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Fall prevention

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White County Medical Center has a fall prevention program to identify patients at risk and maximize safety. All patients are assessed for fall risk on admission and daily using a standardized tool. This places patients into risk levels of I (low), II (moderate), or III (high). Higher risk patients receive additional interventions like armbands, increased monitoring, and bed alarms. If a fall occurs, staff must notify leaders and complete reports to document and address the incident.

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Fall Prevention
Fall Prevention o White County Medical Center follows a fall prevention program to maximize patient safety throughout the hospital stay by identifying patients at risk for falls o Fall prevention is every associate’s responsibility
Falls Defined o 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 Risk o All patients are evaluated and assessed for fall risk regardless of age o All patients are considered at risk for falls o The Fall Risk Assessment tool helps to determine the level of risk o All patients or their guardian receive age-specific fall prevention education upon admission and when fall risk level changes
Assessment o 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 occurs o The Fall Risk Assessment tool has been modified to incorporate such known fall precursors related to age, history of falls, medications and mobility o Patients are then placed at risk levels I, II, or III depending on the Fall Risk Assessment score
Risk Levels o 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 I o 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 II o 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 III o 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 Fall o Notify the Charge nurse, unit manager, and supervisor o Notify the physician and initiate any orders received o Complete an ORM/Variance Report o “Recent Fall” yellow sheet is placed in the chart for ancillary departments and physicians to see o “Recent Fall” yellow laminated poster is placed at the head of the patient’s bed

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Fall prevention

  • 2. Fall Prevention o White County Medical Center follows a fall prevention program to maximize patient safety throughout the hospital stay by identifying patients at risk for falls o Fall prevention is every associate’s responsibility
  • 3. Falls Defined o 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
  • 4. All Patients are at Risk o All patients are evaluated and assessed for fall risk regardless of age o All patients are considered at risk for falls o The Fall Risk Assessment tool helps to determine the level of risk o All patients or their guardian receive age-specific fall prevention education upon admission and when fall risk level changes
  • 5. Assessment o 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 occurs o The Fall Risk Assessment tool has been modified to incorporate such known fall precursors related to age, history of falls, medications and mobility o Patients are then placed at risk levels I, II, or III depending on the Fall Risk Assessment score
  • 6. Risk Levels o 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
  • 7. Level I o 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
  • 8. 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
  • 9. Level II o 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
  • 10. 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
  • 11. Level III o 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
  • 12. In the Event of a Fall o Notify the Charge nurse, unit manager, and supervisor o Notify the physician and initiate any orders received o Complete an ORM/Variance Report o “Recent Fall” yellow sheet is placed in the chart for ancillary departments and physicians to see o “Recent Fall” yellow laminated poster is placed at the head of the patient’s bed