Question

A patient has just fallen in the hospital unit where you work and fractured their skull. A team of personnel are asked to collaborate and develop a fall prevention program that includes using the Morse Fall Scale.

Identify the members included on the team and why they are important to include.

Identify the components used in the Morse Fall Risk Scale.

Identify key points to consider when developing a fall prevention plan (Use the literature to support your decision) Base your initial post on your readings and research of this topic.

. Your initial post must contain a minimum of 250 words. References, citations, and repeating the question do not count towards the 250 word minimum.

Answer 1

The team members involved in the fall prevention programm can be Ward Nurses, ICU Nurses, Geriatric Nurses, Doctors, House keeping workers, Physiotherpist, Pysciatrist.

Importance of Team members in Fall Prevention Programm:

• Nurses:They are the ones who will be closely monitoring the patient. They usually know the behaviour of the patient and also thier risk factors.Hence their role is very important.
• ICU Nurses: Patient in ICU need more observation. Since 1 nurse is alloted to 1 patient, it is more effective if a ICU nurse gets trained in this programmes as she plays a vital role in patient care.
• Geriatric Nurse: Old age patients are at high risk of falling. So role of geriatric nurse is very vital.
• Doctors: All doctors need to be involved in this programme. They can support the nurses when they are on rounds such as if an untoward incident take place or incase they need to handle a situation by themselves.
• House Keeping Workers:They have to take care of patient when helping in toiletting or changing beds etc.Hence thier role in handling patient is very important.
• Physiotherapist:They know what kind of care to be given in case of a fall and how to educate patient and family members .
• Psyciatrist:Their role is very important in handling mentally unstable patient, restricting thier movements etc.

The components used in Morse Fall Scale are:

1.History of Falling:This component recognises if the patient has fallen for the first time(Sore is 0) or he has had a previous fall (Score is 25).

2.Secondary Diagnosis: If patient has more than one diagnosis (Score is 15), the expectation is his chance of falling is more. Because his physical condition is so deteriorated that he is not able to maintain balance.

If he has only one diagnosis (score is 0), his chance of falling is less.

3. Ambulatory Aid: If the patient moves with supports like holding an immobile structure (score is 30), chances of fall is more. If a patient uses movable supports like crutches, walkers, cane(has a score of 15) also his falling presumption is moderate. If he walks without any support or is bed rest(score is 0), chances of fall is less.

4. IV access:If a patient is attached to an IV line, he probably might hurt himself when he falls with all the connections on him(SCore is 20). If he is not attached to any IV line(Score is 0), it means he is healthy and doesnot need any medical intervention.Presuming his chance of fall is less.

5.Gait: If an invidual has a good and normal gait,his score is 0.

If a person is week in his gait, able to walk but in stooping position, then his score is 10.

If a person has impaired gait then his score is considered 20. Because he might try to get up many times , there is chance to fall. Therefore more support is required to such kind of patients.

6. Mental Status: If a person is in a position to asess his own capacity then patient is normal and his score is 0. In case the patient is not proper in his answering or not able to assess himself, then his score is 15, beacuse it is understood that he cannot protect himself.

Risk score:

Level	Morse Fall Scale Score
Low risk	0-24
Medium Risk	25-44
High risk	45 and above

Key points to consider when Developing Fall Prevention Plan are:

• Always orient pateint /person to the situation around him.
• Make him familiar with all rooms, especially bathroom which needs to be frequently used.
• Make the provision of light at the reach of patient.
• Verbally communicate the Fall prevention Intervention to patient as well as his family members.
• In this programme involve multi disciplinary group so that they know the risk factor with respect to each patients.
• Change of position every 2 hourly is very important for patients.Place patient always in comforatable positions.
• Avoid all sharp items away from patients side.
• When patient is on bed, side rails has to be raised so that patient doesnot fall.Or low beds can be used.
• Provide a commode at bedside if necessary.
• Never leave patient unattended.
• Keep sharp items away from patient side so that he doesnot hurt himself.