DO fall more...but many of the falls are because the patients are attempting to practice their newly learned skills without waiting for appropriate supervision by the staff.

Look at a baby who is learning to walk...They fall, not because their legs are weak, but because they have not yet fully developed the art and skill of "balance" versus the "effects of gravity".

They must first learn to balance themselves in a sitting position, then creep, crawl and toddle BEFORE they walk. How many times do they actually fall before they take that first independent set of steps?

The patients assume that because the therapist had them "up walking" in a 1:1 therapy session, they are now able to go to the bathroom by themselves.

What they forget is that it took 2 people to get them up, that it was a mod-max assist to stand and that after only 3 feet, they were ready to go back to their bed!

debross · Sep 11, 2001

We have been restraint free for the last four years and have seen no increase in our fall rate. Our fall rate is less than on the med/surg. units because of our increased focus on toileting as part of the rehab process. We also have involved all staff, including housekeeping, to keep a watch for signs that might increase safety risks. We also make part of our rounds to make sure items needed are in easy reach. We do utilize companions ,especially at night for the high risk, cognitively impaired patients. We give all our patients and their families a handout on tips to avoid falls.

Debby:)

jevans · May 3, 2002

Hi,

I am a deputy warde manger for a stroke unit

I have recently completed an audit of all clinical incidents for 2001.

of all our clinical incidents 52% are due to falls. only 10% result in minor injury and 0% result in major injury.

It is the nature of rehab that falls occur. we aim to enable our patients to their full potential. if a unit informed me that they had no falls I would seriously be concerned tnat nurses failed to empower their patients. Our job as nurses is to minimise risks

Good luck

j

jevans · May 3, 2002

Hi,

I am a deputy ward manager for a stroke unit

I have recently completed an audit of all clinical incidents for 2001.

of all our clinical incidents 52% are due to falls. only 10% result in minor injury and 0% result in major injury.

It is the nature of rehab that falls occur. we aim to enable our patients to their full potential. if a unit informed me that they had no falls I would seriously be concerned tnat nurses failed to empower their patients. Our job as nurses is to minimise risks

Good luck

j

LucieRN · Jan 10, 2003

Its important to do a care plan and assess the pt's risk for falls upon admission and /or update a care plan that exists and apply interventions for prevention. Restraints usually cause more injury-so its important to get to the CAUSE that the peron may be falling so that you can implement a plan from there.. Many facilities use a scoring system that correlates with the pts risk factors..The more risk factors the higher the score. Determining the patients risk factors is the KEY to prevention: What meds are they on? Are they incontinent? Do they have a previous history of falls in the last 6 mos? Many of these factors should be assessed...

Good Luck! There is info out there to help you on your mission..

RedWeasel, RN · Jun 20, 2007

Rehab patients DO fall more...but many of the falls are because the patients are attempting to practice their newly learned skills without waiting for appropriate supervision by the staff.
Look at a baby who is learning to walk...They fall, not because their legs are weak, but because they have not yet fully developed the art and skill of "balance" versus the "effects of gravity".
They must first learn to balance themselves in a sitting position, then creep, crawl and toddle BEFORE they walk. How many times do they actually fall before they take that first independent set of steps?
The patients assume that because the therapist had them "up walking" in a 1:1 therapy session, they are now able to go to the bathroom by themselves.
What they forget is that it took 2 people to get them up, that it was a mod-max assist to stand and that after only 3 feet, they were ready to go back to their bed!

They also forget that they were up with PT at 1000 and it is 2200 now - BIIIIGGGG difference! :nono:

alwillia · Jun 6, 2009

I am working on an action plan regarding frequent falls on our rehab unit. We are having a difficult time coming up with any interventions that we are not currently using except for a consistent toileting program or using hi lo beds. For the past two yrs I have worked on a unit that frequently uses restraints but had previously worked on a rehab unit that did not. I don't believe that restraints helped decrease falls. The risk of injuring is increased and if a pt really wants to get out of bed they will regardless.