Research Questionnaire - Reducing Patient Falls

NurseKatie08, MSN · Oct 2, 2009

i am a student from arizona state university majoring in product design and my senior year project is to develop a product that can help reduce patient falls in the hospital. i am currently researching existing procedures and equipment and would appreciate your help in answering the following questionnaire. your knowledge and insights could help me develop a great product to help solve this unfortunate problem.

thank you very much for your time!

1.have you ever witnessed a patient fall? yes

2.where, and during what activity, do patients fall most often? attempting un-assisted toilet transfers, or attempting to ambulate when they are confused & have an unsteady gait as well as poor safety awareness.

3.what procedures or protocols does your hospital have in place to help reduce patient falls? frequent safety checks, bed alarms, reorientation/activities, 1:1 staff

4.what problems do you experience with your hospital's current fall prevention procedures? nothing specific...i just think some patients are going to fall no matter how many preventative measures are in place (as an aside...my facility is restraint-free.)

5.what tools does your hospital use to assess patients' fall risk? we use a fall risk assessment tool on admissions (don't remember the exact name of it)....if a patient scores >10 and/or has a hx of falls, a fall care plan is initiated.

6.is there any specialized equipment that your facility uses to prevent falls? (floor mats, bedside commodes, bed alarms, etc.) bed alarms, floor mats, low beds.

7.what problems do you experience with your hospital's current fall prevention equipment? none

8.what equipment to you use to assist with patient transfers, re-positioning, or moving? (patient lifts, transfer belts, turning discs, etc.) patient lifts, transfer belts

9.what is the most common reason for a patient falling? typically a need to toliet that they can't verbalize, or in the rehab setting, attempting to transfer by themselves late in the evening when tired "because i did it so well in therapy with barely any help". also, most of them are just plain confused...a lot of this goes hand and hand in my experience.

10.what do you think your hospital could change to help reduce patient falls? not much, other than hire more staff so that patient needs can be met more quickly...over all we really don't have very many falls.

ursus57 · Oct 3, 2009

Gait belt 100% of the time for ANY transfer, non skid foot wear. Under staffing will cause a patient to not want to wait for assistance and attempt to ambulate when they can not. Trying to trasnfer a patient by yourself, when two people are needed to do a transfer, again poor staffing.

Iv'e been a CNA for a year, graduating LPN school in November '09.

Great question!

Sean 91 · Oct 3, 2009

1.have you ever witnessed a patient fall?

yes. several times, been near. have heard the thud. in most instances, the bed and/or other alarm(s) are not in place--but some people are just quick and are over the rails and out of bed before you can respond in time.

2.where, and during what activity, do patients fall most often?

trying to go to the bathroom.

3.what procedures or protocols does your hospital have in place to help reduce patient falls?

bed alarms and tabs (string attached to pt's gown and pulls away from wall alarm to sound loud alarm) for pts with high fall risk which is >49. trouble is some nurses, aides, pts, others do not not replace these alarms. there are four rails. supposed to be frequent checking of pt for bathroom, food, drink needs. some staff do not respond quickly to the alarms--or may be tied up in other pt matters.

4.what problems do you experience with your hospital's current fall prevention procedures?

the procedures are not consistently adhered to.

5.what tools does your hospital use to assess patients' fall risk?

total points from: fall risk if ordered by md, previous falls, multiple diagnoses, ability to ambulate without aide, iv site present, narcotic meds being administered.

6.is there any specialized equipment that your facility uses to prevent falls? (floor mats, bedside commodes, bed alarms, etc.)

bed alarms as above.

7.what problems do you experience with your hospital's current fall prevention equipment?

as above, not adhered to al of the time. pt's who are a&ox3 but who shouldn't be getting up on their own do not call for help--think they can do it on their own--at least the first time before they fall.

8.what equipment to you use to assist with patient transfers, re-positioning, or moving? (patient lifts, transfer belts, turning discs, etc.)

gait belts not available. pivot to chair or bsc, usually after assessment by pt, if ordered by md. but often people who seem be able to walk to bathroom with minimal assist/guarding can fall, if for instance, they rely for support on moveable objects such as bedside tables.

9.what is the most common reason for a patient falling?

as above, lack of alarms being engaged. poor response time by some staff.

10.what do you think your hospital could change to help reduce patient falls?

at one hospital i worked at there were mobile coputers and also a computer outside each room which made it easy to keep an eye on high riskers. unfortunately, my current hospital (built in the mid 1990s) has only a central nursing station. have to put high risk pts in beds by the nurses' station--but that is not always possible when rooms have filled up, then it seems inconvenient to transfer pts around.

put younger no-fall risk or lower fall risk pts further out from the nurse's station and save rooms by the station for fall risks.

charge nurse should check high fall risk pts for alarms every two hours--or at least twice a shift--can't depend on staff nursing and aides in all cases.

at our hospital you get a black mark (your name on a list on the bathroom wall) if you miss charting a pt's bath and linen change--but no demerits if one of your pts falls--if the alarms weren't on. (incident reports are filled out, of course.)

we have gone from rugs to a floor covering that has a rubber liner that is softer and absorbs impact. but not all units or hospitals in the city chain have it.

Sean 91 · Oct 3, 2009

Oh yeah, we have "skid proof" footwear which does make a difference over the bare feet or athletic socks many pts come in with.

Gait belts are unavailable exc to PT--probably a $ matter. We do dead lifts (pivots), for some pts.