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Five tips to improve your SNF's fall prevention program

Nurse Manager Weekly, August 22, 2003

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Accidents are among the top complaints reported to state ombudsmen, according to a July 2003 report from the Office of Inspector General (OIG). That's why now is a good time to keep an eye on your facility's quality indicator scores in the accident domain and review your facility's fall-prevention program.

Since 1999, the staff at the Veterans' Affairs (VA) Medical Center in Lexington, KY, has worked hard to reduce falls and fall-related injuries. The facility began its prevention program by collecting data on falls and tracking when and how they occurred.

The following are pieces of advice from the staff at Lexington VA Medical Center on shaping up your prevention program:

1. Educate staff in all departments about your fall risk program: When making any type of change at your facility, know that you'll need to do extra training and periodic in-services. "We use [monthly staff meetings] to report who's at a fall risk," says Ethel Hanna, RN, nurse manager for the long-term care unit. As a daily reminder, the unit uses a chart that displays which residents fell during the previous month.

2. Include the fall-risk assessment with the resident's initial assessment: Performing the fall-risk assessment immediately will aid in the care-planning process. Staff should consider the following factors during the fall-risk assessment, recommends Kay Kiesler, RN, MSN, medical surgery/clinical nurse specialist: any history of falls, weakness, cognitive problems, wheelchair use, or difficulty with balance and gait.

3. Develop a system that easily identifies residents at high risk for falls: "Communication is part of our process. It starts at admission with the identification of fall-risk patients with an orange bracelet, so all departments are alerted that the patient is a fall risk," explains Kiesler. "The doorframes are also tagged orange, so you can see it from the hallway. The in-house people realize what that means, but it doesn't communicate anything to somebody from the outside, so we still are under the HIPAA (Health Insurance Portability and Accountability Act of 1996) regulations."

4. Educate residents and their families about fall-prevention tactics: Staff members need to educate residents about why fall prevention is important and what interventions exist to protect them. One approach that greatly reduced fall-related injuries at Lexington VA was the use of hip protectors, which "provide padding to the hip area so that if [a resident] does fall, there's less impact on that area and it can prevent a fracture," says Kathy Yates, MSN, RN, gerontological clinical nurse specialist.

5. Cultivate a partnership between nursing and management: "While financial support can be hard to come by these days, the good news is that fall prevention can help reduce costs-which is music to any long-term care facility administrator's ears," says Toni Woodard, the center's patient safety officer. "The cost savings projected with implementation of hip protectors was $16,065 to $44,415."

Taken from Briefings on Long-Term Care Regulations: http://www.hcmarketplace.com/Prod.cfm?id=62

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