American Nurse Today

Vascular access device stabilization and line securement

Proper primary and secondary securement can reduce complications, increase patient comfort, and save money.


  • Millions of peripheral IVs and central venous catheters are inserted every year.
  • Securement choices include several types of tape, transparent dressings, sutures, engineered securement devices (ESDs), subcutaneous ESDs, and medical cyanoacrylate tissue adhesives.
  • Decisions related to securement should be considered equally as important as the choice of the catheter itself.

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Fall prevention: Applying the evidence

This is the first in a series of three case studies illustrating success stories in preventing falls and injuries from falls. The series is brought to you by Posey. Watch for the next case study in the September issue of American Nurse Today. Successful fall prevention programs use multimodal interventions, such as detailed fall risk assessments, frequent monitoring by staff, and appropriate … Read more

We’ve made gains in preventing falls, but more work remains

This year marks the 20-year milestone of the American Nurses Association’s (ANA) leadership in making patient falls a nurse-sensitive indicator. In 1995, ANA’s work on nurse-sensitive indicator development resulted in the Nursing Care Report Card for Acute Care. This report included falls as a nurse indicator, demonstrating that nurses play an important role in outcomes … Read more

Assessing your patients’ risk for falling

An estimated 25,500 Americans died from falls in healthcare and community settings in 2013. Countless more suffered life-changing injuries, such as fractures, internal injuries, and traumatic brain injury. Experts estimate that more than 84% of adverse events in hospital patients are related to falls, which can prolong or complicate recovery. This article identifies risk factors … Read more

Taking appropriate precautions against falls

Falls pose a major public health problem around the world. In the United States, unintentional falls occur in all age groups. Such falls are the leading cause of nonfatal injuries treated in emergency departments (EDs) among all age groups except ages 10-14 and 15-24, for whom these falls are the second leading cause. Commonly called … Read more

Creating an environment of falls prevention

Falls are a major concern for older adults in all settings, causing significant morbidity and mortality and affecting quality of life. In the hospital, falls occur at an estimated rate of 8.9 per 1,000 patient days. About 30% to 50% of these falls cause injury. Falls increase hospital stays and may necessitate a long-term stay. According … Read more

Preventing injuries from patient falls

While falls prevention has become standard in inpatient care, injury prevention has gotten less attention, both in research and everyday practice. Injuries from falls can have serious consequences in patients, ranging from minor cuts and bruises to fractures, head injury, and even death. An estimated 11,000 patients die from falls in U.S. hospitals every year. … Read more

When and how to use restraints

Few things cause as much angst for a nurse as placing a patient in a restraint, who may feel his or her personal freedom is being taken away. But in certain situations, restraining a patient is the only option that ensures the safety of the patient and others.

As nurses, we’re ethically obligated to ensure the patient’s basic right not to be subjected to inappropriate restraint use. Restraints must not be used for coercion, punishment, discipline, or staff convenience. Improper restraint use can lead to serious sanctions by the state health department, The Joint Commission (TJC), or both. Use restraints only to help keep the patient, staff, other patients, and visitors safe—and only as a last resort.

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Enclosure bed: A protective and calming restraint

An enclosure bed can be used as part of a patient’s plan of care to prevent falls and provide a safer environment. This specialty bed has a mesh tent connected to a frame placed over a standard medical-surgical bed. Although it’s considered a restraint because it limits the patient’s ability to get out of bed, … Read more

Choosing the right restraint

Nurses at the bedside are experts in driving the safest, most effective patient care. In some cases, nursing assessment and clinical judgment suggest the need to apply restraints. A patient who is violent or self-destructive or whose behavior jeopardizes the immediate physical safety of him- or herself or another person may meet the behavioral health … Read more