How to Manage the Risks of Patient Wandering

Patients living with dementia or Alzheimer’s can be prone to wandering. Unfamiliar environments like the hospital can increase the likelihood of wandering, which can create a challenge for hospitals to manage at-risk patients and ensure their safety at all times.

One of the biggest concerns for wandering patients in the hospital is falling, either when getting out of bed or when wandering. Exiting the hospital bed without nurse assistance can cause patients to trip or fall especially when experiencing altered perception at unfamiliar heights. Wandering through the hallways can lead to stumbling and tripping caused by weakness and disorientation. When patients fall, serious injury such as fractures, lacerations, or brain injuries can occur.

Most wandering prevention programs are put in place when a patient has been identified as a wandering risk. If a patient has not been diagnosed with dementia or Alzheimer’s, hospital staff may not realize immediately that the patient could be prone to wandering.

As a result, elderly patients should be screened for any signs of a memory problem or disorientation upon admission. This process can be similar to a fall risk assessment and should look for signs of memory loss or cognitive impairment. Since a patient’s condition can change throughout a patient’s stay, staff should continually observe patients for changes in functioning, mood, or awareness while simultaneously assessing fall risk.

If a patient’s mental condition changes, or if the patient has been assessed as a wandering risk upon admission, staff will need to ensure that there is regular supervision to minimize risk. Hospitals can use any combination of the following strategies to reduce wandering:

·         Sitters

·         Bed-exit alarms

·         Locating the patient’s room near the nurses’ station

·         Hourly nurse rounding

·         Watching for indications that the patient is trying to leave

Sitters can be a costly method to reduce patient wandering, but does employ constant supervision to eliminate wandering. A more cost-efficient solution would be to use a bed-exit alarm to monitor when a patient is exiting the hospital bed or showing signs of movement. When a patient is located close to the nurses’ station, staff can quickly respond and return the patient to bed or provide help if a patient requires toileting assistance.

Hourly nurse rounding can be used alongside a bed-exit alarm for regular supervision of wandering patients. Each hour, nurses can check in on patients and assess the patient’s condition and mental state. If a patient is confused and is asking about family members, this may indicate that a patient may be looking to leave the hospital bed to find his loved ones. When a patient is tying up shoes or putting on a coat, this is also an indication of wandering that should be addressed through intervention.

However, since patient wandering is not always entirely preventable by nurse intervention, staff should ensure that safety measures are put in place for when a patient wanders:

1.       Use a low hospital bed to reduce falls and injury when patients get out of bed unassisted

2.       Ensure patients are located far away from exits, stairs, and other hazards

3.       Outfit patients in appropriate footwear for safe wandering and slip/fall prevention

If a patient does leave the bed without nurse intervention, low hospital beds can provide a safe resting height that can minimize the risk of injury from trips and falls out of bed. Assuring that the patient is located far away from exits, stairs, and other dangerous areas can limit the adverse events that can occur when a patient wanders. Appropriate footwear should be worn by the patient at all times to minimize the risks of slips and falls.

Maintaining a safe environment for patients is the key to creating a wandering management and prevention program in your facility. Implementing the necessary steps to identify patients who are at-risk of wandering can prevent slips, trips, falls, or other adverse events that can occur when a patient wanders.

CHG Hospital Beds specializes in low hospital beds that are designed to prevent patient falls and related injuries within acute care environments. We are focused on patient and nurse safety and deliver innovative solutions to meet the needs of our customers.

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