Sitting a patient on the floor

[Nursemommyme]

Have you ever had to sit a dementia with behaviors patient on the floor temporarily for safety? If so, what other interventions did you try first?

[crazin01]

I've only used putting patient on floor, if patient is already falling, classifying fall as 'controlled' fall.

As far as keeping the patient (who wont stay in bed) busy: We would place them in a wheelchair and have them sitting at nursing station while staff charted.

giving them a simple task: disheveling wash clothes & asking patient if they could help staff with folding linens. Such a small, silly & simple task, was usually successful. My thinking is that the older folks want to feel productive.

a more elderly patient,

[Nursemommyme]

What if they keep trying to climb out of their chair or bed even with activities and food offered? I'm at a loss.

[Dakeirus]

Once a upon a time, I put the mattress of a stretcher on the floor for one of our cray cray patients who kept trying to get out of bed. He rolled around that mattress all night and the 1:1 kept him from crawling out of the room. He didn't fall and we didn't have to constantly go to the room trying to wrestle him and keep him on the bed.

[Penelope_Pitstop, BSN, RN]

Do you have low beds? When I did acute care, we could obtain a low bed with floor mats without a physician's order. It's almost like sitting on the floor. In this particular case, I would try to order a safety sitter.

[hppygr8ful, ASN, RN, EMT-I]

Have you ever had to sit a dementia with behaviors patient on the floor temporarily for safety? If so, what other interventions did you try first?

I once had to use an MMA take down on an aggressive dementia patient who came at me with a dinner fork - My chart "Patient swung on this writer with a steel dinner fork. He lost his balance and was gently assisted to the floor."

Hppy

[martymoose, BSN, RN]

Controlled fall is stil la fall. Medicare will noq not pay that pts bill, and you are now in trouble with your employer.

[VivaLasViejas, ASN, RN]

A fall is any unanticipated change in planes, ergo, assisting a patient/resident to the floor is still considered a fall and you have to put them on alert charting with vital signs and charting done every shift for 72 hours minimum (this is in LTC). You also have to notify the patient/resident's family and PCP. I liked low beds and floor mats to prevent falls; it's hard to fall from the floor to the floor! Saved us a lot of injured people.

[canoehead, BSN, RN]

We had a woman with amputation of both legs in a delirium that convinced her she could get up and walk. She was determined to prove us all wrong, and not distractable. We ended up putting her mattress on the floor instead of physically holding her down.

[OpinionatedCNA, CNA]

I had an extremely confused dementia resident who becomes combative easily ended up crawling under his bed on the floor trying to chase some hallucination. I ended up leaving him there because it was obvious he wasn't coming out unless we physically dragged him out, and I'm not wrecking my back for any patient. Kept the nurse updated and kept checking in on him until like an hour and a half later he calmed down and let me help him up.

Also had this s u p e r confused and agitated dementia patient who fell and would just constantly try to walk/crawl outside of his wheelchair. Even parked right next to the nurses station he would crawl/fall out of his wheelchair and end up on the floor like immediately after he would lift him up and put him back in, no amount of distractions or talking to him helped. At the end of the shift his nurse just told us (the CNA's) to leave him on the floor until whatever mood he was in passed.

But then it seems like some dumb **** like this only ever happens at a facility that is always understaffed, like mine, so you get one or two of them every shift plus another 10 residents and it wears you down so fast. You can't keep your eyes on them at all times so they're just on the floor constantly until the facility finally decides to put them on 1:1.