Watch Those Wipeouts

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Reducing the frequency of patient falls has become a higher priority for many hospitals as The Joint Commission pressures facilities to address the issue. With an average patient age of 67, Saint Thomas Hospital in Nashville, Tenn., is high-risk when it comes to patients taking a tumble. The 515-staffed-bed facility is the alpha site for Ascension Health's systemwide FALLS program. The 65-acute-care-hospital system started the effort in 2004 to limit falls and fall-related injuries. Since implementation, Saint Thomas has reduced falls with injury by 42 percent, while the total number of falls has decreased by 50 each year since 2002. The program involves a "fall risk assessment" given to patients upon admission, says Saint Thomas patient safety officer Deanie Lancaster, R.N. The test analyzes a patient's ability to rise from a sitting position. "If it takes them a while, or several pushes, their risk score increases," Lancaster says. Yellow arm bands are used to alert hospital staff to which patients are high-risk for falling. Double-treaded slipper socks and gate-belts are also used as a last line of defense for preventing accidents. In addition, yellow signs that read SAFE (Stay Alert for Fall Event) are placed on the outside of patients' doors. During the FALLS evaluation process, patients and their families are given a safety kit outlining fall prevention techniques that can be used in the hospital or at home. Techniques include removing heavy draperies that limit sunlight, installing grab-bars near toilets and tubs, clearing stairways and eliminating loose throw rugs.Saint Thomas also assembled a multidisciplinary team to assess inadequacies in patient rooms, which resulted in the addition of motion sensor lights in vanity areas, beds with alarms, and the removal of towel racks that patients often mistook for grab bars. "The hospital is an unfamiliar environment, and patients don't know the landmarks, especially at night," says Lancaster, who attributes many falls to patients' desire to be independent. "No matter how many times you tell them not to get up without help, they're still going to do it, especially if they're accustomed to being independent and want to remain that way." -Matt Rogers




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