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.
Basic interventions overlooked when things get busy.
The results of their pilot intervention are interesting. Even though “everyone knew what to do” to protect high-risk patients, basic interventions were sometimes overlooked in the midst of a busy shift. Two of the most common errors revealed by use of the checklist were that the patient’s bed alarm was not properly activated or the “high risk for falls” signage was missing!
Read about this successful QI project—including staff response to using the checklist, and plans for modifying it in the future—in the March issue of AJN. The article will be free until March 21.
yah got me, in same boat or sinking ship. a lot geared to minimizing damages , not a lot of prevention, the alarms gives you about 10 seconds to ‘prevent’
Just wondering, aside from alarms and signs, what are your strategies? I am retired recently, but in long term care, now it is considered against a resident’s rights to use an alarm. And when you have perhaps one nurse and one CNA for 30 – 35 residents (many with dementia), other than sitting the resident in front of the nurse, what is left to do?