Fall Intervention

Jamie Myers
Outcomes
By the end of the class the learner will know:
Why falls are important to decrease
What interventions should be used Hourly Rounding, Bed Alarms,
and Gait Belts
Instruct why there is a need to use hourly rounding, bed alarms, and
gait belt
Demonstrate how to put the gait belt on
Demonstrate proper body mechanics
Demonstrate how to transfer with gait belt
Demonstrate how to ambulate with gait belt
Why Its Important to Decrease
Falls
Falls with injury cost the organization and patient
more money.
On average falls with injury can increase the cost
of the patients stay by $4,000, which the facility
will have to pay (Inouye, Brown, & Tineti, 2009)
Falls create an unsafe environment for patients
Falls can create unsafe environment for caregivers
Hourly Rounding
This should be done with all patients
Some high risk fall patients (those scoring higher than 10 on
Hendricks fall scale) will need every 15 minute rounding
done
Why should this be done?
Reduces call lights
Increases patient satisfaction
If done correctly the patient will know when you will return
and decrease anxiety for the patient.
Implementing Hourly Rounding
Patient Care Strategies: Achieving Nursing and Patient Care Excellence
Use the following behaviors and tasks when conducting hourly rounds.

8 KEY BEHAVIORS
1. Use opening key words and/or actions to introduce yourself,
your skill set, your experience, and others.
2. Perform scheduled tasks.
3. Address the 5 Ps of pain, potty, position, possessions, and
pump.
4. Assess additional comfort needs.
5. Conduct environmental assessment.
6. Use closing key words and/or actions.
7. Explain when you or others will return.
8. Document the round on the log or chart.

 What should you address during

rounding?
1. PAIN: How is your pain?
2. POSITION: Are you comfortable? Let me help you turn on to your side. Let me
adjust your pillow for you.
Turn and position patient for safety and comfort.

3. POTTY: Let me help you to the bathroom. I have time.

(Check Foley)

4. PERIPHERY: Im going to move the phone, call light, trash can, water cup, etc.
closer for you.
Move the phone, call light and/or trash can within reach. Arrange the over bed table and fill
the water cup.
Eliminate unnecessary clutter.
Check that bed alarm is on.

5. PUMP: Check the IV pump.

Check Enteral pump. Ensure all equipment is plugged in and operational.
Bed Alarms
Reduce the risk of fall to patient
One study showed overall falls decreased by 25% and the rate of
unassisted falls (no caregiver present) decreased by 38% by using bed
alarm (Geffre, 2013).

Bed Alarms need to be used on every fall risk patient (anyone who
scores higher than a 5 on Hendricks scale)
How to set Bed Alarm
Bariatric Bed Alarm
http://link.videoplatform.limelight.com/media/?mediaId=72cf65407e2c4a46
9d68fe4cc334a7f5&width=480&height=411&playerForm=PlayerStandard

Versa Care (Unit inpatient bed)

http://link.videoplatform.limelight.com/media/?mediaId=0e9a48949a844c6
29180af55e77adf3f&width=480&height=411&playerForm=PlayerStandard
Why use a Gait Belt?
Stability
Lowers risk of injury to staff and patient
It is estimated that each year 12% of nursing personnel will consider
a job transfer to decrease risk and another 12%-18% will actually
leave the nursing profession due to chronic back pain. Work-related
musculoskeletal disorders in nursing are quite expensive and include
indirect costs associated with temporary hires for replacement
personnel, overtime to absorb the duties of an injured worker, legal
fees; time loss costs for claim processing, witnesses; decreased output
following traumatic event; training temporary and/or replacement
personnel (Nelson & Baptiste, 2004).
Who needs a gait belt?
Anyone that is unstable
Anyone that needs assistance from bed to chair
Anyone that is a fall risk
Fall risk patients are anyone scoring a 5 or above on the Hendricks scale
How to apply gait belt
Put the belt around the person's waist over their clothing with the
buckle in front.
Thread the belt through the teeth of the buckle. Put the belt through
the other 2 loops to lock it.
Be sure the belt is snug with just enough room to get your fingers
under it. (Mount Carmel, 2014)
Demonstration on how to apply
GB
https://www.youtube.com/watch?v=qcp0B7E1uh8
Proper Body Mechanics
Any transfer, lift, or ambulation should follow the following body
mechanics
Maintain the back's natural curves by keeping the ears, shoulders, and hips
aligned.
Lift and lower with your legs, not your back.

Keep the weight close to your body.

Bend at the hips, not the waist.

Avoid twisting or turning the upper body when carrying or lifting.

Explain what you are doing to patients and other employees who are
participating.
Make sure that both you and the patient are wearing non-slip footwear.

Be sure the floor is dry and obstacles are removed.

Get assistance whenever possible. (Cross Country University, 2013)

How to transfer with gait belt
Grip the belt tightly, bend your knees, and keep your back straight.
Lift or move the person with your arm and leg muscles. Do not use
your back muscles.
Do not twist your body when you move or lift the person. (Mount
Carmel, 2014)

How to ambulate with gait belt

Have the patient scoot towards the edge of the chair/bed
Grab the belt and have the patient push up from the bed/chair to a
standing position
Stand to the side of the patient (If they have a weaker side, stand on
that side)
Grab the belt at the back of the patient with the palm of the hand
facing up towards the ceiling.
Walk with the patient at their pace and return to sitting position
before leaving the patient.
Demonstration on how to
ambulate with GB
https://www.youtube.com/watch?v=JHCF-ryaYA0
References
Cross Country University. (2013). Patient transfers and body mechanics. Retrieved
from My Learning Community:
https://www.mylearningcommunity.com/online_learning/custom/cctc/cgs09trans/medi
a/CGStrans.pdf
Geffre, S. (2013). Bed alarms: Investigating their impact on. Retrieved from Bed
Check: https://www.stanleyhealthcare.com/files/pdf/st-alexius.pdf
Hill-Rom. (2017). Bed product training modules. Retrieved from Hill-Rom:
https://www.hill-rom.com/usa/Education/Education-by/E-Learning/Product-Training-
Modules/
Inouye, S., Brown, C., & Tineti, M. (2009). Medicare nonpayment, hospital falls, and
unintended consquences. Retrieved from Medable:
http://www.nejm.org/doi/full/10.1056/NEJMp0900963
Mount Carmel. (2014). Gait belt - Safe use. Retrieved from Mount Carmel:
http://www.mccn.edu/library/patienteducation/patienteducatio_/safetyandlegal_/gaitb
eltsafeuse/GaitBelt-SafeUse.pdf
Nelson, A., & Baptiste, A. (2004, September). Evidence-Based Practices for Safe
Patient Handling and Movement. The Online Journal of Issues In Nursing, 9(3).