Why Nurses Assist Falling Patients Despite the Risk

A too-common scenario.

Joe opens his eyes and looks through the window of his hospital room. He has always been early to rise. Even at age 82, he can’t shake the habits he learned when he was young.

“I’m woozy again,” Joe thinks as he sits up in bed. His medication sometimes makes him feel that way. Joe presses the call light so a nurse can help him to the bathroom. The nurses have been reminding him to do that so he won’t fall.

Then he reconsiders. “I can make it on my own. I don’t want to bother the nurses. They need to help the patients who really need it.” Joe moves to the edge of his bed. His walker isn’t nearby, but he urgently needs to reach the bathroom. Still dizzy, Joe holds onto the bed for a moment to keep from falling forward. After a moment, he manages to stand up and walk to the bathroom. As he enters the room, his dizziness returns, and his legs suddenly feel weak.  A feeling of dread washes over Joe as he begins to fall…

Nurse Smith starts her rounds and is looking forward to seeing Joe. He is always up early to greet her with a smile and a joke. As she opens the door to his room, she sees him entering his bathroom without his walker. She moves quickly toward him, but he suddenly sways forward. She knows he is going to fall. Reacting immediately, she grabs him by the torso […]

August Issue: CBT for Treatment-Resistant Schizophrenia, RNs’ Role in Transforming Primary Care, More

“It is not to save the world we are called—it is to care.”—Alison Stoltzfus in her August Reflections essay, “To Care When There Isn’t Enough”

The August issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

Original Research: Cognitive Behavioral Therapy for Symptom Management in Treatment-Resistant Schizophrenia

This integrative review examines the efficacy of CBT as an adjunct to antipsychotics—notably clozapine—in alleviating symptoms of treatment-resistant schizophrenia in various study populations.

A Tai Chi for Arthritis and Fall Prevention Program for Older Adults During COVID-19

The authors describe their experience converting an in-person tai chi fall prevention program to a virtual program during the pandemic, as well as participants’ responses to the virtual program.

The Role of RNs in Transforming Primary Care

A discussion of the need to improve primary care delivery in the United States, and how preparing RNs to practice at the top of their license can play an important role in this effort.

[…]

2022-07-25T10:36:55-04:00July 25th, 2022|Nursing|0 Comments

Are Fall Prevention Precautions Missing the Mark?

Happy first day of autumn! Let’s have some fall talk.

If you spend any time in the acute care setting, you’ll be inundated with signs of fall precautions: yellow alert armbands, yellow nonslip socks, yellow signs on patient room doors, and of course the constant ringing of bed alarms.

It appears that hospitals put a lot of effort into fall prevention, and understandably so—falls cost hospitals money. These costs include tests and procedures that aren’t covered by insurance, increased length of stay while the patient recovers, and lawsuits from injured patients or from their families.

Checking boxes vs. individual patient needs.

However, the current approach of applying all precautions to all patients at risk for falling isn’t supported by research, and may decrease patient satisfaction. Sometimes it seems more focus is put on checking boxes about having prevention strategies in place than on the actual patient’s preferences or needs. For example, a former patient told me about a time she was in the bathroom of her hospital room and felt lightheaded. Rather than risk falling, she eased herself to the floor and hit the call bell for assistance to get back to bed. Upon finding her on the floor, the staff were so focused on filling out an incident report and assessing her for injury that they ignored her attempts to explain what actually happened.

The ‘next era’ in fall reduction.

2021-09-22T09:47:00-04:00September 22nd, 2021|Nursing, patient safety, Patients|0 Comments

AJN September Issue: Ischemic Stroke, A New Approach to Fall Prevention, More

“Pain is a complex experience. Offering patients an opportunity to express their feelings, listening to their words, looking into their eyes and sensing their uncertainty are all part of the compassionate side of healing.”—Barbara Wukovits in her September Reflections column, “My Pocket of Care”

The September issue of AJN is now live. Here’s what’s new. Some articles may be free only to subscribers.

CE: Acute Ischemic Stroke

A review of ischemic stroke pathophysiology; risk factors; presentation; and the evidence-based treatments, nursing assessments, and monitoring protocols that are critical to patient recovery.

CE: Reimagining Injurious Falls and Safe Mobility

This article by the author of the Hendrich II Fall Risk Model proposes a new approach to fall prevention—one grounded in evidence-based protocols known to positively impact the health of older adults.

AJN Reports: The Troubling State of Public Health

How underfunding, attrition, and COVID-19 are affecting the nation’s public health agencies and nursing workforce.
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2021-08-27T08:48:20-04:00August 27th, 2021|Nursing|0 Comments

Falls in Behavioral Health: Different Population, Different Risk Factors

“I need help in 230A! Mr. Johnson is on the floor!”

(click image to enlarge)

Does your heart still sink when you hear a patient has fallen? We’ve gotten better at preventing falls, but we haven’t eliminated them. They remain one of the most common “incident” reports in hospitals. And did you know that adult behavioral health inpatients have more falls and fall-related injuries than patients on medical-surgical units?

In this month’s Cultivating Quality article, “Preventing Falls Among Behavioral Health Patients,” free until July 20, Stephanie Ocker and colleagues discuss their very successful falls-related interventions on an inpatient behavioral health unit. As they proceeded with their root cause analyses of recent falls, an unusual risk factor stood out:

“Patients frequently walked in the unit’s common area with bath blankets hanging around them and often trailing under their feet. When nurses would ask patients not to walk around with blankets to reduce the risk of tripping, patients would say they were cold.”

[…]

2020-07-06T10:53:28-04:00July 6th, 2020|Nursing|1 Comment
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