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Monitoring of High Fall Risk Patients

Monitoring of High Fall Risk Patients

Case Summary

The case involves a 93 year old, female patient who was admitted to the ER with pneumonia. Within a half hour or so, she fell out of bed and broke her humerus while the nurse was changing her sheets. The patient was in the hospital for seven to eight days thereafter. Prior to the date of her going to the ER, the patient was largely self sufficient, able to drive a vehicle, go to the doctors, and take care of herself and her husband. After the incident, her condition deteriorated, she never returned to her residence and was taken to a residential care facility where she ultimately passed away.

Questions

Was there a Breach in Standard of Care? Should the staff have handled and monitored the patient differently given that she was high risk for falls?

Expert Findings

AMFS expert (Nursing) reviewed this case matter and provided the following opinion: There was a breach in the standard of care by the nursing staff at the medical center. There is apparent evidence that there was a failure to provide safe care to an elderly, but alert and oriented patient (who later became disoriented during the evening hours). She had been determined high-risk for fall after being observed ambulating earlier in the day and was unsteady; she also required standby assistance. However, there was no reported attempt to assist the patient in getting out of bed or take adequate precautions to prevent the fall. Additionally, there was a failure to appropriately notify a physician of the extent of injury or obtain a medical evaluation on the patient after she hit her head and had a laceration.

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