02.05 Fall and Injury Prevention

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Prevention of Falls (Picmonic)

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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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