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 […]

2024-02-20T10:44:39-05:00February 20th, 2024|Nursing, nursing research, patient safety, Quality improvement|1 Comment
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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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If We Know How to Prevent Falls, Why Are Our Patients Still Falling?

Falls: at least ‘theoretically preventable.’

Sometimes it can feel as though managing fall risk takes up a big part of the day. You do your regular risk assessments, put safety measures into place, and still—patients fall.

Considering the frailty of some patients, the many meds that contribute to falls, and the fact that even mild cognitive impairment can be made worse by a hospitalization, it’s a tribute to good nursing care that there aren’t more falls.

But because falls sometimes cause serious injury and are, at least theoretically, preventable, it always feels like we’ve failed when a patient ends up on the floor.

A checklist for high-risk patients.

Nurses at one hospital decided that they needed a new way to approach fall safety. In “Using a Fall Prevention Checklist to Reduce Hospital Falls,” authors Madeline Johnston and Morris Magnan describe their use of a 14-item change-of-shift checklist based on the hospital’s existing fall prevention protocol. For a patient known to be at high risk for falls, oncoming staff went through the checklist to be sure that all prevention interventions were in place before taking responsibility for the patient. […]

2019-03-01T11:40:56-05:00March 1st, 2019|Nursing, patient safety|2 Comments
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Patient Safety: The Basis for Nursing

Making patients safe is where nursing begins.

by Lars Plougmann/via Flickr

It doesn’t matter how or where a nurse may practice—acute care, long-term care, home health, school nursing—making sure patients are safe is where nursing begins.

In 1999, the famed Institute of Medicine (now the National Academies of Science, Engineering and Medicine) report, To Err is Human: Building a Safer Health System, woke us up to the fact that medical errors were causing thousands of deaths annually in the very places where people go to restore their health. In 2004, another report, Keeping Patients Safe: Transforming the Work Environment of Nurses, detailed nursing’s critical role in health care delivery, particularly in ensuring patient safety.

We can always do better.

While there have been significant improvements in reducing adverse events, and nurses are leading many quality improvement initiatives, we can always do better. In May 2016, I wrote the following in an editorial (“A Culture of Safety Stars With Us“):

“Nurses have always been the sentinels, the around-the-clock watchers, detecting the changes that might herald a patient’s deterioration. Nurses are the ones that the system looks to—and often blames—when there’s a failure to rescue.”

This is still true.

This week marks an emphasis on patient safety—it’s what we do every day. In honor of the week, we’ve made the following […]

2018-03-13T07:59:37-04:00March 13th, 2018|Nursing|0 Comments
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Helping Family Caregivers with Fall Prevention in the Home

“Because mobility in later life results in positive health benefits but increases exposure to falls, many researchers and health care providers in geriatric nursing and medicine have called for ensuring safe mobility while protecting older adults from harm. It’s especially important to identify strategies that can potentially reduce the risk of fall-related injuries in older adults.This increasing focus on fall-injury prevention—in addition to fall prevention—represents a major shift in safety practice.”

(Click image to enlarge)

How can nurses best help family caregivers?

How can nurses help family caregivers identify fall risk in their family members, prevent falls, and respond to them if they occur?

According to the authors of “Preventing Falls and Fall-Related Injuries at Home“—the latest in our ongoing series of articles and videos, Supporting Family Caregivers: No Longer Home Alone—the need for better education and resources on such topics is widespread among family caregivers:

“In a national survey of caregivers who provide unpaid care to a relative or friend, 46% reported they assisted with medical and nursing tasks. Of these, 43% said such help involved the use of assistive mobility devices, such as walkers or canes. Almost half of family caregivers are also known […]

2018-01-25T10:24:11-05:00January 25th, 2018|family caregiving, family caregiving, Nursing, patient safety|0 Comments
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Views expressed on the blog are solely those of the authors or persons quoted. They do not necessarily reflect AJN’s views or those of Wolters Kluwer Health/Lippincott Williams and Wilkins.
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