Ans)Situation given: Patient
fallen in hospital unit.
Fall prevention
program includes Morse fall scale:
- The Morse Fall Scale (MFS) is a rapid and
simple method of assessing a patient's likelihood of falling. Fall
risk assessment scale.
-The goal of patient safety practices like fall prevention is to
prevent additional harm to patients while they are
hospitalized.
Members included in team:
- The Unit Team will include everyone on the unit, such as RN,
LPN, CNA, medical staff, pharmacist, physical therapist /
occupational therapist, and other staff assigned to a unit on a
regular basis.
- The Unit Team members provides daily direct patient care by
conducting fall risk assessments, planning care for fall prevention
also ensures care is performed and documented therefore they all
are important in the team.
Components used in the Morse fall Risk
scale:
- History of falling: immediate or within 3 months
No 0
Yes 25
- Secondary diagnosis:
No 0
Yes 15
- Ambulatory aid:
Bed rest/nurse assist 0
Crutches/cane/walker 15
Furniture 30
- IV/Heparin Lock
No 0
Yes 20
- Gait/Transferring:
Normal/bedrest/immobile 0
Weak 10
Impaired 20
- Mental status:
Oriented to own ability 0
Forgets limitations 15
Key points to consider when
developing a fall prevention plan
- Universal fall precautions, including scheduled rounding
protocols.
- Standardized assessment of fall risk factors: Morse fall scale
in initial assessment.
- Care planning, interventions and evaluation.
- Postfall procedures includes: Take patient to bed, assess vital
signs, inform to on -call Dr, carry out the orders given, fill in
CQI form and perform root cause analysis.
As prevention is better so focused on prevention:
- Morse fall risk assessment scale
- Identify the patients at risk for fall
- Include them in vulnerable patients category and have a
seperate ID band to identify them easily.
- Familiarize the patient with the environment.
- Have the patient demonstrate call bell use.
- Maintain call bell within patient's reach.
- Keep the patient's personal possessions within patient safe
reach.
- Have sturdy handrails/ grab bars in patient bathrooms, room,
and hallway.
- Show them night lamps.
- Compulsory one attendant with parient.
- Place the hospital bed height in low when a patient is resting
in bed; raise bed to a comfortable height when the patient is
transferring out of bed.
- Side railings of bed should be always up so patient while
sleeping won't fall.
- Keep hospital bed brakes locked.
- Keep wheelchair wheel locks in "locked" position when
stationary.
- Keep nonslip, comfortable, well-fitting footwear on the
patient.
- Avoid slippery floors.
- Use of caution boards by housekeeping staffs while cleaning
floor to create awareness.
- Keep floor surfaces clean and dry. Clean up all spills
promptly.
- Keep patient care areas uncluttered.
- Follow safe patient handling practices
- Safety boards in room to develop awareness.
- Anti skid mats outside bathrooms.
- Get your vision and hearing checked annually to avoid
- Use safety belts during transportation.