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Fall Preventiono White County Medical Center follows a fall prevention program to maximize patient safety throughout the hospital stay by identifying patients at risk for fallso Fall prevention is every associate’s responsibility
Falls Definedo Fall: “an unintended event resulting in a person coming to rest on the floor/ground or other level (witnessed) or is reported to have landed on the floor/ground (un-witnessed)o Falls do not include when a patient is assisted to the ground with no injury • This is reported as a near miss
All Patients are at Risko All patients are evaluated and assessed for fall risk regardless of ageo All patients are considered at risk for fallso The Fall Risk Assessment tool helps to determine the level of risko All patients or their guardian receive age-specific fall prevention education upon admission and when fall risk level changes
Assessmento The Fall Risk Assessment Tool is completed on admission, daily on each 7A-7P shift, any time the patient’s condition changes, following an in-house transfer, or after a fall occurso The Fall Risk Assessment tool has been modified to incorporate such known fall precursors related to age, history of falls, medications and mobilityo Patients are then placed at risk levels I, II, or III depending on the Fall Risk Assessment score
Risk Levelso There are three levels of fall categories as follows: • Level I: Low/Normal Risk • Level II: Moderate Risk • Level III: High Risk Level II & III patients are placed on Fall Prevention
Level Io Level I (Score 0-5): Low/Normal Risk – All Patients • Anticipate/plan for environment/equipment needs • Beds are kept in the lowest position to the floor • Upper side rails should be used as needed • Call bell is to be kept in reach at all times • Patient care areas require adequate lighting • Patient rooms need to be kept neat and orderly • The path to the bathroom is free of clutter • Assistive devices are within reach
Level I (continued)• Patient care equipment is kept in working order• Promptly clean spills• Encourage non-skid socks/slippers for ambulation• Frequent visual checks as determined by patient need• Offer assistance with toileting every 2 hours while awake• Offer fluids/nutrition as appropriate• Ambulate patient in hallway• Relieve discomfort promptly• Incorporate family in care of the patient
Level IIo Level II (Score 6-14): Moderate Risk • In addition to the interventions of LEVEL I… • Place Fall Prevention magnet on door • Place “Yellow” Fall Prevention armband on patient • Encourage family presence and support • Label chart with Fall Prevention sticker • Review medications with physician
Level II (continued)• Document visual checks as indicated by patient status• Offer and assist with the toileting/hygiene ADL’s on a regular schedule based on patient needs/assessment• Ambulate with assistance only (as appropriate)• Do not leave unattended while in the bathroom• Place patient closer to nurses’ station if possible• Evaluate for bed alarm prn
Level IIIo Level III (Score 15+): High Risk • In addition to the interventions of LEVEL I & II… • Increase documentation of visual checks as patient’s conditions warrants. • Place colored non-skid slippers on patient • Request family presence or discuss the option of a sitter • Evaluate for bed alarm • All noncompliant patients will be placed on a bed alarm
In the Event of a Fallo Notify the Charge nurse, unit manager, and supervisoro Notify the physician and initiate any orders receivedo Complete an ORM/Variance Reporto “Recent Fall” yellow sheet is placed in the chart for ancillary departments and physicians to seeo “Recent Fall” yellow laminated poster is placed at the head of the patient’s bed