02.05 Fall and Injury Prevention

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Overview

  1. Fall & Injury Prevention
    1. Fall risks
    2. Fall prevention
    3. Assistive devices
    4. Body mechanics
    5. Make life easier

Nursing Points

General

  1. Fall risk
    1. Age
    2. Education
    3. Cognition
    4. Tripping Hazards
      1. SCD
      2. Other equipment
  2. Fall prevention
    1. Call light
    2. Declutter room
    3. Non skid socks
    4. Bed alarm
    5. Lighting
    6. Frequent toileting
  3. Using assistive devices
    1. Walker
    2. Cane
    3. Wheelchair
    4. Crutches
  4. Body mechanics
    1. Lift with legs
    2. Never bend and twist
    3. Step up
  5. Make life easier
    1. Move bed up
    2. Use PT/OT
    3. Grab other HCP for moving patients

Nursing Concepts

  1. Safety

Patient Education

  1. Make sure patients understand the use of call light and place it within reach

Reference Links

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Video Transcript

In today’s lesson, we’re gonna look at preventing falls for your patient and preventing injuries for you.

Fall prevention is a big deal. It’s a big deal from the Joint Commission, and its part of their hospital regulation. To be honest, falls in the hospital are expensive, are not reimbursed by insurance or Medicare, and add to the length of stay for the patient. Honestly, falls suck. And the best way to reduce falls is to prevent them. And the best way to prevent them is to figure out and identify risks for falls.

There are a couple of things that should tell you that there’s a risk. Younger and older patients are at a much higher risk for falls. So keep that in mind. Babies can be dropped by sleep deprived parents (it really happens) and the elderly can fall because they think they can do more than they can, and they have lots going on.

You also need to think about the patient’s ability to understand and comprehend information. If they’re confused or unable to understand your teaching, they’re at a higher risk of wanting to get out of the bed and they may fall.

When you go into your patient’s room, take a look around and identify tripping hazards. Those cords or plugs that stretch across the room definitely increase the likelihood of someone tripping. Also, be sure to take off or secure your patient’s SCDs or sequential compression devices if they’re up walking around, because they’ll be sure to trip over them. You can sometimes just tuck the tubing into SCD itself, or just take them off completely.

Next we’ll look at ways you can prevent falls.

Ok, so when we look at prevention, these are things that you can do.

First, and foremost, place the call light next to the patient and make sure your patient knows how to use it. I see this all of the time. Make sure your damn call light works! Also declutter the room and remove tripping hazards.

Give your patient those trendy yellow non-skid socks and make sure the room is well lit, especially if your patient has trouble seeing. This will at least make slipping much more difficult.

Be sure to offer your patient the opportunity to go to the bathroom frequently. Don’t wait until your patient tries to do it without your help. What’ll end up happening is that it becomes an “emergency” to the patient, and you’re running in there trying to keep them from making a mess and falling out of the bed. Just be proactive and take them to the bathroom frequently or give them a bedpan or urinal.

If you’re concerned your patient isn’t with it enough to call you before they get out of bed, then put the bed alarm on .I don’t even try to mess with this. If my patient is wild and dangerous (we often called them WADDY), then I hit that bed alarm to make sure it lets me know before I hear any crashing sounds. This will let you know when your patient is trying to get out of bed, even if your patient won’t.

Now, all of your patients who have mobility issues may have to use an assistive device, like a walker or cane. As much as they’re a help, they can also contribute to falling. Your job is that you need to educate them on proper use, or re-educate them on how to use them after physical or occupational therapy comes to work with them. Watch them until you’re 100% certain they can use them correctly.

Now that we’ve talked about protecting your patient, now let’s talk about protecting you.

You’ll hear nurses of all experience say this, and I’ll be sure to say it here. Protect your back. Be smart and don’t overextend yourself. There have been lots of times I thought I was Superman and I thought I could turn the patient myself and I ended up needing help.

Let’s talk body mechanics. When you go to lift patients, be sure to lift with your legs and keep your back straight. Never bend and twist;this is a guaranteed way to hurt your back.

So what if your patient slides down in bed. When you go to lift them up, lift the patient up with your cool draw sheet and step toward the head of the bed. Don’t twist. . If not, you’ll come away aching.

Now that we’ve taken a look at what you can do for yourself to prevent injury, here are a few things you can do so that at the end of your shift you’re not hurting.

, I’m pretty tall, and if I kept the bed in the low and locked position, I’d kill my back all day. I usually tell patients that they’re going for a ride and I raise that bed all the way up so I can have a solid working height. Just make sure you lower that bed all the way down before you leave the patient.

Another thing you can do is to use PT or OT to mobilize your patients. Getting your patients out of bed is crucial to their success. But doing it safely is important. Try to coordinate care with PT or OT and try to schedule their appointments to when you need to get your patient up.

Also, grab other nurses when you need to safely move a patient. Work smarter, not harder.

Nursing concepts for this lesson focus on safety not only for your patient, but also for you.
Ok, so let’s recap:

When you work with your patient, look around and identify fall risks for your patient.

Make sure your patient’s call light works, and is within reach.

Educate your patient on fall risks, and when to call. If they don’t understand or are confused, take the necessary precautions.

When you go to transfer patients, know your limits and get help. Whether that’s PT, OT or other nurses, get extra hands.

Lastly, be sure to use proper body mechanics and protect your back.

That’s all we have for our lesson on fall and injury prevention. Make sure you check out all the resources attached to this lesson. Now, go out and be your best selves today. And, as always, happy nursing!!

Read more

  • Question 1 of 8

While admitting a client, the nurse has determined the client is a fall risk. What is a priority nursing intervention?

  • Question 2 of 8

The risk management nurse at a long-term care facility is reviewing the facility’s data related to recent client falls. The nurse should consider which of the following as a risk factor for client falls? Select all that apply.

  • Question 3 of 8

The nurse is caring for an older adult client who has a urinary tract infection. The client has mild dementia, is confused but easily reoriented, and continues to attempt to get out of bed. Which of the following is an appropriate safety measure for this client? Select all that apply.

  • Question 4 of 8

A nurse is caring for a 9-year-old client who is considered a fall risk because of a history of seizures. Which of the following interventions should be implemented to prevent falls in a pediatric client? Select all that apply.

  • Question 5 of 8

A home care nurse is working with a client who is a fall risk. The nurse notes that the patient uses a step stool in the kitchen and has many items placed high in the cupboards. Which information should the nurse provide that would best help this client to stay safe?

  • Question 6 of 8

The nurse is caring for a client who is confused. This client has multiple cardiac IV drips, sequential compression devices, and a Foley catheter. The client is becoming increasingly agitated and is pulling at the IV lines and Foley catheter tubing. Which of the following is an appropriate intervention?

  • Question 7 of 8

A nurse is working in the surgical unit and is assigned the following clients. Client A, a 78-year-old male client who recently had a hip fracture and who suffers from Parkinson’s disease. Client B, a 60-year-old client who is visually impaired and who is post-op day three after hernia surgery. Client C, a 56-year-old client who has a prescription for keterolac and who had shoulder surgery. In which order would the nurse categorize these patient’s fall risk from greatest risk to least risk?

  • Question 8 of 8

A nurse is filling out a fall risk assessment on a client who is considered to be at high risk of injury due to falls. Which of the following information is documented as part of the fall risk assessment?

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