Noting that there are far too many falls in healthcare settings, The Joint Commission (TJC) has issued a Sentinel Event Alert, telling hospitals and other providers to take steps to identify patients at risk for a fall, and implement preventive interventions. However, while most falls occur in hospitals, preventing falls in the emergency setting presents some unique challenges.
- Since 2009, TJC says it has received 465 reports of patient falls with serious injury, and more than half of these have resulted in death.
- Most fall risk assessment tools are too cumbersome and take too long to complete at triage in the ED.
- The ED at Hartford Hospital in Hartford, CT, has implemented a streamlined risk assessment tool with just five “yes or no” factors for the triage nurse to consider.
- In concert with the risk assessment tool, the hospital has implemented a series of prevention interventions, including hourly rounding, bed alarms, post-fall huddles, and a non-punitive culture for reporting falls.