Preventing Pt Falls and success rate

[Advocate1]

On my unit, just like everyother unit, we are trying to decrease pt falls. I know we try hard and use preventative measures but nevertheless pt's do fall. I work on a tele floor with the majority of the pts aged 65+. Most falls seem to occur at night when the sundown. I have a few question to fins ways to improve our patient safety.

What does your unit do to prevent pt falls?

How many falls occur per month?

Do you believe that 100% of falls are preventable? If so why and how?

Thanks in advance

[glasgow3]

We place purple wrist bands on all patients who are fall risks; these bands repel all fall goblins and gremlins totally eliminating patient falls.

[oldiebutgoodie, RN]

We place purple wrist bands on all patients who are fall risks; these bands repel all fall goblins and gremlins totally eliminating patient falls.

Ooooh! Ooooh! Where do you get those wrist bands??

We put magic signs outside our patients doors.

Unfortunately, restraints is one of our weapons. Our hospital recently eliminated sitters, and yet want us to prevent falls. ????????

I wish I had something constructive to add, but the hospitals keep upping the expectations but removing the tools.

Oldiebutgoodie

[Advocate1]

Well at least now I dont feel like our unit is not PERFECT. Thanks guys.

I wrote this question b.c i read an article in the magazine "ADVANCE for Nurses" that Southwestern Vermont Medical Center was able to implement a program on how nursing can reduce falls. It stated that that program was able to produce zero falls in the last month on a med/surg unit with a "high population of very sick, elderly medical and orthopedic patients"

I tried to look up the "program" called "Institute for Healthcare Improvements (IHI) 5 Million Lives Campaign" and found Zilch.

[Ms Kylee]

We use bed alarms, and all patients who are a fall risk wear red slippers that have treads on both sides of the slippers. We also make sure that when they want to get out of bed, there is someone there to escort them to the bathroom or to the chair, or back to bed.

[TiggerBelly]

We use bed alarms to help keep patients in bed. We have 3 different colored stars- green, yellow and red. The stars are hung outside of each patients door. Green means that they are not at risk for falls and do not need their bed alarm on. Yellow means they have some risk of falls so they have the bed alarm on but can have one side rail down. Red means that they are at an increased risk for falls and the bed alarm is on and all four side rails are up. It does help decrease falls especially for the older confused lady that insists her doggie is right outside the room barking for her and she needs to get him.

[Dempather, RN]

Patients on my floor have treaded slippers and wear purple wrist bands. For people who are at a real risk, we end up putting them on a 1:1, however that severely limits the staffing of NAs on the floor (like everybody else, it's a work in progress). Three side rails up at most. TiggerBelly, are four allowed up in your hospital without a restraint order?

[Virgo_RN, BSN, RN]

What does your unit do to prevent pt falls?

We have a falls risk order set that is activated when a falls risk is identified. The order set includes things like using the bed alarm and toileting patients every two hours. Assessment of fall risk for every patient is done on every evening shift, so if a person comes in and is not identified as a falls risk initially, that could change depending upon if their condition changes.

How many falls occur per month?

Good question. I'm not up on that info.

Do you believe that 100% of falls are preventable? If so why and how?

No, I do not. Patients do not always comply with the falls prevention precautions we put into place. As long as patients have minds of their own, falls will never be totally eliminated.

[OC_An Khe]

IHI should have information with regard to fall prevention. Essentially fall prevention comes down to two essential facts. Identifying the patients who are at risk for falls. Secondly having the appropriate and adequate level of staffing to put preventive proceedures in place.

[dbsn00]

We use bed alarms, and all patients who are a fall risk wear red slippers that have treads on both sides of the slippers. We also make sure that when they want to get out of bed, there is someone there to escort them to the bathroom or to the chair, or back to bed.

We use the pull away tab alarms or mat alarms that are placed under the linen (resident shifts weight trying to get OOB alarm sounds). We put them in a geri chair if they are very restless or agitated so they can be at the nurse's station or closer to staff for observation at night. We also started putting a resident's mattress directly on the floor with floor mats around him - 3 falls over 3 nights - & this seems to be working well. The key is having someone close by to actually hear an alarm & get in the room ASAP (not always possible). Make sure every intervention is updated in the care plan - I have a few residents that we have just exhausted every possible intervention, short of tying them up! (yes, I'm just kidding) & we're not allowed to use posey vests.