5 Ways ER Nurses Can Help Prevent Patient Falls
By Jane Anderson, contributor
An accidental patient fall can occur in a split second. American Nurse Today states that “40 percent of falls occur within 30 minutes of a rounding visit by healthcare providers.” ER nurses are in a prime position to prevent falls in hospitals by following, promoting or creating hospital guidelines. Their input, based on professional experience, helps the hospital administration team create a successful prevention plan.
Five Tips to Prevent Patient Falls in Hospitals
1. Keep communication open with patient and caregiver. If the patient has not been identified as a fall risk, remind them that their illness or medication could make them unstable. In the case of elderly patients, the caregiver may be a spouse or another family member. ER nursing shifts move quickly, so let them know an aide or nurse will be along to help with all mobility needs.
Jaclyn Smith, BSN, RN, stresses the importance of explaining the use of the call button and making sure it’s nearby. “You don’t want a patient attempting something on their own that they normally wouldn’t do, simply because they can’t get a hold of someone.”
Tip: One way to reduce patient falls is to ensure your patient is wearing a brightly colored wristband to indicate they are a fall risk. This band will visually and quickly alert all staff to the potential.
2. Inspect the patient’s room. Cords and tubes should be managed so they don't dangle, and light switches must be within easy reach. Make sure the path to the bathroom is clear, and watch for loose bed coverings that may reach the floor. Non-slip socks are an added safety feature that ER departments can stock and supply to minimize additional patient falls.
Tip: Make time for regular environmental round inspections. They will save you time in the long run. Check wall handrails and toilet rails for stability, and make sure rooms are properly illuminated.
3. Use the hospital technology and tools. Strategically located video cameras and glass walls provide views of the patient without compromising privacy. Floor mats and seat alarms warn if a patient is attempting to get out of bed or rise unattended from their wheelchair.
Smith’s work in the hospital has given her an appreciation for these surveillance alarms. “You are able to react quickly to help a patient once you hear one of these alerts go off.”
Tip: Familiarize yourself with these alarms and the sounds they make when they go off. You can never be too prepared when your focus is patient falls prevention.
4. Review the safe patient handling policy. Patients need to be transported to testing areas and onto diagnostic tables. The Agency for Healthcare Research and Quality has a clinical pathway tool that can be used or modified to meet the needs of the ER department.
Tip: In ER nursing there is a vantage point to being in the ER. Most nurses and staff have a visual into the way patients are transported to and from the hospital. Make sure all hospital volunteers and aides are following correct patient transport procedures to reduce the chance of patient falls during such transitions.
5. Make sure ambulatory aids are visible. Patients who attempt to move by themselves, when they should not, need extra care and observation. Ambulatory aids such as walkers, canes and crutches should be visible to patients and in good working order.
Tip: If you see a patient wobbling around or not using an aid correctly, step in and be prepared to show them. For instance, gait belts let caregivers help unstable individuals transfer to a wheelchair. Not only will you be instrumental in preventing a potential fall, but you'll also be educating that person on correct use for any future needs they might have.
Depending on the size of the institution, ER nurses may instruct the patients themselves, or this task might fall to ancillary staff. Regardless, the ER nurse should ensure correct instruction is given and that the patient can use the device properly.