Patient Falls and Injuries

A patient fall is an unexpected fall to the floor or an extension of the floor, such as a chair or bed, during a hospital stay. To avoid a more serious injury, staff members may lower a patient to the floor.

Serious injuries, such as hip fractures or bleeding in the brain, can result from a fall. Falls may also result in a longer hospital stay and more difficult recovery.

Patient Falls by ICU

What are we doing to reduce patient falls?

To reduce patient harm from patient falls, the BWH nursing staff uses the following tools and interventions:

• Fall and injury risk assessments for each patient
• More sensitive bed alarms or chair alarms to help alert staff that a patient is getting up and may need assistance
• Video, informational brochures, and communication signs to inform patients and families about fall risks and how to be safe in the hospital
• Patient Comfort Rounds, which includes routine safety checks on each patient by the nurse or care assistant to make sure that the patient:
  • Is comfortable and pain is controlled
  • Receives assistance with toileting and other personal or special needs
  • Is assisted with re-positioning in the bed or chair
  • Can reach personal items
• Is in a safe environment
• Discussions with pharmacists and doctors to review and adjust certain medications as needed if a patient is at high risk for falling
• Communicating the risk for falls, injuries from a fall, and a safety plan to patients/families and other members of the health care team
• Having no more than three side rails up on the bed at any one time to allow patients an easy pathway out of the bed
• Mobility supports and assistive devices that meet the patient's needs

How are we doing?

We have fewer patient falls than our peer group average. However, we have more patient falls with injuries in our adult medical population. We do not want to see any patients fall in the hospital and we will keep doing our best to improve our fall rate.

What can patients do to help?

When you are in the hospital, you are in unfamiliar surroundings and are often taking one or more medications that may make you disoriented and less stable and within this new environment. Getting around is not the same as it was in your home.

Patients can take the following precautions:

• Be informed – know or ask about your risk for falls and farm from falls
• Participate in making the safety plan to keep you safe
• If you are asked not to get up without assistance, refrain from doing so; this is for your protection
• If you are allowed to get out of bed and walk on your own without assistance, make sure there is a light on where you are and where you are going
• Ask for help when using the bathroom, getting up, or walking around the unit, especially if you are not feeling well
• Sit or stand up slowly; sit on the side of the bed before standing and slowly stand up; do not attempt to walk by yourself if you feel weak or unsteady on your feet
• Let your nurse know if there is any equipment in your way before you walk
• Make sure you can easily reach your call button, telephone, and any other personal items that you might need; if these items are out of your reach, ask the nurse or your family member to move them for you
• Ask your nurse to make sure that your bed is lowered to the lowest position
• If you have been given equipment such as a cane, walker, or other device to help you with daily activities such as washing or dressing, make sure that you know how to use it
• If you need to walk with equipment, such as an IV pole, let your nurse know if the equipment is difficult to maneuver
• Use your glasses or hearing aid to help you participate in your care
• Wear non-skid socks or rubber-soled slippers or shoes when walking
• Talk with your doctor or nurse about any medications that you are taking that may increase your risk for falls by making you feel dizzy or unsteady on your feet