Patient Falls in the Hospital: Reducing the Risk

Nurses help reduce patient fallsDid you know Botsford Hospital has a “Falls Prevention Team?”  It includes members from five nursing units as well as departments across the hospital including administration, risk management and Trauma Services.  The team of 12 recently swept through nursing units across the hospital looking for new ways to prevent patient falls.

Why all this attention on falls?  Because nationally, falls have consistently been the largest category of reported hospital patient safety incidents since the 1940s. An estimated 7 million elderly patients fall in hospitals each year in the U.S. About a third of those falls result in injury, although only two percent of those injuries are severe. The average cost of an inpatient fall to a hospital is $19,440. Generally, “fallers” are frail or just don’t want to bother the nurse.

“We can’t seem to find a magic prediction rule that discriminates between people falling and those who fall and injure themselves,” says Dahlia Klein, RN, Botsford’s director of nursing. “This is why our latest approach to this patient safety initiative is one of injury prevention.”

The Falls Prevention Team began tackling the problem from this new angle. To start, Laura Gervasi, RN, 4 North Education Specialist, and Diane Lenk, RN, Clinical Nurse Specialist, went through nursing units looking for opportunities that could be quickly implemented, including:

  • Replacing 21-inch cords on patient phones with seven-inch cords (80 percent of falls occur in patient rooms.)
  • Adding nightlights to patient bathrooms (11 percent of falls are in patient bathrooms.)
  • Hanging laminated signs in patient bathrooms, urging patients to “please call, don’t fall”
  • Adding grab bars in patient bathrooms on some units

The team has also brought on a new tool: Nurses now use the Hendrich II Fall Risk Model to assess patient fall risk on admission and each day thereafter. Included in it is a numerical rating system for patients at risk.

The next process the team is working on is called a post fall huddle review. Staff caring for the patient who fell will gather information while it is fresh. This information will be logged, reviewed and trended in an effort to identify new fall awareness measures.

Finally, nurses are educating patients and their families, giving them tips on reducing fall risks in patients’ homes and listing medications that increase fall risk.

Here are more ways the team is helping to prevent falls in the hospital:

  • Patients with higher fall risk wear yellow bands on their wrists to ensure caregiver awareness is raised.
  • Every hour, nursing staff stops in to see each patient to check patient position, pain level and need to urinate. It’s that last one that reduces fall risk, because many would prefer not to bother their nurse just to use the bathroom.
  • Magnets are placed on patient room doors that alert anyone entering about the patient’s heightened fall risk.

With all this effort, we hope to make staying in a hospital even safer for patients.

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