What is the role of the nurse in fall prevention program implementation? How does this role vary between design and implementation of healthcare programs? 

Fall prevention should be a multi-disciplinary effort including physicians, physical and occupational therapists, patients and their families, and of course, nurses. Because RNs and LPNs spend so much time with patients, a lot of the responsibility falls on you during direct care.

The role of nurses varies based on staffing configurations and management decisions, but generally the nursing role in fall prevention includes:

1. Completing and documenting patient fall risk screening and assessment
2. Documenting patient-specific fall prevention practices
3. Monitoring the patient's medical condition for any changes
4. Reporting falls to the physician
5. Obtaining medical orders from the physician as needed
6. Supervising nursing aides
7. Educating the patient and family on fall prevention
8. Obtaining the supplies (cane, walker, bed alarm, etc.) need to prevent patient falls

To prevent fall, there should be patient specific plan to take care by nurses. Time to time evaluation of team and infrastructure should be done. There are some Patient-Specific Fall Prevention Strategies that should be done by nurses as follows:

1) My patient has fallen in the past.

• Discuss the cause of the previous fall and how to prevent it from occurring again.

2) My patient has an unstable walking gait.

• Ensure your patient has access to mobility aids, if needed.
• Make sure your patients are always wearing non-slip shoes or socks.
• Use a gait belt to assist your patients during ambulation.
• Ensure your patient goes to their scheduled physical therapy.

3) My patient has urinary incontinence.

• Follow a toileting schedule.
• Use incontinence briefs and draw sheets.
• Round hourly (alternating with a nursing assistant, if needed).

4) My patient is on medication that has a high fall risk.

• Be aware of the potential side effects of your patient's medication and develop a plan.

5) My patient has an altered mental status.

• Don't use side rails with this patient (they may fall trying to climb over them).
• Use a bed or chair alarm for continuous monitoring.
• Use a floor mat to prevent injuries from falls.
• Round hourly (alternating with a nursing assistant, if needed).

6) My patient has another fall risk.

• Other intervention