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Running head: TECHNIQUES USED TO REDUCE PATIENT FALLS

Techniques Used to Reduce Patient Falls


Danika Baker
Ferris State University

Techniques Used to Reduce Patient Falls


A patient fall is defined as a sudden, unintentional change in position, coming to rest on
the ground or other lower level. This action can result with or without patient injury and still be
considered a fall. Falls are among the most commonly reported adverse hospital incidents with
more than 1 million events occurring annually (Mion, 2012). There are many factors that go into
how and why patients fall. Health care providers are taking numerous measures in order to
prevent them.
Factors contributing to patient falls can be broken down into different categories.
Intrinsic factors that contribute to falls are patient specific. They can range from having an
impaired gait or vision, generalized weakness, postural hypotension, urinary incontinence,

certain medications such as diuretics, tranquilizers, sedatives, hypnotics or analgesics or


impairment in cognition with forgetfulness, poor judgment, and impulsiveness (Taylor 2011).
Extrinsic factors that contribute to falls in the hospital have to do with the unfamiliar
environment such as furniture on wheels, cluttered pathways, poor lighting, IV poles, or urinary
catheters. There are some events that are considered situational such as the patient leaning
forward or reaching up for an object. Transferring patients from the bed to chair or to the
bathroom also puts the patient at risk unless the proper transfer techniques and precautions are
being utilized correctly. Organizationally, staffing numbers, knowledge, policies (such as hourly
rounding and type of fall prevention programs), bed and chair alarms, or surveillance monitoring
also contribute to patient fall factors.
Some techniques used to reduce these falls include identifying who is at a high risk for
falling, the use of bed and chair alarms, hourly rounding including scheduled toileting, if able,
moving the patient into a room that is closer to the nurses station, and keeping the room free of
cluttered paths to the door and restroom.
High fall risk patients will been determined using a fall risk assessment tool. This is
usually in an algorithm format upon admission, per hospital protocol. The assessments ask
questions such as how many times the patient has fallen at home in the last six months, does the
patient use a walker at home, age, what medications they are currently on, how well their
eyesight is and if they live alone. How steady their gait is on admission, also plays a role in the
deciding score that the patient receives. A substantial number of fall risk assessment tools are
readily available and assess similar patient characteristics. However, their diagnostic accuracy
showed a wide variability when it came to comparing the different techniques. Each hospital has

TECHNIQUES USED TO REDUCE PATIENT FALLS

their own fall assessment tool that they use, which makes it difficult to compare across the board
at a national level (Perell et al., 2001).
Bed and chair alarms are used widely in the hospital setting. They not only signal the
healthcare workers to a patient that is trying to sit up or get out of bed, but they also warn the
patient that they are doing something that they should be waiting for assistance with. Not having
the bed or chair alarms properly used is a major reason for any ineffectiveness. Staff training
and education with equipment such as with bed and chair alarms will maximize success in fall
prevention.
Hourly rounding is an intentional tactic to make a visual and verbal check with the
patient. With this method, the patient will then expect someone to be in checking on them. The
healthcare worker will ask if the patient needs anything, to use they toilet, then when returning to
bed or chair, be sure that they patient has their call light and if needed make sure that the bed or
chair alarm is hooked up properly. By using intentional hourly rounding, the goal is to limit the
patients need for wanting to get up alone knowing that someone will be back in to check on
them within the hour. If a patient were impulsive or confused, moving their room closer to the
nurses station would increase visibility for workers to maintain the patients safety.
There is no one right way to prevent patient falls. However, there are many techniques
that can be beneficial in reducing occurrences. Each patient requires a different approach and a
specialized plan of care in their fall prevention once admitted to the hospital. It is the nurses
responsibility for the safety of the patients and to make sure that the appropriate measures and
techniques are being taken to reduce patient falls.

TECHNIQUES USED TO REDUCE PATIENT FALLS


References
Mion, L. C. (2012). Patient falls in the hopital setting: a persistent problem [Entire issue].
XTRAwise a publication for the medical community, 14(4). Retrieved from
www.sizewise.net/getattachment/70b1fddf-ca54-4126-8a73fe272744d109/Patient_Falls.aspx
Perell, K. L., Nelson, A., Goldman, R. L., Luther, S. L., Prieto-Lewis, N., & Rubenstein, L. Z.
(2001). Fall risk assessment measures an analytic review [Entire issue]. The Journals of
Gerontology, 56(12). http://dx.doi.org/10.1093
Taylor, C., Lillis, C., Lemone, P. & Lynn, P. (2011). Fundamentals of nursing: The art and
science of nursing care (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

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