Falls
Most common reason for falls in hospital
What is urgent need to use the bathroom
Questions to ask before leaving the patients room
5 P's
Do you need to use the pain?
Do you need anything else before I leave?
Priorities immediately after a fall
- ABC
- Head injury
- Spinal Injury
- Fracture
- Notify MD and DO NOT move patient until they are assessed.
Risk Factors
What are,
- medication
- Balance
- Chronic health conditions
- Vision
- Footwear
- Cognitive status
Environmental causes that can cause falls
- Lighting
- Clutter
- Footwear
- Commonly used items not in reach
A fall with suspected head injury or unwitnessed (increased risk of bleeding)
What is a type 1 Fall
Red bordered yellow triangle signage
What are high alert falls
Patient education for any patient before ambulating
- Get up slowly
- Use your walker or cane for support
- No bare feet
- Glasses or hearing aids if needed
A witnessed fall with no head injury and no increased risk of bleeding
What is a type 2 Fall
Yellow arm band
Q15 monitoring
Bed alarm on
Gait belt with assistance
What are high falls risk interventions
Changes to the care plan after a fall
- Increased Monitoring
- Increased Toileting Opportunities
- Increase presence of family
- Consult to PT, OT, Geriatrics, pharmacy
- Education to patient and family
15 min x4
1 hours x4
4 hours x8 ( for a total of 37 hours), then as ordered
What is post falls monitoring (Specifically Type 1 Fall)
When someone falls they may get nervois leading to a fear of this
What is Fear of falling
A safety device alarm for high falls risk patient who is out of bed
What is chair alarm
The interprofessional team meeting post fall
What is post fall debrief/huddles
- Identify the likely cause of the fall
- Make recommendations to care plan
- Update Kardex