expert report from nurse on patient who fell on his face while in hospital

What did a nurse practitioner do after a patient fell?

A nurse practitioner examined the patient after the alleged fall and sent the patient to a nearby hospital. X-rays were taken, and the patient was sent home despite his complaints of pain.

What should a nurse do if a patient has fallen?

Here’s what should be done by a nurse in the assessment of a patient who has fallen, hit her head or had an unwitnessed fall. The first priority is to make sure the patient has a pulse and is breathing. Next, the caregiver should call for help. Then the providers should assess the patient’s ability to move her arms and legs.

What does the nurse see on the patient’s forehead?

The nurse sees a large bruise on the patient’s forehead and calls the physician. Muriel’s CT scan completed in the emergency department shows she has a large subdural hematoma which is shifting her brain tissue to one side. It is too late to intervene.

What should a nurse do if a patient hits their head?

Post Fall Assessment for a Head Injury Here’s what should be done by a nurse in the assessment of a patient who has fallen, hit her head or had an unwitnessed fall. The first priority is to make sure the patient has a pulse and is breathing. Next, the caregiver should call for help.

How do you assess a patient who has fallen?

Stay with the patient and call for help.Check the patient's breathing, pulse, and blood pressure. ... Check for injury, such as cuts, scrapes, bruises, and broken bones.If you were not there when the patient fell, ask the patient or someone who saw the fall what happened.

What is the impact of patient falls in hospitals?

Patient falls in hospitals are common and may lead to negative outcomes such as injuries, prolonged hospitalization and legal liability. Consequently, various hospital falls prevention programs have been implemented in the last decades.

What is the most common patient activity result in falls?

ambulationThe most common activity performed at the time of the fall was ambulation (35/183; 19%).

What should you assess after a fall?

Check the skin for pallor, trauma, circulation, abrasion, bruising, and sensation. Check the central nervous system for sensation and movement in the lower extremities. Assess the current level of consciousness and determine whether the patient has had a loss of consciousness. Look for subtle cognitive changes.

How do falls affect patient outcomes?

The consequences of falls range from physical injury (e.g., fractures) to psychological distress in the form of depression, anxiety, fear of falling, and decline in overall balance confidence. These consequences not only lead to activity restriction and avoidance, but contribute to a rise in health care costs.

What are some of the physical consequences of a fall?

Consequences of fallspain.bruising.scratches and other superficial wounds.haematomas.lacerations.fractures.intracranial bleeding.

What are the most common causes of falls in hospitals?

The top 10 contributing factors—conditions identified most frequently by hospitals—for falls and falls with injury were grouped into six categories: 1) fall risk assessment issues, 2) handoff communication issues, 3) toileting issues, 4) call light issues, 5) education and organizational culture issues and 6) ...

What are the 3 types of falls?

Falls can be classified into three types:Physiological (anticipated). Most in-hospital falls belong to this category. ... Physiological (unanticipated). ... Accidental.

Why are falls common in hospitals?

The unfamiliar environment, acute illness, surgery, bed rest, medications, treatments, and the placement of various tubes and catheters are common challenges that place patients at risk of falling. Falls are devastating to patients, family members, and providers.

What should a nurse do when a patient falls?

The American Journal of Nursing provides four steps that nurses should take in response to a fall to both keep the patient safe and help protect the nurse's license in case of complications. These steps are assessment, notification and communication, monitoring and reassessment, and documentation.

What should a nurse do when a patient begins to fall?

If a patient begins to fall from a standing position, do not attempt to stop the fall or catch the patient. Instead, control the fall by lowering the patient to the floor.

What to do if a patient falls in a nursing home?

Call for assistance/alert senior staff. Keep person warm and note any changes. Assess level of injury, provide reassurance and take appropriate action (eg call ambulance/GP/NHS 24). If competent take vital signs eg BP.

Why are falls in hospitals a problem?

The unfamiliar environment, acute illness, surgery, bed rest, medications, treatments, and the placement of various tubes and catheters are common challenges that place patients at risk of falling. Falls are devastating to patients, family members, and providers.

Who is affected by patient falls?

Older people have the highest risk of death or serious injury arising from a fall and the risk increases with age. For example, in the United States of America, 20–30% of older people who fall suffer moderate to severe injuries such as bruises, hip fractures, or head trauma.

What is the estimated injury rate for patients who fall in the hospital?

About 25% of falls in hospitalized patients result in injury, and 2% result in fractures. There are significant costs associated with falls, including patient care costs, increased length of stay, and liability.

How many patient falls occur in hospitals each year?

700,000 to 1 million patient fallsEach year, roughly 700,000 to 1 million patient falls occur in U.S. hospitals resulting in around 250,000 injuries and up to 11,000 deaths.

What happens when a patient falls within a healthcare environment?

When a patient falls within a healthcare environment, the actions of the staff members can be critical. They can make the difference between life and death, between the patient getting a prompt evaluation for injuries or a delay in treatment, and between normal function and paralysis.

What is the first priority of a patient?

The first priority is to make sure the patient has a pulse and is breathing. Next, the caregiver should call for help. Then the providers should assess the patient’s ability to move her arms and legs. The risk of a spinal cord compression from a back or neck injury has to be ruled out before the patient can be moved.

How often should a nurse perform vital signs?

Vital signs and neurological observations should be performed hourly for 4 hours and then every 4 hours for 24 hours, then as required.

Why is intracranial bleed worse?

The intracranial bleed was much worse because of the anticoagulation. Failure to change the plan of care. I’ve seen cases in which the nurses did not change the care interventions, and the patient had multiple falls. Post fall assessment is crucial. The medical record, deposition testimony, incident reports and internal investigations should paint ...

What is the last part of a post fall assessment?

The last part of the post-fall assessment is to review the plan of care and to add more fall prevention strategies. The biggest risk factor for another fall is a history of a prior fall.

What should a nurse be concerned about when a patient is injured?

Whenever a patient for whom one is caring is injured, a nurse should be concerned that the care provided was consistent with standards of practice for that patient. Additionally, a nurse also needs to be certain he or she did not provide what may be viewed as negligent care that caused the injury. In this instance, the patient was ...

Did the nursing home dismiss the complaint against it?

The trial court opined that since the decedent’s negligence claim involved malpractice and the decedent did not file an affidavit of a medical expert (required in such cases), the nursing home’s motion to dismiss the complaint against it was granted. The decedent’s administrator appealed that decision.

Is medical malpractice a form of negligence?

The court held that since medical malpractice is a form of negligence, the two are not mutually exclusive. Moreover, nursing homes and hospitals, the court continued, have an obligation to protect patients’ safety when the patient is unable to do so for himself or herself.

What is the Nurse Practice Act?

(1 contact hr) Nurses have an obligation to keep abreast of current issues related to the regulation of the practice of nursing not only in their respective states but also across the nation, especially when their nursing practice crosses state borders.

Why do nurses have a duty to patients?

Because the practice of nursing is a right granted by a state to protect those who need nursing care, nurses have a duty to patients to practice in a safe, competent, and responsible manner. This requires nurse licensees to practice in conformity with their state statutes and regulations.

Why was the patient sent home after X-rays?

X-rays were taken, and the patient was sent home despite his complaints of pain. The next day, the patient was informed by phone that he was being picked up by ambulance to return to the hospital because the X-ray indicated he had broken his back. He was treated there with surgery and physical therapy.

Why did the medical assistant ask the patient to get on the table?

The patient said he could not do so but the assistant “insisted” that she needed him to get on the table so she could take his blood pressure.

Is Kaplan an expert witness?

The appellate court had to resolve many legal issues before it in this professional negligence case, but Kaplan’s qualifications to be an expert witness when determining if a nurse practitioner, an LPN and/or a medical assistant met the applicable standard of care is germane to this blog.

Who was the expert witness in the case of the Kaplan case?

After a hearing, the trial court granted the motion. In so doing, the court also held the patient’s expert witness, neurosurgeon Edward Kaplan , MD, was not familiar with the standard of care for nurse practitioners, LPNs or medical assistants in a clinic setting.

Did a medical assistant record a patient falling down her leg?

The medical assistant said as the patient was beginning to fall, she held him and he “sort of slid down her leg.”. An LPN, who was outside of the room, stated she heard a noise and found the patient sitting on the exam table when she entered the room. No fall was recorded in the patient’s medical record.

What is quality assurance?

Quality assurance is all about patient safety, customer satisfaction, and improving healthcare quality. Quality control groups comb through incident reports to look for indicators that suggest a patient received high-quality, patient-centered care at a reasonable price. Educational tools.

What is incident report?

An incident report is an electronic or paper document that provides a detailed, written account of the chain of events leading up to and following an unforeseen circumstance in a healthcare setting.

How long does it take to complete an incident report?

To ensure the details are as accurate as possible, incident reports should be completed within 24 hours by whomever witnessed the incident. If the incident wasn’t observed (e.g., a patient slipped, fell, and got up on his own), then the first person who was notified should submit it.

Why are incident reports important?

Incident reports are used to communicate important safety information to hospital administrators and keep them updated on aspects of patient care for the following purposes: Risk management. Incident report data is used to identify and eliminate potential risks necessary to prevent future mistakes.

What are some examples of reportable events in New York?

Examples: adverse reactions, equipment failure or misuse, medication errors.

What is the third leading cause of death in the U.S.?

According to a 2016 study conducted by Johns Hopkins, medical errors have become the third-leading cause of death in the U.S. and threaten the safety and well-being of patients. As time-consuming as incident reports may be, their role in patient care cannot be ignored.

What are the concerns of nurses?

Stressing over getting the report done or about what to include are common concerns for nurses — not to mention worrying about whether filing the report reflects badly on your performance. Mistakes happen all the time, and healthcare facilities are not immune.