ED fall education part 5

JP
by Jennifer Pletcher0 views·Updated Nov 18, 2022
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  1. Hello everyone.
  2. Now we're gonna do a case study with john
  3. John is an 82 year old man with diabetes who has arrived
  4. to the emergency department complaining of chest pain and shortness of breath.
  5. On arrival he was found to be alert and oriented and was placed on a cardiac monitor
  6. with an ivy
  7. during his fall risk assessment, johN reported
  8. that he normally walks independently with a cane.
  9. However,
  10. the nurse understands the doctor's order was
  11. to walk with the cane and assistance only
  12. with further questioning. The patient reported.
  13. He had fallen at home several times over the past year,
  14. most recently the last month
  15. as the nurse assists the patient to the bathroom.
  16. She noted that initially he used the bedside table and other furniture
  17. as guides and needed to be reminded to use his cane.
  18. Once given his cane, john walked with short steady steps to the bathroom
  19. so
  20. he has a history of following. So we indicate, yes
  21. he's not confused, he's not intoxicated or sedated.
  22. Yes he has an impaired gait.
  23. Yes he uses a cane
  24. and no he does not have an altered elimination status.
  25. So he has a score of five.
  26. Now we're going to complete his tailored fall prevention plan.
  27. So we check that,
  28. yes he has a history of falls could have some medication side effects.
  29. He walks with an aid.
  30. Um He is gonna likely have an I. V. Pole and or equipment such as the cardiac monitor.
  31. He does normally walk with an unsteady gait and he may or
  32. may not choose to call or forget to call for assistance.
  33. Additionally, we're going to indicate that on the right hand side as well.
  34. So we're indicating that he is a high fall
  35. risk on the right hand side in that red square
  36. that he uses a cane.
  37. That we're going to assist him when walking.
  38. We're going to have a toilet ng schedule of every hour to help him go to the bathroom.
  39. Um we're gonna probably use a bed alarm and at least one person should walk with him.
  40. Most patient falls are preventable
  41. and evidence based programs
  42. includes the following components, a standard definition
  43. and a use of universal fall
  44. precautions.
  45. So we've gone through the three steps of fall prevention.
  46. Now we can talk quickly about the post
  47. fall risk huddle must be completed.
  48. A dark note,
  49. a safety report completed
  50. but we don't want to mention that in our clinical notes
  51. and implementation of continuous quality
  52. improvement with an interdisciplinary approach.
  53. What are the next steps for this program?
  54. We're going to
  55. um implement the tips signage and that will be available in patient rooms.
  56. Nurses should update and review every shift and
  57. please engage the patients in the planning.
  58. We want to make sure that they understand
  59. that we're worried about them and that we are
  60. doing everything we can to prevent the fall
  61. patient education will also be given to other disciplines
  62. as we already noted in the um slides,
  63. nurses are not the only people who in who work with these patients
  64. and
  65. we're going to do a repeat post education survey now and then again in two weeks.
  66. Thank you so much for your time in completing this education.
  67. Your commitment to consistent practice of evidence based
  68. fall prevention planning will keep patients safe.
  69. Thank you.