Nursing Management Of Falls.docx

Nursing management of falls The management of falls is challenging to the nurse, especially when older individuals expreience multiple or recurrent falls. In these cases, it is helpful to identify a pattern, if any, to the falling. Similarities in antecendets that lead to filling or specific symptoms might help identify the underlying cause. The goal of management are to identify the underlying cause, to reduce the incidence of recurrent falling, and to prevent serious injury. Several aids for monitoring and preventing fall are available. The fall diary helps to monitor fall occurrences, injuries, and patterns. Community-dwelling older patients may use a fall diary to jot down all the important information that led to the fall, occured during the fall, or folowed the fall. This information is extremel useful in determining antecendents and consequences of falling. Fall diaries are inexpensive or may be created by the nurse simply by using a pen, paper, and ruler (Box 12-8). For institutionalizad older individuals at risk for serious injury frombed or chair falls, the use of bed or chair alarms help alert the nurse when movement is initiated. A sensor is attached to apatient attempts to get up, he wire falls f the sensor and signals an alarm. These alarms are noninvasive and do not restict voluntary movement in any way. The alarm is fairly loud and may startle an older adult, so it is important to alert the patient and family about the noise to beexpected when the alarm is triggered. In the corridors of hospitals and nursing facilitias, video surveillance cameras help staff view ambulatory patients around the corner or in distant areas. These cameras are prohibited, however, in private areas such as patient rooms because of privacy laws. Other safety aids include safety belts in wheelchairs and the lap buddy”, which is a soft foam cushion that fit on the patient’s lap and wraps underneath the armrests f a wheelchair. However, if a patient is unable to remove these device voluntarily, they are considered restraining devices. If the use of these aids fits the criteria for “restraint” for a particular patient, then the clinical guidelines for restraint use must be instituted. Health care providers must ensure that the use of these aids is the least restrictive alternative available for the patient purposeful activity. Injury epidemiology is the study of the interaction of effects f injury on the host, the environment, and the gent. The process of aging, along with the effect of disease, results in changes that affect the host. One aim of injury prevention is to alter factors that impnge on the host by maximizing patient health and functional status, reducing unnecessary medications, and altering risk-taking behaviors. These combined efforts will reduce the ris of unintentional injuries. Alterations in environment through the elimination of enviromental hazards will reduce accidental injuries that occur in older patients’ homes. Improved technology through research seeks to alter the transfer of energy and thus modify those agent-related factors contrbuting to injuries in older adults. One such example is the alteration in the transfer of energy by use of supersoft mats and floor surfaces designed to absorb the impact of a falling body and redistribute its mass. Thus, when an older patient falls on a special floor surface, the rate of injury is likely to be lower than on a conveentionl surface. For all older patients at risk for falls and those at risk for serious injury from a fall, it is advisable to discuss with them the possibility that falling will result in serious injur and how to reduce the potential for such injury and how to reduce the potential for such injury. Patients should be given the choice of reducing moblity to prevent serious injury or continuing ambulation, knowing that the risk of serious injury is present. Patient autonomy should be promoted and respected; it is the patient’s choice. In instance in which patients are demented or unable to make informed choices, discussion with the families or guardians is required. In any event, the goal of the gerontologic nurse is to promote safety.

Fall and injuryprevention modalities have received much attention in recent years. Evidence suggests that certain activities that improve flexibility and balace will prevent injury (Agostini, han, & Tinetti, 2004). It is advisable to follow the recommendations for treating a patient who has fallen.