{"id":7542,"date":"2024-06-26T13:56:05","date_gmt":"2024-06-26T03:56:05","guid":{"rendered":"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/uncategorized\/how-can-we-prevent-falls"},"modified":"2024-07-10T11:18:16","modified_gmt":"2024-07-10T01:18:16","slug":"how-can-we-prevent-falls","status":"publish","type":"post","link":"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/news\/how-can-we-prevent-falls","title":{"rendered":"Why do hospital falls happen and how can we prevent them?"},"content":{"rendered":"<div class=\"fusion-fullwidth fullwidth-box fusion-builder-row-1 fusion-flex-container nonhundred-percent-fullwidth non-hundred-percent-height-scrolling\" style=\"--awb-border-radius-top-left:0px;--awb-border-radius-top-right:0px;--awb-border-radius-bottom-right:0px;--awb-border-radius-bottom-left:0px;--awb-flex-wrap:wrap;\" ><div class=\"fusion-builder-row fusion-row fusion-flex-align-items-flex-start fusion-flex-content-wrap\" style=\"max-width:89.44rem;margin-left: calc(-4% \/ 2 );margin-right: calc(-4% \/ 2 );\"><div class=\"fusion-layout-column fusion_builder_column fusion-builder-column-0 fusion_builder_column_1_1 1_1 fusion-flex-column\" style=\"--awb-bg-size:cover;--awb-width-large:100%;--awb-margin-top-large:0px;--awb-spacing-right-large:1.92%;--awb-margin-bottom-large:20px;--awb-spacing-left-large:1.92%;--awb-width-medium:100%;--awb-order-medium:0;--awb-spacing-right-medium:1.92%;--awb-spacing-left-medium:1.92%;--awb-width-small:100%;--awb-order-small:0;--awb-spacing-right-small:1.92%;--awb-spacing-left-small:1.92%;\"><div class=\"fusion-column-wrapper fusion-column-has-shadow fusion-flex-justify-content-flex-start fusion-content-layout-column\"><div class=\"fusion-text fusion-text-1\"><h1>Why do hospital falls happen and how can we prevent them?<\/h1>\n<div id=\"attachment_7543\" style=\"width: 610px\" class=\"wp-caption alignright\"><img decoding=\"async\" aria-describedby=\"caption-attachment-7543\" class=\"wp-image-7543 size-fusion-600 lazyload\" data-src=\"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-content\/uploads\/sites\/5\/2024\/06\/walking-shutter-600x400.jpg\" alt=\"A patient\u2019s falls risk and mobility is everybody\u2019s responsibility. (Shutterstock)\" width=\"600\" height=\"400\" data-srcset=\"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-content\/uploads\/sites\/5\/2024\/06\/walking-shutter-200x133.jpg 200w, https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-content\/uploads\/sites\/5\/2024\/06\/walking-shutter-225x150.jpg 225w, https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-content\/uploads\/sites\/5\/2024\/06\/walking-shutter-300x200.jpg 300w, https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-content\/uploads\/sites\/5\/2024\/06\/walking-shutter-400x267.jpg 400w, https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-content\/uploads\/sites\/5\/2024\/06\/walking-shutter-600x400.jpg 600w, https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-content\/uploads\/sites\/5\/2024\/06\/walking-shutter-768x512.jpg 768w, https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-content\/uploads\/sites\/5\/2024\/06\/walking-shutter-800x533.jpg 800w, https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-content\/uploads\/sites\/5\/2024\/06\/walking-shutter.jpg 900w\" data-sizes=\"(max-width: 600px) 100vw, 600px\" src=\"data:image\/svg+xml;base64,PHN2ZyB3aWR0aD0iMSIgaGVpZ2h0PSIxIiB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciPjwvc3ZnPg==\" style=\"--smush-placeholder-width: 600px; --smush-placeholder-aspect-ratio: 600\/400;\" \/><p id=\"caption-attachment-7543\" class=\"wp-caption-text\">A patient\u2019s falls risk and mobility is everybody\u2019s responsibility. (Shutterstock)<\/p><\/div>\n<h4>When a patient falls in hospital, it can lead to a \u2018stacking\u2019 effect, where physical injuries and\/or a loss of confidence usually mean an extension of their stay. That impacts the patient, their family and staff, with more resources needing to be diverted to that patient.<\/h4>\n<p>RBWH registered nurse Jacob Haberley recently spoke to the <a href=\"https:\/\/fivethingsnursing.podbean.com\/\">Five Things Nursing Podcast<\/a> about the impacts of hospital falls and, crucially, what can be done to prevent them.<strong>\u00a0<\/strong><\/p>\n<h3>Why do patients fall?<\/h3>\n<p>Outside of a hospital setting, 32 per cent of falls are from tripping on an object on the ground, quite often carpet.<\/p>\n<p>In hospital that is less of an issue, primarily due to non-carpeted floors.<\/p>\n<p>The primary contributors to falls in a hospital setting are:<\/p>\n<ul>\n<li>Delirium, dementia and cognitive impairment<\/li>\n<li>Environmental issues \u2013 limited space in a hospital ward environment<\/li>\n<li>Issues of incontinence and the shame associated with that \u2013 the patient may make a decision to try and get to the toilet as quickly as they can<\/li>\n<li>A degree of physical frailty or disability \u2013 age is a significant contributor<\/li>\n<li>Visual impairments \u2013 age is also a factor here<\/li>\n<li>Neurological and sensory concerns \u2013 can be a result of diabetes<\/li>\n<li>Significant time on bedrest for older patients sees fairly rapid degradation (2-3 per cent in one day of bedrest) in muscular function and a patient\u2019s ability to independently mobilise<\/li>\n<li>Medications can have an effect on perception and balance.<\/li>\n<\/ul>\n<p>\u201cHaving a buzzer close by and having a plan to get patients to the toilet is absolutely critical when it comes to preventing falls. Ideally you would want to be checking on patients several times an hour but that is not always practically possible,\u201d Jacob said.<strong>\u00a0<\/strong><\/p>\n<h3>How do you screen for the risk of falls?<\/h3>\n<p>Risk assessments are important but shouldn\u2019t replace clinical judgement.<\/p>\n<p>\u201cTaking a comprehensive history of the patient is essential and especially so for falls risk. It\u2019s very important to ascertain the patient\u2019s previous level of function. Do they use a walker or walking stick? How do they usually get around?\u201d Jacob said.<\/p>\n<p>Assessing for injury, pain and disability is also important. An injured leg could cause a patient to limp and stumble or be hesitant to mobilise at all.<\/p>\n<p>\u201cAnother step is identifying concerns relating to incontinence. If they have urgency incontinence, you need to be able to rapidly attend to them,\u201d Jacob said.<strong>\u00a0<\/strong><\/p>\n<h3>What is the impact of falls on patients?<\/h3>\n<p>The clearest is the physical impact.<\/p>\n<p>This can result in head injuries \u2013 which can then have more severe consequences down the line, such as brain haemorrhages. As well as being traumatic for patients, these may also require a significant amount of hospital resources, like CT scanners.<\/p>\n<p>Fractures are also a possibility \u2013 to whichever part of the body the patient happened to land on.<\/p>\n<p>Falling once can also cause patients to be very wary of falling again, leading to a kind of mental block towards further mobilising. And that can have a significant impact on a patient\u2019s recovery.<\/p>\n<p>Essentially, falls tend to add to a person\u2019s time in hospital \u2013 which leads to a stacking effect on the patient, staff, resources and other patients.<strong>\u00a0<\/strong><\/p>\n<h3>How do we prevent falls?<\/h3>\n<p>There are some practical strategies bedside nurses can implement to prevent falls, according to Jacob:<\/p>\n<ul>\n<li>Exercise clinical judgement. The majority of patients can mobilise and it\u2019s important to facilitate mobility wherever possible.<\/li>\n<li>Ensure adequate pain management. Patients will be more willing to mobilise in a way that is safe if pain is under control.<\/li>\n<li>Prevent inpatient functional decline as much as possible. 900 steps is the daily requirement to prevent functional decline due to bedrest.<\/li>\n<li>Be mindful of any changes in medications.<\/li>\n<li>Keep the environment as clutter-free as you practically can.<\/li>\n<li>Make sure the patient is able to access their buzzer.<\/li>\n<\/ul>\n<p>Jacob said there is no hard evidence that restrictive practices (such as bedrails), bed alarms or grippy socks have any effect in reducing falls.<strong>\u00a0<\/strong><\/p>\n<h3>The role of stakeholders<\/h3>\n<p>A patient\u2019s falls risk and mobility is everybody\u2019s responsibility \u2013 clinicians, family and community supports. Everyone from cleaners to dietitians can contribute.<\/p>\n<p>Sitting out of bed leads to better food intake. Cognitive activities with patients are helpful. A lack of mental engagement can quickly result in delirium.<\/p>\n<p>\u201cPatients love a change of scenery. Family members who visit should encourage them to get up and about, even if it means a walk around the ward,\u201d Jacob said.<\/p>\n<p>You can listen to more of Jacob\u2019s advice on hospital falls on RBWH\u2019s <a href=\"https:\/\/www.podbean.com\/media\/share\/pb-4r8r2-162235d?utm_campaign=w_share_ep&amp;utm_medium=dlink&amp;utm_source=w_share\">Five Things Nursing Podcast<\/a> with Dr Liz Crowe and Jesse Spurr.<\/p>\n<\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"<p>Falls in hospital can lead to extended stays. There are some practical strategies bedside nurses can implement to prevent falls.<\/p>\n","protected":false},"author":77,"featured_media":7543,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_searchwp_excluded":"","footnotes":""},"categories":[2],"tags":[],"class_list":["post-7542","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news"],"acf":[],"_links":{"self":[{"href":"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-json\/wp\/v2\/posts\/7542","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-json\/wp\/v2\/users\/77"}],"replies":[{"embeddable":true,"href":"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-json\/wp\/v2\/comments?post=7542"}],"version-history":[{"count":3,"href":"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-json\/wp\/v2\/posts\/7542\/revisions"}],"predecessor-version":[{"id":7546,"href":"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-json\/wp\/v2\/posts\/7542\/revisions\/7546"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-json\/wp\/v2\/media\/7543"}],"wp:attachment":[{"href":"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-json\/wp\/v2\/media?parent=7542"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-json\/wp\/v2\/categories?post=7542"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/metronorth.health.qld.gov.au\/redcliffe\/wp-json\/wp\/v2\/tags?post=7542"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}