Falls

By Elizabeth Rickard and Lauren Kasperlik

Definition
unplanned descent to the floor with or without injury to the patient.
Cause: Bed check alarm not on, lack of or improper use of gait belt,
noncompliant patient/staff
Contributing factors: Orthostatic hypotension, narcotics or sedation, confused,
lack of fall risk protocol, patients who have difficulty walk and transferring
Complications: broken bones, longer hospital stay, head injury, death
Scope of Problem: 700,000 to 1 million fall in the US, 30-50% of falls result in
injury. 1 in 30 adults 65+yrs fall each year. Fact is a fall can happen to anyone

Implication of Problem
Patient: Longer hospital stay, injury, broken bones, loss of work, permanent
disability, reduced quality of life
Institution: loss of reimbursement, poor reputation
Healthcare Resources: staffing, and rehabilitation

Recommendations
Patient Care: Use call light when assistance is needed,
patient will inform staff if dizzy or lightheaded
Prevention/Prophylaxis:
Use gait belt, ask appropriate questions, assess
mobility before moving, bed check or bed alarm,
dangling before transfer, assess environmental safety,
quick response to bed/chair alarm, bed in lowest
position, be within arms reach of patient, call light
within reach of patient

Nursing Role
Assess: cognitive dysfunction, mobility, gait, environment, medications, risk for
falls
Plan: Communicate risk factors with patient and family, expectations of
assistance required, extra/help for transfers, communicate with staff about
mobility of patient, use gait belt
Intervention: Remove excess equipment and supplies, frequent toileting
schedule, fall risk band and sign on door, use non-slip socks, answer call light
promptly, never leave patient, use staff assist button for fall, good lighting
Evaluation: decrease number of falls in a given time frame, decrease answer
time of call light, staff able to state falls protocol

Initiatives
No Pass Zone
Motto: We all KNOW, we all CHECK, and we all RUN.

Know which patients are at risk for falling,

Check if patient needs are met and rooms are free of clutter, and

Run when a bed/chair alarm sound

Build unit-based fall prevention champions

Education Materials
Patients:
Dont fall for it!
http://www.health.gov.au/internet/main/publishing.nsf/Content/phd-pub-injury-don
tfall-cnt.htm
Steadi
http://www.cdc.gov/homeandrecreationalsafety/Falls/steadi/patients.html
Staff:
http://www.cdc.gov/homeandrecreationalsafety/Falls/steadi/materials.html

References
http://www.cdc.gov/HomeandRecreationalSafety/Falls/fallcost.html
http://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/fallpxtoolkit.pdf