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#NurChat - Preventing and managing the effect of falls

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Did you miss the latest #NurChat Twitter debate about falls? Let us sum it up for you…

There is no doubt that slips, trips and falls have a huge impact on patients, nurses and organisations and as nurses we are all aware of the implications of falls - patient injury, loss of patient confidence and longer hospital stays are just a few. I was very pleased when this #NurChat came on to the agenda as recently I came across a patient who had fallen and issues following the fall that had not been addressed; this led to the patient becoming unwell and to massive complications in their condition. So I have been very much reminded lately of the devastating effect of falls and the importance of falls management. It seems that NurChatters agreed with me that this is a vital subject as this was a very fast Nurchat with lots of ideas exchanged, a read of the transcript is a must (via the NurChat blog)… even if you took part !!

This chat kicked off by Nurchatters raising the subject of bed rails in relation to falls prevention.

@IanIreland tweeted “Cot sides (bed rails) should never be used as falls prevention. Maybe they should be banned altogether.”

@michellemellor3 said “Huge risk of entrapment with bed rails #patientsafety”

And @cherylwilson2 added “Often not correct for type of bed and/ or the bumpers too short”

The chat rapidly moved on to assessments and the vital part they play in falls prevention.

@TaskerKaren tweeted “Full assessment of level of risk then preventional management” @maria101 stated “Multidisciplinary and multifaceted issue. Assess risk, act on what you identify as a problem! DOCUMENT findings” She went on to add “Reassess when things change and record and communicate the changes!”

Assessment tools were also discussed: @DelphineAtQuest stated “There are loads out there, the ones developed by Salford Royal and South Tees are excellent”

@1stSteps1stAid added “…Work in older peoples rehab. Use ‘traffic light’ assessment tool on admission v effective.”

@TaskerKaren explained “Traffic light as in green/amber/red, allows easily identification of risk level by colour” And continued “Traffic light system certainly helps embed into practice”

@1stSteps1stAid went on to add “Red, yellow or green circle put above patients bed following assessment on admission to identify who is high risk asap”

A common thread throughout the chat was that small things matter when reducing falls - glasses, hearing aids, mobility aids, call bells, toilets, signage and shoes we all identified as key.

@michellemellor3 tweeted “start the prevention with #sloppyslipper campaign” and added “#sloppyslipper campaign great initiative by physio & @age_uk Swap old slippers 4 new fitting slippers #innovation #harmfreecare”

Reporting and analysis of falls was raised:

@dgfoord stated “Good point about reporting. Good root cause analysis of falls can help improve risk reduction of future falls”

@DelphineAtQuest added “Royal Devon & Exeter created a “fall map” showing a dot where a patient fell on a ward and identified high risk areas that way.”

Finally it was discussed that we must also consider staff in relation to falls:

@nursiedeb tweeted “It was a simple fall at work that robbed me of my mobility and the profession I love. Not just pts at risk”

@StudentNurseTT stated “My “true fall” story is at the end of episode 2 of the student NT podcast really long song. I’d love to hear what you think!”

Being able to reduce the incidence of patients falling is a nursing skill that all nurses need - identifying those at risk and being able to plan care that ensures that the patient remains independent yet safe should be a key aim for all nurses. But as the NurChatters pointed out it is not just the management of patient falls that we need to consider we also must address issues surrounding all falls. We need to take a holistic and comprehensive approach to all falls management whether it be or patients at risk or ourselves.

@karenmanning_1 summed it up when she tweeted: “Continue to raise awareness. Multidisciplinary approach. Full assessment. Everyone’s business!”

Teresa Chinn heads up NurChat for Newcross Healthcare Solutions.

Nurchat is a fortnightly Twitter chat exploring different topics that vary enormously.

Anyone can suggest a NurChat discussion subject simply by tweeting @NurChat or by visiting the NurChat blog.

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