The nursing staff are caring for a confused patient who is at risk for falling.
What action by the nurse would be appropriate in order to avoid restraining the patient?

Choice A rationale:

Using correction fluid to correct an erroneous written entry is not appropriate as it can obscure the information and raise questions about the accuracy of the documentation. It is better to strike through the error with a single line, write the correct information, and sign and date the correction.

Choice B rationale:

Documenting changes in the patient's status is crucial for ensuring continuity of care and keeping all healthcare providers informed about the patient's condition.

Choice C rationale:

Leaving a blank line for the charge nurse to add additional documentation is not recommended. Each entry should be complete and include all relevant information at the time of documentation.

Choice D rationale:

Planning to finish charting the procedure after returning from a break is not appropriate. Charting should be done in real-time to ensure accuracy and timeliness of the information.

Choice E rationale:

Charting using military (24-hour) time is appropriate as it reduces confusion and ensures a standardized way of documenting time across different healthcare settings.

Choice A rationale:

Providing non-slip footwear to patients during their stay is a good preventive measure, but it only addresses the risk of falls related to slippery floors. It does not address the overall fall risk, especially for elderly patients who may need constant supervision and assistance.

Choice B rationale:

Keeping the bed in a high position for ease of care might seem practical, but it increases the risk of falls when the patient attempts to get out of bed. Lowering the bed reduces the risk of injury if a fall occurs and is a more appropriate intervention.

Choice C rationale:

Instituting a policy requiring a sitter for all patients above the age of 60 is the best option among the choices provided. Elderly patients are at a higher risk of falls due to various factors such as weakened muscles, balance issues, and medication side effects. Having a dedicated sitter ensures constant supervision, timely assistance, and prompt intervention if the patient attempts to get out of bed, significantly reducing the risk of falls.

Choice D rationale:

Avoiding the use of a night light in the room to promote sleep is not a recommended intervention. While promoting sleep is essential for overall patient well-being, patient safety should always be the priority. Providing adequate lighting, especially at night, reduces the risk of falls and other accidents.