Accreditation 2023 - Communication

Fall Risk and Prevention by Kyle Rowley

From the lens of a patient admitted to the hospital; patients are at greater risk of falling and injuring themselves as they find themselves in an unfamiliar environment while also adjusting to a change in their physical or cognitive functioning (Stephenson et al., 2016).  Reducing injuries from falls can increase quality of life, prevent loss of mobility and pain for clients, and reduce length of stay and costs.

Effective fall prevention and injury reduction requires an interdisciplinary approach and support from all levels of an organization. It is helpful to implement a coordinated approach to fall prevention and injury reduction within Pembroke Regional Hospital, while recognizing the unique needs across different services, and to have designate individuals to facilitate its implementation. PRH has implemented a Falls Prevention Strategy that adopts precautions and universal interventions for everyone who comes to the hospital and aims to reduce the risk of falls. 

Universal interventions of falls prevention for our patients in their care environment at PRH include: 

• Familiarize the client to the environment
• Keep call buttons within reach at all times and observe clients demonstrate their use
• Keep clients’ personal possessions within reach
• Sturdy handrails in bathrooms, rooms, and hallways
• Keep the bed in low position with brakes locked
• Provide non slip, well-fitting footwear to clients
• Use night lights or supplemental lighting
• Keep floor surfaces clean and dry
• Clean up all spills promptly
• Keep care areas uncluttered 

Preventing falls is everyone’s responsibility. Below are strategies that PRH uses: Click here to get Q-Tip.  

1.  Keep the PRH environment safe and free of fall risks:

• Report potential hazards such as spills, water, debris, and uneven surfaces to our environmental services team
• Track falls in your area.
• Review the number of falls at Safety Huddles, LEAN Huddles or Departmental Unit Leadership Team meetings.

2. Reduce the incidence and severity of injury from a fall:

• All PRH staff involved in transferring patients are responsible for completing a point of care risk assessment prior to each patient transfer.
• On admission, perform the Morse Fall Scale, a validated screening tool used to assess a patients’ likelihood of falling; to all patients admitted to Medical, Surgical, ICU, Rehab and Acute Mental Health Units. Additional precaution strategies are implemented based on low, moderate and high-risk stratification according to the Fall Risk Assessment, Prevention & Intervention policy
• High-risk patients scoring >45 are identified with a yellow Fall Risk bracelet
• Use appropriate gait aides, level of assistance from staff members, and fall matts place at bedside and/or hip protectors if required
• Wear footwear appropriate for your environment or activity that complies with the hospital’s Footwear Policy.
• Stay alert when walking or using stairs and be aware of your surroundings. Avoid distractions such as your phone – do not text on stairs.

3.  Reduce the risk of patient falls in the community and at home:

• Provide screening to high-risk outpatient populations for falls risks (age >65years) using the Staying Independent Checklist upon initial contact and communicate the patient’s falls risk with the care team.

4.  POST-FALL RESPONSE- If you witness a fall at the hospital:

• PRH has follows a Safe Patient handling policy. Do not lift/move someone that has suffered a fall. Lifting or moving someone inappropriately can cause further injury to the individual and to you. Allow them to move on their own, with minimal assistance. If you do assist someone who has experienced a fall, be mindful of your body mechanics.
• Gather names of bystanders who were in the area at the time of the fall as they may have information about the mechanism of injury or contributing factors. Include this information in in RIMS report.
• Document appropriately and report all falls in RIMS.
• Communicate with team members and any substitute decision makers/care givers/families at a Post-Fall Huddle as part of the Post-Fall Management strategy.

To learn more, review the “Falls Risk Assessment, Prevention & Intervention Strategy”, “Post Fall Huddle Review”, “Post Fall 48 Hour Monitoring Report”, “Preventing Workplace Slips, Trips, and Falls”, “Morse Fall Scale” and “Safe Patient Handling”.