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Discussion

pt falls

The unit I work on has had 21 falls from Jan to end of Oct.. I need advice on how to decrease these falls... we do frequent rounding, yellow socks, armbands, signs, sect, and anyone his is not up ad lib is on a bed alarm... I don't know what we can possibly do to make things better... I would appreciate any ideas anyone has

Featured Replies

  • Guides
Yellow socks, schmello socks.. the only thing that can prevent falls is adequate stafffing.
I like the assessment and protocols. The take time. Sufficient staffing will be needed to implement the protocols.

AJN article: http://journals.lww.com/ajnonline/Fulltext/2012/12000/Staffing_Matters_Every_Shift.21.aspx

Nurse staffing and patient falls on acute care hospital units: http://www.nursingoutlook.org/article/S0029-6554(03)00230-6/abstract

Missed Nursing Care, Staffing, and Patient Falls: http://journals.lww.com/jncqjournal/Fulltext/2012/01000/Missed_Nursing_Care,_Staffing,_and_Patient_Falls.2.aspx

  • Author

We have a 31 bed unit and our staffed about 4-5 sometimes 6 patients per nurse on days and one tech from 7-730 and a bath tech from 8-4 and no unit secratary . On nights the nurses have 4-6 often 5 or 6. And are lucky of they have one tech for the entire unit. Anyone who is not up ad lib such as 40 year old chest pain patients get bed alarms and we do yellow socks and hourly rounds

Do you have CNA on your floor? Get them involved. Talk to your supervisor, maybe it's time for a staff meeting. Patient safety is number one. You also have your unit's reputation at risk. Make a list and start from there. Make sure your include everyone. Get feedback from your patients that fell also. Start at the source.

Feel the need to expand on the yellow socks,schmello socks point of view.

Each and every patient is a fall risk and needs to be so regarded.

Each and every patient needs non-slip foot wear, etc.

The time wasted putting on color coded socks, signs, arm bands.. may have actually prevented a fall.

most of our patients are nursed in open wards (that look kinda like this one, but is not my hospital). So it is very easy to see all the patients, and if we don't, we normally get the pt in the next bed hitting their call light to say pt x is getting up.

We have a lot of elderly, confused patients, on some wards but we manage to have a fairly low falls rate because somebody is always walking around to check on patients, or we have 1:6 or 1:1 (if they really need it) in the bays to sit with them all.

  • Guides

Decades ago I worked on a 32 bed ward. It was common for a patient to call, "Hey nurse; look what he's doing."

  • Author

That would be kinda nice ... but unfortunately all our rooms are private

Staffing. There is no other magic bullet to prevent falls.

Sometimes I'll park myself in the hallway with my computer and monitor my higher risk pts. Chart and watch...chart and watch.... It makes for a long night.

There is a segment of confused pts that will get out of bed no matter what. They remove the alarm, they turn it off, or they take off the gown and go naked. They will get up no matter what. For those pts, I wait for the fall and hope nothing breaks.

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