Patient Safety in Psychiatry-2.5 Falls

Video Transcription

Falls are common problems in psychiatric patients due to the effects of medications, due to  delirium or confusion, the effects of ECT, the effects of other medical conditions combined with psychiatric conditions, or poor judgment.  The traditional fall prevention methods may include alertness to specific patient factors such as mental status changes, a history of drug or alcohol abuse or use, a history  of fractures or injuries, current, real-time weakness or ataxia, arrhythmias, or impaired vision. What have we done?  Generally, there has been attention to modifying environmental risk factors. Proper length clothing and appropriate shoes, use of handrails, use of appropriate assistive  devices, good lighting, hip protectors. These are all factors that can improve the environment in which the patient exists and prevent falls.  In the future, other patient safety-related approaches might include attention to modifying medication usage and improvement of physical functioning.  These can be prospectively or generally done factors that can prevent patients from falling or from having adverse events due to falls.  It's important to remember patient safety culture encourages the use of standardized instruments or standardized procedures.  The Morse falls scale is one such method that can be used or used on a standard basis, approach every patient, and try to inquire about their fall risk.  So a patient safety quality improvement approach to falls includes the clinician thinking about  and identifying the potential risk of a patient's falling, making fall prevention a team effort  and something in the interest of the team, discussing with patients the potential fall risks given his or her underlying conditions, taking time to inform all care providers of  the patient's fall risks through appropriate communication channels, consideration of new instruments for assessment, and monitoring and addressing high-risk factors for falling.  These are not necessarily mutually exclusive from the traditional approaches to fall prevention,  but they should provide us with a new avenue for thinking about preventing falls and their risks.

Video Summary

This video discusses the common reasons why psychiatric patients may experience falls, such as medication side effects, delirium, confusion, or other medical conditions combined with psychiatric conditions. Traditional methods of fall prevention include identifying patient factors like mental status changes, substance abuse history, fractures or injuries, weakness or ataxia, arrhythmias, and impaired vision. Environmental factors such as appropriate clothing, shoes, handrails, assistive devices, lighting, and hip protectors can also help prevent falls. In the future, focusing on modifying medication usage and improving physical functioning can further reduce fall risks. The use of standardized instruments like the Morse falls scale and improving communication among care providers are also important for fall prevention. This approach complements traditional methods and provides a new perspective on preventing falls. (No credits granted.)

Keywords

psychiatric patients

falls

medication side effects

delirium

fall prevention