Prevention Strategies to Reduce Falls in Psychiatric Settings

Abstract

A Fall Committee was developed in response to an increase in the rate of falls by patients at a primarily behavioral health, urban teaching hospital in the mid-Atlantic region of the United States. The Fall Committee identified interventions to potentially lessen the number of patient falls and areas where documentation could be improved to better describe an incident in the medical record. The Fall Committee developed paperwork to be completed after each patient fall and made changes to the low fall risk and high fall risk treatment plans. This article describes the recommendations submitted by the Fall Committee and its subsequent implementation. Although not causational, the fall rate decreased after the recommendations of the Fall Committee were implemented; however, a recent rise in the fall rate was noted and attributed to higher patient acuity on the unit. The committee investigation into this issue highlighted the paucity of research in this field and the need for a streamlined, easy-to-use, behavioral health fall scale to more accurately judge the fall risk of patients in this specialized subset.

Patient Safety Strategies in Psychiatry and How They Construct the Notion of Preventable Harm: A Scoping Review

“…The studies within the risk management theme (Table 1) predominantly concentrated on how to efficiently calculate the risk of, or enhance conditions for assessments of, suicide, self-harm, violence, or falls 14,17,20–22,26,28,29,32,34–36 . These studies highlighted the importance of carefully choosing the right instrument to measure risk and showed that a poorly conducted risk assessment process can impact practice, policies, and management strategies in an undesirable way 22,24,25,27 . It is even argued that interventions to reduce risk, in some cases, can give rise to and legitimize ineffective and unethical practices within psychiatric inpatient care 30 .…”

“…14,17,[20][21][22]26,28,29,32,[34][35][36] These studies highlighted the importance of carefully choosing the right instrument to measure risk and showed that a poorly conducted risk assessment process can impact practice, policies, and management strategies in an undesirable way. 22,24,25,27 It is even argued that interventions to reduce risk, in some cases, can give rise to and legitimize ineffective and unethical practices within psychiatric inpatient care. 30 Other studies noted that adequate assessment of a patient's risk of adverse events or suicide required enhancing the ability of the staff to engage in an empathic dialogue with the patient.…”

Understanding Design Vulnerabilities in the Physical Environment Relating to Patient Fall Patterns in a Psychiatric Hospital: Seven Years of Sentinel Events

“…Falls are one of the most critical patient safety concerns in all hospital settings (Ulrich et al, 2008), and this includes psychiatric hospitals. The physical environment has been recognized as a contributing factor to patient falls constituting 9% to 16% of falls (Al-Khatib et al, 2013). This study reviewed patterns of patient falls in relation to the physical environment within the context of a psychiatric hospital from a 7-year period of sentinel event reports and contributes new insights regarding environmental design factors related to inpatient falls in a psychiatric hospital.…”

Escalas De Avaliação De Risco Para Queda: Revisão Integrativa Da Literatura

“…A fim de evitar danos graves e até mesmo a morte decorrente da queda, é necessária uma ferramenta de avaliação de risco eficiente e confiável, que identifique precocemente os riscos e auxilie o planejamento e a implementação de intervenções para prevenção de quedas (16)(17) . (18)(19) . Além disso, um eficiente instrumento de avaliação de risco de queda pode ser aplicado por equipes multidisciplinares para identificar fatores de risco e o desenvolvimento de planos de intervenção (20) .…”