Clinical Tips
Quick and practical tips for your nursing practice
🔢 How to Approach a Colleague You're Worried About
1️⃣ Choose the moment — Private, unhurried, not mid-shift crisis 2️⃣ Lead with observation — "I've noticed you seem rea
❌ Myth: "Everyone's tired — it's just part of nursing"
Reality: Normalizing burnout is the single biggest barrier to recognition When a colleague says "I dread coming in,"
❌ Myth: "The tool says low risk — no additional measures needed"
Reality: Fall risk tools have an AUC of 0.5-0.7, barely better than chance Margaret scored "low risk" this morning. F
🎯 FAIR: Fall Risk Assessment
F — Fatal: 1 in 4 adults 65+ fall yearly; 38,000+ deaths/year; 60% fall again within 12 months A — Assess: FAST-R in 15
📊 1 in 4 adults over 65 fall every year
60% of those who fall will fall AGAIN within 12 months. 38,742 fall-related deaths in 2021 alone. And here's the unco
📋 FAST-R: The 15-Minute Admission Protocol
| Letter | Action | Key Question | |--------|--------|--------------| | F | Fall history | "Have you fallen in the past
🚨 FRIDs: Fall-Risk Increasing Drugs
| Drug Class | Risk Increase | |------------|---------------| | Antidepressants | OR 1.68 +68% | | Antipsychotics | OR
🧠 The Intrinsic Five: What Actually Predicts Falls
1. Prior fall history → 3-6x increased risk best predictor 2. Lower-extremity weakness → 4x risk 3. Gait/balance impair
❌ Never say "mechanical fall"
This term implies the fall was random and unavoidable. It stops investigation. It hides modifiable risk factors. When
👤 Robert, 74, pneumonia, Morse score 35 = "low risk"
FAST-R reveals what the score missed: • F: "A little stumble last month" — fell at night, dizzy • A: Confused about dat
💡 Exercise reduces falls by 20-30% — USPSTF Grade B
Non-slip socks and bed alarms don't address root causes. What works: multicomponent programs targeting: • Balance trai
💡 Anticholinergic burden is CUMULATIVE — add them up
| OTC/Rx | Drug | ACB | |--------|------|-----| | OTC | Diphenhydramine Benadryl, PM products | 3 | | Rx | Oxybutynin b