Fall Prevention in a Psychiatric Hospital Requires Creativity

Falls in hospitals can result in serious injuries and setbacks for patients. They're a particular problem for older patients as noted by Patti Dykes, who led the INQRI team that tested a fall prevention tool kit. They're also a problem for psychiatric patients, as an article in Advance for Nurses notes.

The article, by Christine Waszynski, a geriatric nurse practitioner at Hartford Hospital in Connecticut, reports on a fall prevention program being implemented in the psychiatric hospital within Hartford Hospital. Psychiatric patients are encouraged to remain ambulatory and independent to the extent possible during their hospital stays, so any interventions that limit their mobility or require close supervision can have a deleterious effect on their mental health. Moreover, many psychiatric medications can cause dizziness or an unsteady gait.

Waszynski describes the multidisciplinary fall prevention program which includes "post fall huddles" and "mini root cause analysis" after each fall. A Fall Rounding Tool is used to discuss existing fall risks and how they can be mitigated. Patients now wear shower shoes to avoid falls in the shower and shorter pajama pants to avoid tripping. Other strategies include a Fall Prevention Teaching Sheet which is reviewed with each patient upon admission.

Data collected a year prior to inception of the program up until 2012 shows the hospital has made noticeable improvements, decreasing overall number of falls and falls resulting in injury by 25 percent.