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Preventing Patient Falls in the Hospital

Falls are a common cause of injury, both within and outside the hospital setting. According to the U.S. Centers for Disease Control and Prevention, more than one-third of adults over 65 fall each year.  While not all falls cause injury, falls can be serious and may result in bone fractures, excessive bleeding, or even death.

An estimated 500,000 falls happen each year in U.S. hospitals, causing 150,000 injuries. Patients have a higher risk of falls if they:

  • Have an impaired memory.
  • Are older than 60.
  • Have weak muscles or problems walking.
  • Take drugs or a combination of drugs that make them sleepy.
  • Use a cane or walker.
  • Have chronic conditions.
  • Need to use the bathroom frequently.

At JFK we use best practice evidence based processes to prevent patient falls. Every hospital inpatient is assessed for their risk to fall. Special precautions are taken for patients considered to be at a high risk to fall such as:

  • Providing assistance when patients transfer in and out bed.
  • Keeping the call bell in reach.
  • Using a safety belt while in a wheelchair.
  • Placing a yellow wrist band on the patient to alert staff that a patient is at risk of falling.
  • A blue wrist band may also be used to as a reminder when a patient should not be left alone in the bathroom.
  • Using non skid yellow socks.
  • In some instances a bed alarm is used as an alert when the patient leaves the bedside without assistance.

Preventing falls is not simple.  Fall precautions must be balanced with other patient care considerations such as minimizing restraints and promoting mobility.

Keeping patients safe by preventing falls is one of our highest priorities.

What are we measuring?

We define a fall as any sudden, uncontrolled, unintentional or intentional dropping downward from a standing, sitting or lying position that results in landing on or contact with a surface or object. This includes instances where a staff member is present and intervened to prevent injury.

We track all patient falls including those without injury and where a staff member was present and assisted the patient to the floor to prevent injury. 

The graph shows a rate of inpatient falls. The rate is determined by dividing the number of falls by the number of patient days and multiplying by 1000. This rate is an industry standard.

 

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What is our performance telling us?

This graph shows that our efforts to prevent patient falls are working.  The downward trend line shows that fewer patients are falling.  However, we continue to work to reduce falls by staying current with best practices and reviewing all falls.  This allows us to find opportunities to enhance our fall prevention program. 

Keeping patients safe by preventing falls is one of our highest priorities. Our goal is to eliminate injuries from falls.

What can you do to reduce the chance of patient fall?

Patients, families and visitors have an important role in preventing falls.  You can help avoid falls by:

  • Making sure that needed personal items as well the the call bell are within reach.
  • Not leaning on furniture or using the IV pole for support.
  • Always using the call light before getting out of bed for any reason.
  • Wearing the non skid yellow socks.
  • Sitting at the bedside and standing slowly when getting out of bed.
  • Not interfering with bed alarms.

Patients as well as their families and visitors are essential members of the health care team and can help avoid falls. Printed information on the prevention of falls is given to each new patient.  Patients and their families should read this important information.  In addition, there are poster board presentations on patient care units that provide information about fall risk assessments, requesting assistance, and strategies to prevent falls. 

Additional information about how you can prevent hospital patient falls and falls outside the hospital at this Agency for HealthCare Quality and Research webpage: http://www.ahrq.gov/news/columns/navigating-the-health-care-system/030111.html