Fall and Injury Prevention

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Brad Bass
ASN,RN
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Study Tools For Fall and Injury Prevention

Prevention of Falls (Picmonic)
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Outline

Overview

  1. Fall & Injury Prevention
    1. Fall risks
    2. Fall prevention
    3. Assistive devices
    4. Body mechanics
    5. Make life easier

Nursing Points

General

  1. Fall risk
    1. Age
    2. Education
    3. Cognition
    4. Tripping Hazards
      1. SCD
      2. Other equipment
  2. Fall prevention
    1. Call light
    2. Declutter room
    3. Non skid socks
    4. Bed alarm
    5. Lighting
    6. Frequent toileting
  3. Using assistive devices
    1. Walker
    2. Cane
    3. Wheelchair
    4. Crutches
  4. Body mechanics
    1. Lift with legs
    2. Never bend and twist
    3. Step up
  5. Make life easier
    1. Move bed up
    2. Use PT/OT
    3. Grab other HCP for moving patients

Nursing Concepts

  1. Safety

Patient Education

  1. Make sure patients understand the use of call light and place it within reach

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Transcript

Hey guys, my name is Brad, and welcome to nursing.com. And in today’s video, what we’re going to be doing is we’re going to be discussing fall and injury prevention. How to prevent falls in patients, and how to prevent injury and healthcare workers. Let’s dive in. 

Now, whenever it comes to falling injury prevention, it’s important to note that prevention is paramount. What did they say? An ounce of prevention is worth a pound of cure, right? Prevention is of the utmost importance whenever it comes to keeping patients safe, preventing falls, preventing injury. And it’s important to know that it all starts with you. 

So it’s important to know what are some of the risk factors associated with increased falls? What patient populations, or what things cause people to be at a higher susceptibility for falling, right? Well we’re talking about age. Okay. Certainly geriatric patients, elderly patients are at an increased risk of falling, just inherently. People who have cognitive disabilities, right? People experiencing things such as delirium or also dementia. People with some sort of cognitive impairment are always at an increased risk of falling. Now there are, of course, medications that can increase a person’s risk of falling as well, right? Things such as pain, medications, sedation medications, maybe muscle relaxers, nerve medications, such as gabapentin. All of these lead to an increased probability of a patient ending up falling.  Now, lines, tubes, drains. This is a kind of a no-brainer, right? Patients who have JP drains, patients who have things over here such as chest tubes, right? Things that are actually connected to patients that would act as a tether or would act as an anchor, holding that patient down in the bed. Should they try to get up, they’re going to trip up. They’re going to fall.  Lines, tubes drains, IV poles, patients being hooked up to an IV pole, right. This right here is another thing that is going to lead to the possibility that a patient falls. And of course, a lot of the equipment that we have patients hooked up to as well. You know, whenever I speak to patients in the ICU, I feel bad for them, of course. You know, it’s like, I’ve never been hospitalized. And I can’t imagine what it’s like being kind of tied down to this bed with all of the drains, tubes, lines, and equipment that you’re hooked up to. I always have empathy for them because they’re so tied down. And all of these things that are hooked up to a patient such as EKG leads, such as SCDs, right? Sequential compression devices, those little leg massagers that we put on patients to squeeze their legs and prevent blood clots from forming. All of these things are tethers, are anchors, are things that can end up causing a patient to fall. 

So what are some things or interventions that we can do as nurses to try and help prevent falls in our patients? Right? Again, prevention is paramount.  Well, of course there are visual identifiers that we can put on our patients to help remind us, as well as any other member of the healthcare team who should interact with this patient, that, Hey, this person is a fall risk. And these things include things such as a fall bracelet on the patient’s risk or these bright yellow, neon yellow socks that have little grippers on the bottom to prevent patients from falling. You also have something such as the call bell, right? I found this cute little image, a call bell. I always make sure that I emphasize to my patients because patients falling is such a big deal. A lot of our patients in the hospital are on blood thinners. Sometimes subcutaneous heparin, sometimes intravenous heparin to try and prevent blood clots when they’re in the hospital. Patients on blood thinners, if they fall, they hit their head, intracranial bleed. It’s incredibly important. I couldn’t stress it more so.  So I always emphasize to my patients, look, this is your call bell. Here is your call bell. I put it in their lap. This big red button is all that you have to push. Push the red button, right? If you need anything, I don’t care how small it is. It’s so important to emphasize that.  Make sure that the patient’s bed is actually low and in the locked position. Also sometimes it’s important to put on bed alarms should a patient be, you know, trying to climb out of bed. It happens. Okay. Another kind of no-brainer is to declutter the room, right? Those SCDs, those foot pumps, tubes, wires, all sorts of things strown about on the floor that could end up leading to a patient falling. You want to make sure that the patient has any assisted devices, walkers, canes, anything that they need in order to increase their mobility and prevent falling. And again, although this is down here on kind of near the bottom of the list, I couldn’t agree with this right here more – proper lighting is so crucial. The first thing I do whenever I go into a patient’s room and it’s time to do any kind of mobility or activity, we’re turning the lights on so that we have proper visualization so that you, as the patient, can see everything in the room, everything in the floor, and hopefully again, prevent these falls. 

Now, again, knowing that prevention is paramount. How do we, as healthcare providers prevent injury to ourselves, right? We want to prevent injury to ourselves. It’s super crucial. It’s very important. If you speak with any seasoned nurse, who’s been at the bedside for, you know, they’re, they’re floating around out there in every department, right? Seasoned nurses who have been doing this for a long time, they will testify to this. This is so crucial, right? You want to protect yourself. You cannot pour from an empty cup, right? As a healthcare giver, we’re so used to giving and pouring into others. You cannot pour from an empty cup. So if you end up hurting yourself, it’s important to make sure that you keep yourself safe so that you can then care for others. How do we do that? Well, we want to make sure that we have proper body mechanics. You know, as nurses, nursing is a physically strenuous job, right? We’re all the time helping get patients up out of bed, get them moving around after surgery, boosting patients up, turning patients in bed to clean patients up, a lot of different things that can end up causing us to hurt our backs. So proper body mechanics: lift with the legs, don’t bend over at the waist, don’t twist at the hips as you’re lifting things. A lot of stuff that we got taught a long time ago, but as nurses, whenever you’re at the bedside and everything is so busy, it’s easy to forget. So make sure that you don’t forget. And we also, of course, want to make sure that we’re protecting our back, raising that bed up to a proper working level, whenever we’re turning our patients, or whenever we’re boosting our patients up in bed. Also make sure that you get help with boosts. Okay. Do things to keep yourself safe. And some of the patient education associated with fall and injury prevention, some of the things that we’ve already gone over, but of course, again, emphasizing the call bell, call me for anything. I don’t care how small it is. I don’t care if you drop the straw on the ground and you want help getting that straw. It’s too great of a risk for you to try and get up alone. Again, maybe also emphasizing how crucially important it is that they don’t get up alone. Should they fall, what could occur.  Sometimes presenting that reality to the patients is important. Also, again, letting them know the risk of ambulating alone. And it’s also important that we utilize our friends with physical therapy and occupational therapy to assist us with ambulating the patient, giving the patient proper education related to ambulation, related to using proper body mechanics so that the patient themselves can prevent their own fall. 

And so to summarize some of our key points surrounding fall and injury prevention, it’s important to understand that prevention is paramount. It all starts with you as the nurse. An ounce of prevention is worth a pound of cure, et cetera. Important to understand a lot of those fall risk factors so that whenever you have a patient who is elderly or a patient who is cognitively impaired, or you realize on your MAR that your patient has a medication that can lead to an increased fall risk, you’ll be much more aware of them. Also understanding fall prevention goes hand in hand with a lot of these interventions that you can do to help prevent: keeping that call bell close by, call me for anything, bed low and locked, et cetera. Also, making sure that you keep in mind proper body mechanics and the way that you can prevent injury to yourself and the patient education that we just discussed. 

I hope that this helped bring a little bit of light to fall and injury prevention. I hope that you guys go out there and be your best selves today. And as always, happy nursing.

 

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Concepts Covered:

  • Test Taking Strategies
  • Respiratory Disorders
  • Prenatal Concepts
  • Prefixes
  • Suffixes
  • Legal and Ethical Issues
  • Preoperative Nursing
  • Bipolar Disorders
  • Community Health Overview
  • Immunological Disorders
  • Childhood Growth and Development
  • Medication Administration
  • Adulthood Growth and Development
  • Learning Pharmacology
  • Anxiety Disorders
  • Basic
  • Factors Influencing Community Health
  • Integumentary Disorders
  • Trauma-Stress Disorders
  • Somatoform Disorders
  • Fundamentals of Emergency Nursing
  • Dosage Calculations
  • Depressive Disorders
  • Personality Disorders
  • Cognitive Disorders
  • Eating Disorders
  • Substance Abuse Disorders
  • Psychological Emergencies
  • Hematologic Disorders
  • Pregnancy Risks
  • Concepts of Population Health
  • Emotions and Motivation
  • Delegation
  • Oncologic Disorders
  • Prioritization
  • Postpartum Complications
  • Endocrine and Metabolic Disorders
  • Basics of NCLEX
  • Fetal Development
  • Labor and Delivery
  • Gastrointestinal Disorders
  • Communication
  • Concepts of Mental Health
  • Health & Stress
  • Labor Complications
  • Musculoskeletal Trauma
  • EENT Disorders
  • Urinary Disorders
  • Urinary System
  • Digestive System
  • Central Nervous System Disorders – Brain
  • Integumentary Disorders
  • Tissues and Glands
  • Developmental Theories
  • Postpartum Care
  • Cardiovascular Disorders
  • Renal Disorders
  • Newborn Care
  • Disorders of Pancreas
  • Upper GI Disorders
  • Liver & Gallbladder Disorders
  • Renal and Urinary Disorders
  • Newborn Complications
  • Neurologic and Cognitive Disorders
  • Cardiac Disorders
  • Musculoskeletal Disorders
  • Female Reproductive Disorders
  • Shock
  • Infectious Disease Disorders
  • Nervous System
  • Hematologic Disorders
  • Disorders of the Posterior Pituitary Gland
  • Psychotic Disorders

Study Plan Lessons

12 Points to Answering Pharmacology Questions
Care of the Pediatric Patient
Menstrual Cycle
54 Common Medication Prefixes and Suffixes
Advance Directives
Family Planning & Contraception
Vitals (VS) and Assessment
Therapeutic Drug Levels (Digoxin, Lithium, Theophylline, Phenytoin)
Epidemiology
Essential NCLEX Meds by Class
Growth & Development – Infants
6 Rights of Medication Administration
Growth & Development – Toddlers
Health Promotion & Disease Prevention
Growth & Development – Preschoolers
Growth & Development – School Age- Adolescent
Legal Considerations
HIPAA
The SOCK Method – Overview
The SOCK Method – S
The SOCK Method – O
The SOCK Method – C
The SOCK Method – K
Anxiety
Basics of Calculations
Brief CPR (Cardiopulmonary Resuscitation) Overview
Cultural Care
Gestation & Nägele’s Rule: Estimating Due Dates
Dimensional Analysis Nursing (Dosage Calculations/Med Math)
Environmental Health
Fire and Electrical Safety
Generalized Anxiety Disorder
Gravidity and Parity (G&Ps, GTPAL)
Impetigo
Oral Medications
Pediculosis Capitis
Post-Traumatic Stress Disorder (PTSD)
Burn Injuries
Fundal Height Assessment for Nurses
Injectable Medications
Somatoform
Technology & Informatics
Fall and Injury Prevention
IV Infusions (Solutions)
Maternal Risk Factors
Complex Calculations (Dosage Calculations/Med Math)
Mood Disorders (Bipolar)
Depression
Isolation Precaution Types (PPE)
Paranoid Disorders
Personality Disorders
Cognitive Impairment Disorders
Eating Disorders (Anorexia Nervosa, Bulimia Nervosa)
Alcohol Withdrawal (Addiction)
Grief and Loss
Suicidal Behavior
Physiological Changes
Sickle Cell Anemia
Discomforts of Pregnancy
Antepartum Testing
Hemophilia
Nutrition in Pregnancy
Communicable Diseases
Disasters & Bioterrorism
Maslow’s Hierarchy of Needs in Nursing
Benzodiazepines
Delegation
Nephroblastoma
Prioritization
Chorioamnionitis
Triage
Gestational Diabetes (GDM)
Disseminated Intravascular Coagulation (DIC)
Ectopic Pregnancy
Hydatidiform Mole (Molar pregnancy)
Gestational HTN (Hypertension)
Infections in Pregnancy
Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate
Fever
Overview of the Nursing Process
Dehydration
Fetal Development
Fetal Environment
Fetal Circulation
Process of Labor
Vomiting
Pediatric Gastrointestinal Dysfunction – Diarrhea
Mechanisms of Labor
Therapeutic Communication
Defense Mechanisms
Leopold Maneuvers
Celiac Disease
Fetal Heart Monitoring (FHM)
Appendicitis
Intussusception
Abuse
Constipation and Encopresis (Incontinence)
Patient Positioning
Complications of Immobility
Conjunctivitis
Prolapsed Umbilical Cord
Acute Otitis Media (AOM)
Placenta Previa
Abruptio Placentae (Placental abruption)
Tonsillitis
Preterm Labor
Urinary Elimination
Bowel Elimination
Precipitous Labor
Dystocia
Pain and Nonpharmacological Comfort Measures
Hygiene
Overview of Developmental Theories
Postpartum Physiological Maternal Changes
Bronchiolitis and Respiratory Syncytial Virus (RSV)
MAOIs
Postpartum Discomforts
Breastfeeding
Asthma
SSRIs
Cystic Fibrosis (CF)
TCAs
Congenital Heart Defects (CHD)
Intake and Output (I&O)
Defects of Increased Pulmonary Blood Flow
Blood Glucose Monitoring
Postpartum Hemorrhage (PPH)
Defects of Decreased Pulmonary Blood Flow
Mastitis
Insulin
Obstructive Heart (Cardiac) Defects
Mixed (Cardiac) Heart Defects
Specialty Diets (Nutrition)
Enteral & Parenteral Nutrition (Diet, TPN)
Histamine 1 Receptor Blockers
Initial Care of the Newborn (APGAR)
Nephrotic Syndrome
Enuresis
Newborn Physical Exam
Body System Assessments
Histamine 2 Receptor Blockers
Newborn Reflexes
Babies by Term
Cerebral Palsy (CP)
Renin Angiotensin Aldosterone System
Head to Toe Nursing Assessment (Physical Exam)
Head to Toe Nursing Assessment (Physical Exam)
Meconium Aspiration
Meningitis
Transient Tachypnea of Newborn
Hyperbilirubinemia (Jaundice)
Spina Bifida – Neural Tube Defect (NTD)
ACE (angiotensin-converting enzyme) Inhibitors
Autism Spectrum Disorders
Attention Deficit Hyperactivity Disorder (ADHD)
Newborn of HIV+ Mother
Angiotensin Receptor Blockers
Calcium Channel Blockers
Cardiac Glycosides
Scoliosis
Metronidazole (Flagyl) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Vancomycin (Vancocin) Nursing Considerations
Anti-Infective – Penicillins and Cephalosporins
Atypical Antipsychotics
Rubeola – Measles
Mumps
Varicella – Chickenpox
Pertussis – Whooping Cough
Autonomic Nervous System (ANS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Parasympathomimetics (Cholinergics) Nursing Considerations
Parasympatholytics (Anticholinergics) Nursing Considerations
Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)
Epoetin Alfa
HMG-CoA Reductase Inhibitors (Statins)
Magnesium Sulfate
NSAIDs
Corticosteroids
Hydralazine (Apresoline) Nursing Considerations
Nitro Compounds
Vasopressin
Dissociative Disorders
Eczema
Proton Pump Inhibitors
Schizophrenia