When a person enters a hospital that person is to be take care of for the treatment of sickness or disease. The one thing that cannot occur is to die or be injured by something that you did not enter the hospital for. Falls is one of those things that can occur to a patient which can injure or cause death. A Fall is when a patient should not move by themselves.
A Fall can be defined as an event which results in a person coming to rest inadvertently on the ground or some other lower level. Interventions are steps that hospitals should take to keep all patients safe from Falling, regardless of the risk after being assessed by the Nursing staff. Assessments are checks to see how likely it is that you will Fall.
Assessments for Falls are done to determine if the patient is a risk for Falling. Most of the tools used by the RN in assessing you for Falls are on a numeric scale. Falls can have contributing factors..
One of those factors for Falls are the hospital being short staffed. Unlike a nursing home, it is difficult to show short staffing in hospitals, however it can be done. The reason the hospital is short staffed is due to the hospital trying to save money or putting profits over patients. They do this by not having enough total bodies to care for the patients whether it be just a decrease amount of RN, LPN and/or CNA or PCA. Another way to short staff is to not have sufficient RN to care for the patients. The facilities will use LPN which are cheaper to hire than RNs. Also, the hospital will thinly schedule ie. they schedule just enough to cover their ratio of patients and if one calls in sick or is unavailable the facility or hospital is even more short staffed.
Second factor for Falls is the failure to properly assess the patient to begin with. A full Fall risk assessment should be done by the medical care providers which is RN in the facility. At times the facility will fail to access at all which causes Falls. Other times the assessment is completed but not correctly for Falls. The failure to not assess or not assess properly can be caused by short staffing since no time to do either.
Third factor for Falls is the failure to implement or use Bed Alarms. Bed alarms are defined as devices that contain sensors that trigger an alarm or warning light when they detect a change in pressure. The sensors, which can be pads, are placed under either the shoulder area, or the hip area, underneath the sheets on the mattress. The hospital must keep the Bed alarms in working order to prevent the Falls. Also, the Bed Alarms must be tested and turned on to prevent Falls.
Fourth factor for Falls is the failure to implement or use chair alarms. Chair alarms are defined as devices that contain sensors that trigger an alarm or warning light when they detect a change in pressure. The sensors, which can be pads under the buttocks or rear end of the patient in the chair. The Hospital must keep the chair alarms in proper working order. Additionally, the chair alarms must be tested and turned on to prevent Falls.
Fifth factor contributing to Falls is the failure to remove clutter in the area where the patient might be walking or stepping. Specifically Falls can occur between the patient’s bed or chair and the bathroom. If other chairs or clutter is present that can cause the patient to have Falls.
Sixth factor in causing Falls is the administering medication which increases the Falls risk in a patient already likely to fall without proper interventions. For instance, if you have a high fall risk patient, without being administered sedatives, that assessed Fall risk patient should not be given the sedative or other medication and then placed in a vulnerable situation. One such situation is a moderate to high fall risk patient after being given medication is then placed on a bed side commode. That is just asking for a Fall, injuries and possible death when placing the patient in a vulnerable situation. Seventh factor that might cause Falls is a combination of all of the first 6 factors. Interventions are those steps taken to prevent falls. So, when a patient is assessed as a Fall risk then the hospital is to implement interventions. Those interventions to prevent Falls is to make sure no clutter on floor. Moving the Fall risk patient closer to the nurse station. Making sure the Fall risk patient has his or her door open when next to the nurse station. Making sure all bed alarms are turned up to the maximum volume to be heard. Making sure the chair alarms are turned up to the maximum volume.
Checking on the Fall risk patient as often as possible while caring for other patients but certainly no longer than called for by the hospital fall prevention protocols and procedures of the hospital. The hospital should have Fall prevention protocols and procedures in place. Staff must follow the Fall prevention protocols or procedures in place. Fall prevention assistive devices such as harnesses to be able to lift or assist the patient without Falls for the staff nor the patient. If it is called for in assessment, the prevention of Falls, for a two person assist. This is generally determined in the Fall Assessment.
