For the Hendrich II Fall Risk Model, the resident scored a 5, I assessed her while assisting her to the restroom, and noted she made multiple attempt to stand up from her wheelchair, which was successful with minimal assistance; she confirmed having challenges with getting off the wheelchair due to pain and her vision. The assessments I performed show high risk for falls, therefore, I educated the resident to press the bell whenever she needs help. I checked the bell to ascertain it was functioning, made sure that the locks on the wheelchair and the bed were functioning, and also assessed the room for anything that could lead to a fall. I checked the lights, and confirmed that everything she needs were within reach. Her follow-up care needs
The Hendrich II Fall Risk assessment was chosen as one of the appropriate functional assessments, because the patient stated that he recently had fallen a few weeks ago. Moreover, while observing the patient during the conversation, I noticed slight tremors on the patient’s lower extremities that may place him at risk for falls.
Provide mandatory, up-to-date education related fall prevention. Every single one in this facility can have the adequate capacities to prevent falls and offer education to patients, family members and caregivers regarding skills and knowledge of fall prevention. Develop policies in multifaceted and tailored strategies with evidence-based practice (Breimier, Halfens, & Lohrmann, 2015). Have more awareness and "need for individualizing the care plan and communicating the plan to those working with the patient becomes evident when implementing a fall reduction program" (Ambutas, Lamb, & Quigley, 2017, p 179). In addition, maintain consistency or accuracy in risk identification and action planning, as well as obtain patient and caregiver’s commitment to adhere to the safety plan on the daily basis (Silva, & Hain, 2017). Everyone is in the same page and conduct measures effectively and efficiently. Evaluate and assess the implementation of strategies monthly. Change and correct properly and timely to reach the aim of zero falls.
According to the Joint Commission Resources-JCR (2005), there is no universally accepted definition of a fall. Thus several definitions have been floated over time in an attempt to define the same. One such definition of a fall is "an untoward event that results in the patient or resident coming to rest unintentionally on the ground or another lower surface" (Joint Commission Resources, 2005). Falls are regarded common causes of injury at every age. However, it is important to note that for seniors, falls can have serious consequences. This is more so the case given that a fall can bring about pain, trauma, or even death. With that in mind, the primary purpose of this program remains the reduction of falls and hence the aversion of related injuries amongst the concerned patients. Of key importance remains the identification of patients who appear to be at high risk of falling. This way, appropriate strategies can be developed to reduce the injuries related to inpatient falls.
In addition, high risk participants received education relating to falls which involved nurses instructing participants not to get out of bed without assistance, to press the call-bell for assistance and how to use the call-bell. As part of this study protocol, participants in the intervention group received usual care which include: fall risk assessment, placing the call-bell, TV remote control, eyeglasses, dentures, and hearing aids within the patient’s reach. Other interventions that have been used were bed and chair alarms, bed was in the lowest position at all time except when care was being provided and bed brakes were locked at all times. The patient’s elimination needs were scheduled every two hours, bedside commode was provided for frequent elimination needs, the patient was not left unattended while on bedside commode or in the bathroom. For a safe bathroom environment toilets was raised, toilet seats were secure, and handrails was strong enough to support patients, and patient was also instructed to pull the call light if feeling dizzy or in need of any assistance . Furthermore, the room temperature was
Upon evaluation of the patient outside and inside home environment I was able to identify safety concerns that can potentially provoke a fall. Home entrance was clutter with chair flower pots, and trees, impeding client direct access to main door. Even though Mrs. Cabrera lives in a 1 story home
Falls are highly common amongst the elderly, particularly those who lack mobility, are in hospital, or are living in a nursing home. When an elderly person falls, their activities of daily living may be impacted due to injuries sustained from the fall. It is essential that precautions are put in place to prevent falls in all settings. This essay will discuss the statistics surrounding falls, prevention strategies, and the impacts of a fall on a patient’s ability to complete activities of daily living.
When asked to compare the policies of the clinical facility to that of the best-practice recommendations the following was revealed. First, the acute-care facility does utilize a fall risk assessment similar to that of the Morse fall scale. The patient is then identified as a fall risk one, two, or three. Based on the score, basic fall interventions are required. For example, a fall risk one requires safety rounds every two hours whereas a fall risk three require hourly safety
Falls in an acute care setting lead the list of injury related deaths and deaths in the elderly. “A fall is defined as any event which patients are found on the floor (observed or unobserved) or an unplanned lowering of the patient to the floor by staff or visitors” (Kalisch, Tschannen, and Lee, 2012, p. 6). Medicare and Medicaid changes in 2008 list falls as one of the 10 hospital acquired conditions for which hospitals will no longer be reimbursed because falls are considered preventable conditions. Joint Commission accredited hospitals are required to assess for falls risk and implement falls prevention measures.
Use of fall prevention strategies (call light within reach & bed alarm activated) to protect patient from falling since patient has history of
A study was done at a 1,300 bed urban facility over a 13-week period. The purpose of the study was to describe the causes of inpatient falls in hospitals (Hitcho, et al., 2004). All falls were reported except falls in the psychiatry service and during physical therapy sessions. During the 13-week period, a total of 183 patients at an average age of 63.4 years old fell. Of the total number of falls 79% were unassisted, 85% happened in the patient room, 59% occurred during the evening or overnight shift, 19% were while walking, and 50% were elimination related (p. 732). In this study it was identified that many patients did not use their call bell before getting up because they did not believe they needed assistance. It was stated that, “perhaps patients need to be better educated on the effects that a new environment, decreased activity, medications, tests, and treatments can have on patients’ energy and ability to ambulate safely” (p. 737). The findings of this study showed that falls not only happen in the elderly, but in the younger population as well. Patients that fall in hospitals are often unaided and are due to elimination needs. To prevent falls and decrease injury rates, more studies need to be done.
The increase in patients falls and the number of patients that are fall risks has greatly increase. Part of this is due to the aging population. While there are many prevention methods in place, patients are continuing to experience falls. “Problem solving relies on decision-making, critical thinking, and/or clinical judgement” (Chamberlain College of Nursing, 2015). I recently had a patient that had two falls during his admission. I placed the patient on 1:1 observation. He was a fall risk due to his history, mental status, and medications (narcotic pain meds and antipsychotics). The patient did not fall again while I was at work. However, after my days off I came back and got report that the patient fell again. The patient had been taken
Healthcare organizations rely on incident reports for counting the frequency of falls and collecting fall-related data (Quigley, Neily, Watson, Wright, & Strobel, 2017). When a fall occurs in a healthcare organization, an incident report is completed to record the occurrence and circumstances surrounding a fall (Quigley, Neily, Watson, Wright, & Strobel, 2017). The definition of a fall is a loss of upright position (Quigley, Neily, Watson, Wright, & Strobel, 2017). A sudden, uncontrolled, unintentional, non-purposeful, downward displacement of the body to the floor, ground, or on an object (Quigley, Neily, Watson, Wright, & Strobel, 2017). When a fall occurs in a healthcare organization, an incident report is completed to record the occurrence and circumstances surrounding a fall (Quigley, Neily, Watson, Wright, & Strobel, 2017). The data might include time of day, location, activity, vital signs, and incontinence (Quigley, Neily, Watson, Wright, & Strobel, 2017). From the analysis of the data, one can determine the type of fall, such as accidental, anticipated physiological, and unanticipated physiological fall (Quigley, Neily, Watson, Wright, & Strobel, 2017). Along with the severity of the injury, minor, moderate, major, or severe, as well as to identify overall patterns and trends surrounding fall occurrence (Quigley,
Problem: Patient falls have long been a common and serious problem in hospitals across the nation, causing
L. Holtz, a registered nurse (RN), mentions even with the use of tab alarms, residents still experience falls (personal communication, February 3, 2017). When a resident is first admitted into long term care, they undergo various assessments. One assessment is the Morse Fall Scale (MFS). The MFS is a rapid and simple method of assessing a patient’s likelihood of falling. It consists of six variables that include: history of falling, secondary diagnosis, ambulatory aid, intravenous (IV)/Heparin lock, gait/transferring, and mental status. There are three risk levels based on scoring: no risk, low risk, and high risk. L. Holtz pointed out interventions for high risk residents would include: tab alarms, floor alarms, and lower beds (personal communication, February 3, 2017). She also mentioned each resident is identified as a fall risk by a falling star poster which is attached to their name tag outside their door (L. Holtz, personal communication, February 3, 2017). Other interventions to reduce the occurrence of falls include: regular toileting, clutter-free areas, and well lighted area. Efforts and interventions are placed to assure the safety of the residents. However, even when these interventions are in place, falls still
Assessing patients that are at risk for fall and implementing fall preventative measures like placing a