FALL: ASSISTED FALL:

Unplanned descent to the

floor (or extension of the

floor, e.g., trash can or

other equipment) during

the course of a patient’s

hospital stay with or

without injury to the

patient.

A fall in which any staff

member was with the

patient and attempted to

minimize the impact of

the fall by easing the

patient’s descent to the

floor or in some manner

attempting to break the

patient’s falls.

THERE ARE 3 TYPES OF FALLS:

Anticipated physiological falls (fall prone)-78%

Unanticipated physiological falls (stroke, seizure, cardiac arrhythmias) -8%

Accidental (slipping, tripping) –14%

(Morse, 1997)

NOTE: Use of the Morse Fall Scale itself isn’t sensitive enough to identify patients at the highest risk for falls

Which staff members are involved??

• RN

• PCNA

• HUC

• MD/NP

• EVS

• Transport

• Nutrition Therapy

• PT/OT

Caregivers aware of environment & patient issues

• Low bed

• Bed and chair alarms

• Staff and Patient Education

• Fall Leaves

• Fall Huddle

• Interventions

Environmental Modifications

No BSC’s are to be left next to the patients’ beds

No Walkers are to be next to the patient’s beds unless approved by management

Bed alarms ON for all high risk patients/ICU transfers for 1st 24 hours

Landing Strips/mats ordered on ALL new amputees

Targeted Toileting

Each room will have a clipboard with a targeted toileting flow sheet to be used on patients with high Morse scores.

When entering the room, caregiver is to tell the patient “I have the time and I’m here now to take you to the bathroom.”

This is to be done Q 1hr by a caregiver.

Additional Initiatives

• Document high fall risk patients on the HUC log. • HUC Scripting to remind high risk patients not to get up without

assistance. • HUC is then to immediately call the PCNA or RN to go into the

patient’s room to assist. • If they are unable to go into the room, they are to call the ANM/Charge

phone so that the patient’s needs will be met immediately. • Weekly Unit rounds by ANM - Interviews patients/staff for their understanding of Fall Prevention measures

- Teach back with patients - Unit observation of HUC’s/RN’s/PCNA’s

Bedside Commode Alarm

Toilet Alarm