PATIENT FALLS

PATIENT FALLS. NDNQI. NDNQI.

FALL. A patient fall is a sudden, unintentional descent, with or without injury to the patient, that results in the patient coming to rest on the floor, on or against some other surface (e.g., a counter), on another person, or on an object (e.g., a trash can)..

Include patient falls on the reporting unit: Regardless of the patient’s age Regardless of the patient’s admission status (inpatient, short stay or outpatient).

Exclude falls by: Visitors Students Staff members Patients on units that are not eligible to report falls Patients from an eligible reporting unit who were not on the unit at time of the fall (e.g., an inpatient patient who falls in the radiology department is counted as a fall for radiology, not the inpatient unit that sent the patient to radiology).

TYPES OF FALL.

Assisted Fall. A fall in which any staff member (whether a nursing service employee or not) was with the patient and attempted to minimize the impact of the fall by slowing the patient’s descent. NOTE: Assisting the patient back into a bed or chair after a fall does not make the fall an assisted fall.

Observed Fall. A fall in which any staff member (whether a nursing service employee or not) observed the patient fall. Unobserved falls include any case when a staff member finds the patient on the floor or other surface or a fall is reported by the patient, a family member, or visitor..

Baby/Child Drop. A fall in which a newborn, infant, or child being held or carried by a healthcare professional, parent, family member, or visitor falls or slips from that person’s hands, arms, lap, etc. This can occur when a child is being transferred from one person to another. The fall is counted regardless of the surface on which the child lands (e.g. bed, chair, or floor) and regardless of whether the fall results in an injury. Generally, children older than 5 years of age are not being carried..

Falls During Play. Some units such as psychiatric and pediatric have gyms or other designated play area for patients. ‘Falls during play’ are falls that occur during normal play activities in such areas and should be reported only when they result in injury. Patients who fall while playing in their room or in the hallway, if it is not a developmental fall, should be counted as a fall regardless of whether the fall results in an injury..

Physiological Fall. A fall attributable to one or more intrinsic, physiological factors. Physiological falls include: 1. Falls caused by a sudden physiologic event such as hypotension, dysrhythmia, seizure, transient ischemic attack (TIA), or stroke 2. Falls occurring due to side effects of known “culprit drugs” (e.g., CNS-active drugs and certain cardiovascular drugs) 3. Falls attributable to some aspect of the patient’s physical condition such as delirium, intoxication, dementia, gait instability, or visual impairment..

Suspected Intentional Fall Event. 11. An intentional fall event occurs when patient age 5 or older falls on purpose or falsely claims to have fallen. Patients may fall intentionally or falsely claim to have fallen for various reasons, including seeking attention or obtaining pain medication..

12. Injury Level.

When the initial fall report is written by the nursing staff, the extent of injury may not yet be known. Hospitals have 24 hours to determine the injury level to allow for time waiting for diagnostic test results or consultation reports. If the patient is discharged within 24 hours of the fall, determine injury level at the time of discharge..

None Resulted in no signs or symptoms of injury as determined by post-fall evaluation (which may include x-ray or CT scan).

Major Resulted in surgery, casting, traction, required consultation for neurological (e.g., basilar skull fracture, small subdural hematoma) or internal injury (e.g., rib fracture, small liver laceration), or patients with any type of fracture regardless of treatment, or patients who have coagulopathy who receive blood products as a result of a fall.

16. What to be reported?. PATIENT AGE PATIENT GENDER TYPES OF FALL WHO ASSISTED FALL WHO OBSERVED FALL INJURY LEVEL PHYSICAL OR OCCUPATIONAL THERAPIST SUPERVION.

17. Thanks!. REFERRENCE: https://members.nursingquality.org/NDNQIPortal/Documents/General/Guidelines%20-%20PatientFallsAmbulatory.pdf.