The current consensus among orthopedic surgeons is that the earlier a post-surgical patient safely receives physical therapy, the greater the odds of a successful functional outcome.
Physical therapists tout the very real benefits of post-operative physical therapy, including:
• Restoring or improving mobility and flexibility
• Helping with balance
• Building strength
• Reducing swelling and pain
• Reducing formation of scar tissue with tissue mobilization techniques
In some situations, though, physical therapists can become overly aggressive in rushing to start physical therapy too early, before it’s safe for the patient to do so.
Many hospitals and ambulatory surgery centers performing orthopedic procedures try to get patients into the operating room and discharged to home in the same day.
If a surgery starts later in the day—in the afternoon, for example—the facility or administration’s timing goals can put unreasonable pressure on nurses and physical therapy staff to perform physical therapy education and prepare patients for discharge before the end of the day. Any time a physician or health care provider is rushed, it needlessly endangers the patient.
In the context of orthopedic surgery, where a patient receives anesthesia, it takes time for the anesthetic medications to wear off. Healthcare professionals call this anesthetic effect.
Anesthetic effect can cause patients to experience drowsiness, lack of mental alertness, and, depending on the type of anesthesia, a lack of sensation in the lower extremities. Think of the risk of having physical therapist get a patient up on his or her feet to illustrate how to do physical therapy exercises, if the patient has no sensation in the feet. It creates a recipe for disaster, in the form of patient falls.
When a patient falls following orthopedic surgery, it can cause additional broken bones, the need for another surgery, and the risks, pain, suffering, and mental anguish that go with it.
The standard of care requires nurses and physical therapists to assess and document each patient’s fall risk. This is true after surgery, but also any time a patient presents to an emergency room for care, or is admitted to a hospital.
Many hospitals, surgery centers, nurses, and physical therapists use standardized fall assessment tools such as the Morse Fall Scale, John Hopkins Fall Risk Assessment Tool, or the Hester Davis Fall Risk Scale. Whether using a standardized fall risk assessment tool or not, nurses and therapists should consider anesthetic effect and not allow administrative pressure to quickly discharge post-surgical patients to trump safety.
Whether in the context of post-operative physical therapy or any other type of hospital or surgery center care, patient falls are considered sentinel events (never events). Sentinel events must be reported to the facility’s accrediting body, and the leadership team must conduct a root cause analysis to determine why the fall occurred and what lessons learned can be applied to prevent another patient injury.
If you’ve been seriously injured because of a hospital or surgery center fall in Texas, then contact a top-rated experienced Texas medical malpractice lawyer for free consultation about your potential case.
