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Does fall risk increase in OB departments with rooming-in?

Written By Laura Turley on January 3, 2017

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Entering a dimly lit patient room, Stephanie, OB nurse, gasped as she saw new mom, Courtney, gingerly swing her legs to the side of the bed and attempt to stand. As Courtney’s feet skimmed the floor, Stephanie immediately noticed how unstable and shaky the new mom was. Courtney was getting out of bed to retrieve her crying newborn from the bassinet.  Stephanie’s timing could not have been better as she jumped to assist Courtney giving her much needed stability. What if Stephanie was not there; was Courtney a fall risk for their hospital?

Since the hospital’s transition to rooming-in, Stephanie makes a point to add an extra round or two in her evening rotation. She has personally observed that often new moms are frightened of being alone with their newborn and many are simply exhausted, especially those that endured an extensive delivery. By making an extra round or two, Stephanie feels her availability helps moms feel more comfortable and they do not hesitate to reach out for help and hence reduce the fall risk. According to Nursing Management, “The most common contributing factor is maternal exhaustion. Second night syndrome occurs on the second full night of a newborn’s life when the baby wakes from a restful state and transitions to breast feeding and inconsolable crying. The combination of an alert newborn and a fatigued parent increases the risk of a fall during this phase.”[i]

Not only has extra rounding helped to prevent falls, but Stephanie also follows her hospital’s “Preventing Falls” guidelines stating the importance of lowering beds to the lowest setting. Now, as a standard rule of care, the mom will be closer to the ground, much like her bed at home, so that when they feel unstable, they are less likely to injure themselves or their newborn. Preventing falls is a top priority. According to February 2016 statistics from the Summary Data of Sentinel Events Reviewed by the Joint Commission, patient falls is tied for third place as the most sentinel events in 2015.[ii]

By lowering beds in the OB department, the missing component is easy access to reach the newborn in the bassinet; bassinet heights have remained their same standard height. With the increased attention to ensure the safety of the mother being alone with her newborn, Stephanie is concerned. Breast feeding, skin-to-skin bonding and handling are all done within the room with little or no assistance from the nursing staff. According to Nursing Management, “Even in hospitals that do track infant falls, the rate may be underreported or falsified because of caregiver guilt or fear of judgment.”[iii]  “Parents may be reluctant to report their newborn dropped or rolled to the floor because they are ashamed or are fearful someone may take action against them for neglect and thus do not report the event.”[iv]

“While most of the contributing factors have been identified elsewhere, little has been mentioned about bed design and how that may increase the risk of an infant being dropped when a mother falls asleep while breastfeeding.” [v] Stephanie was looking for a solution and reached out to her contact at Innovative Medical Systems to see what could be done.

 As a result, of Stephanie’s request, a lowered bassinet was custom designed for her facility and is now available to all OB departments. This bassinet offers OB Departments an affordable option to help reduce fall risk and comply with accrediting agencies recommendations to keep a bed at its lowest position when not administering care. Further, it retains the ability to select a variety of finishes and storage configurations to integrate the bassinet into the suite’s décor as well as accessories to eliminate work arounds for optimizing a nurse’s work flow.

 Read the Journal of Healthcare Risk  Management article on reducing fall risk  in the OB. 

 

[i]               Kimberly T. Hodges, MSN, RN and Jason H. Gilbert, MBA, BSN, RN. “Rising above the risk: Eliminating infant falls.” Nursing Management Dec. 2015: 28-32. Print.

[ii]               n.p. “Summary Data of Sentinel Events Reviewed by the Joint Commission.” Joint Commission. Web. Feb. 2016.

[iii]              Kimberly T. Hodges, MSN, RN and Jason H. Gilbert, MBA, BSN, RN. “Rising above the risk: Eliminating infant falls.” Nursing Management Dec. 2015: 28-32. Print.

[iv]              Ann D. Gaffey, RN, MSN, CPHRM, DFASHRM. “Fall prevention in our healthiest patients: Assessing risk and prevent injury for moms and babies.” American Society for Healthcare Risk Management 24.3 (2015): 37-40. Print.

[v]               Ann D. Gaffey, RN, MSN, CPHRM, DFASHRM. “Fall prevention in our healthiest patients: Assessing risk and prevent injury for moms and babies.” American Society for Healthcare Risk Management 24.3 (2015): 37-40. Print.


Topics: rooming-in, Joint Commission, fall risk

Laura Turley

Written by Laura Turley

Empowering others to believe that anything is possible is the core of who I am. My diverse experience in the digital landscape allows me a unique perspective on the healthcare industry and how we can best serve you.

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