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The only way a hospice manager can know why patients are falling is to gather the correct information on incident or occurrence reports, says Charlene Ross, RN, MSN, MBA, partner and consultant with RBC Consulting in Phoenix.
"You must make sure, however, that you gather the right information," warns Ross. Too much information will make analysis of the data confusing and might not give you the answers you need to determine the best interventions, she says. Too little data will not help you focus on the specific issues, she adds.
"You need to know if a fall occurred, where it occurred, and what the patient was doing when it occurred," says Ross. The specific items on the form Ross recommends are:
patient name or other identifier;
location (home or facility);
activity at time of fall: bed transfer, wheelchair transfer, bending or reaching, standing or walking, toileting, and other;
fall observed (yes or no);
injury related to fall (yes or no);
fall caused by factors related to patient's condition (yes or no);
fall caused by factors related to patient's environment (yes or no);
determine whether safety was identified as a risk factor on plan of care? (yes or no).
"It is important to ask if safety was identified as a risk factor at the time the plan of care was developed because it helps you evaluate your assessment process," says Ross.
If the patient was identified at risk for falls upon admission, further investigation needs to be made to see if the proper interventions were implemented, she says. There are falls that occur even with appropriate interventions, but collecting the right information at the time of a fall gives the performance improvement team a chance to identify trends that might need to be addressed.