Fall Prevention and Restraints - Fundamentals of Nursing - Practice & Skills | @LevelUpRN

Summary

This video focuses on fall prevention in both hospital and home settings, along with the proper use of restraints in nursing care. It highlights key measures to prevent falls, such as hourly patient checks, keeping essentials within reach, and ensuring the use of nonslip footwear. The home safety section emphasizes removing scatter rugs and improving lighting. The video also explains the types of restraints—physical and chemical—and outlines essential nursing care steps, including documentation, frequent assessments, and legal considerations. Viewers are encouraged to subscribe for upcoming nursing-related topics, including skin integrity and pressure ulcers.

Takeaways

• 🛏️ Rounding hourly on patients in the acute care setting helps prevent falls by ensuring their safety and comfort.
• 🚶‍♂️ Moving confused patients closer to the nurse's station provides noninvasive monitoring to prevent falls.
• 🧼 Keep floors clean, dry, and uncluttered, and set bed alarms for high-risk patients to prevent falls.
• 👓 Ensure essential items like glasses, water, and dentures are within easy reach for patients to avoid unnecessary movements.
• 🧦 Patients should wear nonslip, well-fitting footwear (like hospital socks with grips) to reduce fall risks.
• 🛋️ At home, remove scatter rugs, improve lighting, and mark steps to prevent falls. Tape down electrical cords securely.
• 🛁 Use grab bars and nonslip mats in the bathroom to avoid slipping, and ensure proper use of assistive devices.
• 🧷 Physical restraints include devices like vests or mitts, while chemical restraints involve sedative medications.
• 📝 Restraint orders last only 24 hours and require frequent documentation, including patient assessments and offered care.
• 🔒 Always assess restrained patients every 15 minutes to avoid positional asphyxia, and ensure restraints are tied properly to the bed frame.

Q & A

What are some effective fall prevention measures in an acute care setting?

Effective fall prevention measures in an acute care setting include hourly rounding, moving patients closer to the nurse’s station, ensuring clean and dry floors, setting bed alarms for high-risk patients, locking the bed in the lowest position, and making sure the patient’s essentials (e.g., water, glasses, dentures) are within reach.

Why should patients wear nonslip footwear in the hospital?

Nonslip footwear, such as hospital socks with grips, helps prevent patients from slipping and falling, reducing the risk of injury.

What is the purpose of bed alarms in fall prevention?

Bed alarms alert staff if a patient at high risk for falls gets out of bed, allowing immediate intervention to prevent accidents.

What are some home fall prevention strategies mentioned in the video?

Home fall prevention strategies include removing scatter rugs, ensuring good lighting (especially near stairs), marking steps with tape, taping down electrical cords, installing grab bars in the bathroom, and using nonslip mats in the shower.

Why is it important to teach patients how to use assistive devices correctly?

Teaching patients to use assistive devices correctly reduces the risk of falls and ensures their safety, especially when transitioning between sitting and standing.

What is the difference between physical and chemical restraints?

Physical restraints are devices like vests or mitts that restrict movement, while chemical restraints involve medications like sedatives or antipsychotics to calm or sedate a patient.

What are the key order requirements for restraints in a hospital setting?

A provider must perform an in-person assessment of the patient within 24 hours of ordering restraints, and the order must be renewed every 24 hours. PRN (as needed) orders are not allowed.

What are the key components of documentation when using restraints?

Key components include documenting the rationale for restraints, the time of application, patient assessment findings (e.g., their well-being), and the care provided (e.g., offering fluids, range of motion exercises).

What is positional asphyxia, and why is it important to monitor restrained patients frequently?

Positional asphyxia occurs when a patient’s position restricts their ability to breathe, which can lead to suffocation. Monitoring restrained patients every 15 minutes helps prevent this dangerous situation.

Why must restraints be tied in a slipknot to the bed frame rather than the side rail?

Restraints should be tied in a slipknot to the bed frame so they can be quickly released in an emergency. The bed frame moves with the bed, while side rails move independently, which could lead to restraints becoming too tight or too loose.