Chapter 3. Safe Patient Handling, Positioning, and Transfers Show
Patient falls are the most reported patient safety events in British Columbia and account for 40% of all adverse events (BCPSLS, 2015). Falls are a major priority in health care, and health care providers are responsible for identifying, managing, and eliminating potential hazards to patients. All patient-handling activities (positioning, transfers, and ambulation) pose a risk to patients and health care providers. Older adults may be at increased risk for falls due to impaired mental status, decreased strength, impaired balance and mobility, and decreased sensory perception (Titler, Shever, Kanak, Picone, & Qin, 2011). Other patients may be at risk due to gait problems, cognitive ability, visual problems, urinary frequency, generalized weakness, and cognitive dysfunction. Specific treatments and medications may cause hypotension or drowsiness, which increase a patient’s risk for falls (Hook & Winchel, 2006). Fall Prevention StrategiesAll clients should be assessed for risk factors, and necessary prevention measures should be implemented as per agency policy. Table 3.7 lists factors that affect patient safety and general measures to prevent falls in health care.
Lowering a Patient to the FloorA patient may fall while ambulating or being transferred from one surface to another. 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. Checklist 31 lists the steps to assisting a patient to the floor to minimize injury to patient and health care provider (PHSA, 2010). Checklist 31: Lowering a Patient to the Floor
Special considerations:
Take this Lowering a Patient to the Floor course for more information on lowering a falling patient to the floor. Video 3.7Watch the video Assisted Fall by Kim Morris, Thompson Rivers University.
Additional VideosVideo 3.8Watch the video How to Use a Hammock Sling by Kim Morris, Thompson Rivers University. Video 3.9Watch the video How to Use a Hygiene Sling by Kim Morris, Thompson Rivers University. Which observation by the nurse best indicates that bladder irrigation for urinary retention has been effective?Fundamentals Exam 2. Which action should be taken if urinary retention is suspected after catheter removal?If retention is suspected, it is important to perform a bladder ultrasound (Yates, 2016) and recatheterise the patient if indicated. Dysurea (pain when passing urine) - Stinging and burning may occur when passing urine; symptoms can last for a few days.
Which patient will most likely require a Coudè catheter?Other reasons you might need a coudé catheter are if you have urethra strictures, are receiving radiation in the pelvic region, if you're about to undergo prostate surgery or if you have previous scars from prostate surgery, if you have an atrophic vagina, if you have a stoma, if you're suffering from urethral trauma, ...
Can a nap perform a bladder scan?The skill of measuring bladder volume by bladder scan can be delegated to nursing assistive personnel (NAP). The nurse must first determine the timing and frequency of the bladder scan measurement and interpret the measurements obtained.
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