But restraining patients would be unethical and represent poor care. In theory, we could prevent all falls by restraining all patients, thereby preventing them from leaving the bed (in actuality, restraints may not prevent falls). A theoretical example can illustrate this point. As you read through this section, think about how you can integrate your fall prevention program with the variety of acute medical treatments that your hospital must deliver.Īnother key point to remember is that fall prevention alone cannot be the goal of a fall prevention program. Hand hygiene to prevent spread of nosocomial infection is an example of a patient safety practice that avoids patient harm without interfering with the patient's medical care. The goal of patient safety practices like fall prevention is to prevent additional harm to patients while they are hospitalized. The hospital's first priority is acute medical care patients come to the hospital because they are ill and their primary purpose is to receive treatment for their illness. Your program is more likely to be successfully implemented and sustained when it is compatible with hospital priorities and what is best for the patient. In addition, at the unit level, you should cover these components in a manner tailored to the types of patients and care flow on each unit (go to section 3.6).

Your practices should be tailored to your organization.

Postfall procedures, including a clinical review and root cause analysis ( section 3.5).

Care planning and interventions that address the identified risk factors within the overall care plan for the patient ( section 3.4).

Standardized assessment of fall risk factors ( section 3.3).

Universal fall precautions, including scheduled rounding protocols ( section 3.2).

To simplify things, we have broken down fall prevention activities into separate steps: Given the complexity of fall prevention, the task of implementing a program may seem daunting. Which fall prevention practices should you use? Each patient has a different set of fall risk factors, so care must thoughtfully address each patient's unique needs.

Fall prevention needs to becustomized.How should the right information about a patient's fall risks get to the right member of the team at the right time? Nurses, physicians, pharmacists, physical therapists, occupational therapists, patients, and families need to cooperate to prevent falls. How should fall prevention be reinforced while maintaining enthusiasm for other priorities, such as infection control? Fall prevention is one of many activities needed to protect patients from harm during their hospital stay.It may be tempting to leave patients in bed to prevent falls, but patients need to transfer and ambulate to maintain their strength and to avoid complications of bed rest. Fall prevention must be balanced with the need to mobilize patients.Yet a fall in a sick patient can be disastrous and prolong the recovery process. The patient is usually not in the hospital because of falls, so attention is naturally directed elsewhere. Fall prevention must be balanced with other priorities for the patient.Some factors that make fall prevention challenging include: Recognize at the outset that implementing these best practices is a complex task. Further information regarding the organization of care needed to implement these best practices is provided in section 4 and additional clinical details are in Tools and Resources. This section helps your organization address these questions. How can your hospital incorporate these practices into a fall prevention program?.How should you assess and manage patients after a fall?.How should identified risk factors be used for fall prevention care planning?.How should a standardized assessment of fall risk factors be conducted?.Which universal fall precautions should be applied throughout the hospital?.Which fall prevention practices should you use?.Team members should reach consensus on the following questions: In this section, 'best practices' are those care processes that, based on literature and expert opinion, represent the best way we currently know of preventing falls in the hospital. Once you determine that you are ready for change, the Implementation Team and Unit Team need to state their plans for implementing best practices.

All my patients are under the bed