This document discusses reducing patient harm from falls in 3 key areas: 1) It defines a patient fall and lists factors that can contribute to falls, such as previous fall history, impaired mobility, confusion, and certain medications. 2) It outlines specific nursing interventions for fall prevention, including risk assessments, education, and safety measures near the bed and in bathrooms. 3) It describes post-fall nursing actions like ensuring safety, documenting the incident, and reviewing circumstances to prevent future falls.

1. Reduce the Risk of
Patient Harm
Resulting from Falls

2. Objectives
By the end of this presentation the
participant will be able to:
 Define the patient fall
 List the factor contributing towards fall
 Discuss the importance of patient’s
assessment and assessment criteria.
 Implement the specific nursing
intervention for fall prevention
 Manage patient after falls
 Aware about the patient fall prevention
program

4. Fall
 “A fall is considered an unintentional event that results in a
person coming to rest on the ground or other lower level.”
(www.UTHCPCProcedures - Fall Prevention and Management
Program.mht)
 “Fall: loss of upright position that results in landing on the floor,
ground or an object or furniture or a sudden, uncontrolled,
unintentional, non purposeful, downward displacement of the
body to the floor/ground or hitting another object like a chair or
stair.”
 Fall Prevention: “strategy using specific interventions to avoid
risks of falling.”
(Briggs National Quality Improvement/Hospitalization Reduction
Study)

5. Factor Contributing To Patient’s Falls
History:History:
 Previous fall history.
Physical Status:Physical Status:
 Fatigue/weakness
 Dizziness/balance problem
 Impaired mobility
 Sensory impairment
 Seizures disorder
 Alteration in elimination

6. Mental Status:Mental Status:
 Confused (illogical thinking)
 Impaired memory/judgment
 Disoriented to time place or person
 Lack of familiar with immediate
surrounding
 Inability to understand/follow instructions
Factor Contributing To Patient’s Falls
cont...

7. Medications:Medications:
 Drugs that have diuretic effects
 Drugs that alter thought process
and or create hypotensive effects
(narcotics and sedatives,
psychotropic, hypnotic,
tranquilizers, antihypertensive)
 Drugs that increase GI motility
(laxative, enemas, cathartics)
Factor Contributing To Patient’s Falls
cont...

9. Other factorsOther factors
 Wet floor
 No orientation to unit
 Slippery floor
 Area under construction
 Less light/darkness
 Obstacles e.g. cords/wires in the way
 Transferring of patients from bed to
Stretcher/wheel chair
 Faulty equipments such as Mobility aids
Factor Contributing To Patient’s Falls
cont...

10. Nurses Assessment

11. Nursing Specific Intervention
 Strict implementation of nursing initial falls
assessment and daily reassessment.
 Patients should be screened by assessing
intrinsic and extrinsic fall-related risk factors
 Orientation to unit
 Calling bell beside patient and in
the bath room
 Patient and family education
regarding medication effects and side effects
 Teach patient use of grab bars
 Bed side and trolley's rails up
 Beds at low level

12. Nursing Specific Intervention
 Lock all equipment while
transferring patients
 Continues dryness of wet
floor and putting warning
signs during cleaning
 Isolate the construction area
 Presence and maintenance of
emergency lights every where.

14. Post Fall Nursing ActionPost Fall Nursing Action
 Immediate call for help
 Assess for injuries
 Obtain and record
sitting/standing vital signs
 Assess for change in range of
motion
 Alert physician
 Follow organizational policies
for patient monitoring
 Assess intrinsic and extrinsic
factors for fall

15. But we need to share the learning from
our mistakes to try and stop them
happening again …..

16. So...So...
 Document the
circumstances in medical
record
 Complete incident report
(HERF(health care event
reporting form), Patient
Safety Event Report:
Fall)

17. International Patient Safety Goals
Goal 6 - Fall Risk Assessment
There is a policy regarding fall risk
assessment and reassessment for all
patients in the hospital, however the
policy did not emphasized monitoring
the unintended related consequences of
the fall reduction measures.

18. Unintended Consequences
 Monitor patient for unintended related consequences
of the fall reduction measures i.e. limiting water
intake, restraint related injuries and patients jumping
over the bed side rail.

21. ReferencesReferences
 http://www.ftmc.com/content.aspx?
PID=231
 http://www.nursingcenter.com/prodev/ceart
icleprint.asp?
 www.ncvhs.hhs.gov/070619p8.pdf
 http://www.kevinmd.com/blog/2009/07/the-
unintended-consequences-of-preventing-
patient-falls.html

22. THANKS
STAY BLESSED