Falls are preventable

Has anyone had a hip fracture?

Did you know the lifetime cost of a hip fracture for elderly patient’s was estimated to be between $21,525 and $86,967 total of all procedures (Frick et al., 2010). Also, the medical costs of falls totaled $19 billion in 2010 (Center for Disease Control, 2008).

           Preventing incidence of falls can be utilized in any healthcare setting or any home settings. Unfortunately, falls do occur in healthcare settings, However, falls are preventable through education and implementation of safety measures. A successful patient outcome is the basis for nurse’s development of a fall prevention plan.

 Strategies of fall prevention should be discussed at in-services. Facility policies should be followed to provide safety precautions. Fall risk profile completed every 12 hours is important initially after a fall. The most successful fall prevention programs reduce fall rates by 30 per cent (Rutledge, &Schub, 2011).

        Did you know approximately, 19 per cent of inpatient falls occur during ambulation, 11 per cent getting out of bed, and 4 per cent using the bedside commode or toilet while hospitalized (Healey, 2010).

        Falls are a leading cause of injuries and deaths among the elderly. A history of falls increases the risk of falling again.  An increase in readmission rate occurs after early discharge. This is seen when appropriate discharge teaching is not implemented. An example of appropriate discharge teaching is education about household fall hazards. Also, healthy behaviors such as participating in exercise and using proper body mechanics when changing positions or ambulating could result in fewer falls. Another idea is teaching the person how to get up from the floor, summon help, move about, and how to keep warm while on the floor. Falls are preventable through education and implementation of safety measures. Did everyone know that bed alarms and low bed height really have little to no benefits in preventing falls? Just to let everyone know according to Sorrentino et al., (2010) there is little to no benefit to using these interventions. Therefore, we need to provide accurate information in fall prevention policies and practices, which will result in increased communication and trust between patients, their family, and the nursing staff.

Nurses play critical roles in fall prevention, decreased falls mean better patient care, and less falls causing injury in a facility lead to greater trust from all patients and community members (Healey, 2010). Nurses will feel confident in their work skills when audits and surveys returned indicate decreasing incidents of falls occurring.

        The goal of the nursing care plan and patient interventions is to make health promotion a way of life for individuals, families, and communities. Improving the safety of patient’s environment will reduce distraction and potential of falls. Fall prevention interventions can include ensuring patient’s change the environment to promote a behavior change (Pender et al., 2011).  For example, the patient's rooms could have televisions mounted on the walls in order to provide more room to ambulate without obstacles. Patients can be taught to use nightlights at night while ambulating.

           Safety at all times is important. The use of medicine increases the risk of falls up to 25% when taking one medicine, up to 60% when taking six or more medicines. Patients can be taught to schedule taking medications while having a full stomach. An effective fall prevention program to be offered by the Advanced Practice Nurse or Nurse Educator would include education of nurses, and nurse’s aids about falls and risk factors to prevent falls.

           Hopefully, everyone learned the importance of following fall intervention programs to prevent or decrease the incidence of falls. Also, remember to use proper body mechanics to prevent injury when assisting others. This blog can be used by healthcare workers, families and the community in order to prevent falls.

Thank you for checking out this blog. Sue

Reference

Center for Disease Control and Prevention. (2008). Preventing falls: How to develop community-based fall prevention programs for older adults. Atlanta GA: National Center for Injury Prevention and Control.

Frick, K.D., Kung, J. Y., Parrish, J. M., &Narrett, M. J. (2010). Evaluating the cost-effectiveness of fall prevention programs that reduce fall-related hip fractures in older adults. Ethics, Public Policy and Medical Economics.The Journal of American Geriatric Society, 58(1).

Healey, F. (2010).A guide on how to prevent falls and injury in hospital.Nursing Older People, 22(9), 16-22.

Itkin, A. First Steps After Suffering a Slip-and-Fall Injury in      California Retrieved from http://www.arkadylaw.com

Pender, N., Murdaugh, C. & Parsons, M. A. (2011).Health promotion in nursing practice. (6^thed.). Upper Saddle River, Pearson Education, Inc.

Post Care Patient Education Using a Transfer Belt (2009).Retrieved from http://www.PreOp.com

RRutledge, D., &Schub, T. (2011) Evidence- Based care sheet: Fall prevention in hospitalization patients.Cinahl Information System

SSorrentino, S. A., Remmert, L. N., &Gorek, B. (2010). Mosby’s essentials for nursing assistants (4^thed.). St. Louis, MI: Mosby Elsevier.

sept. 17, 2012 steps to standing

 Answers to matching:

Range of Motion=ROM

Out of bed =OOB

Activities of Daily Living=ADL

Ambulate=AMB

Anyone have a Backache?

Healthcare workers would benefit from ideas in this blog!

Learn Proper ways to Stand to Prevent Backaches!

 

 

Review Steps to Lifting a Box

There is an abundance of information to learn about preventing falls such as:

Contributing factors to falls:

          Visual impairment

          Disorders affecting gate-osteoporosis

          Lack of balance and coordination

          Medications ex. Lowers blood pressure

          Urinary urgency

          Accumulation of clutter

          Hospitalization

          Confusion, impaired judgment  

Incidence of falls:

          History of falls and severity of injury

          Results in less independence

          Highest incidence over 65 years old,

          Cognitive impairment

          Social, environmental factors

Fall prevention measures:

          Well fitting enclosed shoes, non-skid soles

          Adequate lighting

          Avoid bath oils-may increase risk of falls

          Use of assistive devices- Handrails near stairs

                                                  -Handrail in showers

          Light switch-Shoulder height

          Emergency numbers near phone

To assist with limited range of motion or mobility provide:

                   Handheld shower attachments

                   Long handled bath sponges

                   Nonskid strips in bathtub

                   Grip bars near toilet and shower

                   Raised toilet seats

 Hopefully, everyone will use information learned from visiting this blog!

Review of test question

   1.   C-Tucking to excess gait belt strap is the best answer. Tucking the gait belt is a safe response so the belt is not in the way of transferring a patient.

2  B-Applying the gait belt over clothes prevents shearing of the skin if the belt rubs on the person while moving them.

3.   D. Lowering the person to the floor avoids sustaining injury during the fall.

4.   D. Grasping the gait belt on each side promotes balance for the worker during the transfer

The goal of this blog is to promote safety and comfort when nursing students care for patients whether in acute care or home settings.

Objectives

  §  1. Student will apply knowledge to accurately demonstrate applying a gait belt

§  2.  Student will use gait belt to transfer a patient safely

§  3. Discuss situations when gait belts are contraindicated

§  4. Follow safety measures when performing transfers

Does everyone know how to use a gait belt?

Steps are outlined as a refresher for everyone but also help anyone who did not see video. Situations not to use gait belt include: after recent abdominal surgery, colostomy present on abdomen, large breasted women, obese person, paralysis of lower extremities, floor wet or slippery

Steps to transfer from bed to chair using a gait belt

1)   Introduce self

2)  Call person by proper name, check to make sure you have the correct person

3)  Explain why using gait belt

4)  Wash hands

5)  Apply gait belt with tag toward person and over clothes

6)  Insert gait belt through teeth

7)  Wrap until snug against body and can only insert one finger width under belt

8)  Excess gait belt in tucked under the belt

9)  Buckle of gait belt is on side or back of person

10) Grasp gait belt using underside of palm of both hands on sides     of person

11)     Bend knees,

12)    Brace your knees against the person’s knees. Block his or her feet with your feet or

13)     Use the knee and foot of one leg to block the person’s weak leg or foot 

14)  Place your other foot slightly behind you for balance or

15)   Straddle your legs around the person’s weak leg

16)  Tell person to place hands on bed and push into mattress when lifting off of bed

17) Count out loud to number 3 then proceed with transfer

18)  Tell person to sit in chair when they fell back of legs touch chair

19)   Remove gait belt

20)  Ensure person is safe and comfortable

21)  Wash hands

Do your students explain their skill before beginning a nursing skill?

When students are to ambulate a patient do they know the best ways to communicate the steps to proceed with the nursing task at hand?

Communication before beginning a nursing task promotes comfort and reduces fear in the patient. Explain the

1)  Distance to walk,

2)  What assistive devices will be used,

3)  What symptoms the person is to report to you,

4)  How you will assist,

5)   How you will help if the person begins to fall.

Suggested communication to patient before ambulating with them 

“Mr. Owens, I am going to help you walk from your bed to the doorway and back. This gait belt is to help support you while you walk. I will stay by your side and keep hold of the belt at all times. Let me know right away if you feel unsteady, dizzy, or weak. Also tell me if you feel any pain or discomfort. If you do begin to fall, I will use the belt to pull you close to me and gently lower you to the ground. Do you have any questions?”

Please fill out matching

In our next session you will receive answers to matching

Matching

 A.    ADL            ________Range of Motion

 B.   AMB            ________Out of Bed

 C.  OOB            _________Activities of  

                                         Daily Living

 D.  ROM            _________Ambulate

Sorrentino,S., Remmert, L., & Gorek, B. (2012). Mosby’s essentials for nursing assistants (4^th ed.). St. Louis, MO: Mosby Elsevier.