Purpose/Objectives:
To improve the fall prevention program by promoting safety and minimizing inpatient falls. To establish whether implementation of an interdisciplinary mobility and safety tool at the bedside would decrease fall rates in medical-surgical patients as compared with traditional Kardex communication.
Significance:
At Hoag Hospital, the inpatient fall rates were steady at 40 to 50 falls per quarter or 2.42 falls per 1000 patient-days. Methods that improve communication on the patient's mobility status and fall precautions are essential as per literature.
Background/Rationale:
Improved communication and reduction in overall fall rates are national patient safety goals per the Joint Commission. Initially envisioned as a physical therapy tool, the current mobility safety tool was streamlined to provide all caregivers information regarding safety for out-of-bed activities as well as safety measures needed per fall risk assessment. In an effort to improve patient satisfaction, staff may be sent to the room to assist a patient they are not directly caring for. This caregiver may not have awareness of any special precautions regarding mobility or fall precautions prior to assisting the patient for out-of-bed activity.
Description:
A pilot tool was developed by a multidisciplinary committee and implemented beginning quarter 1 of 2009 on the stroke unit. The tool included the patient's capacity for out-of-bed activity, mobility aids required at the bedside (eg, cane, walker, lift equipment), safety precautions required (eg, bed alarm, strict bed rest), and any restrictions on patient per medical diagnosis (eg, hip fracture).
Outcome:
By quarter 3 of 2009, the initial pilot unit went 4 months without a patient fall. After successful reduction in fall rates on the pilot unit, the pilot was expanded to other medical-surgical units. Fall data were collected monthly by unit, and falls per 1000 patient-days were calculated based on data reported to the Collaborative Alliance for Nursing Outcomes (CALNOC) database.
Interpretation/Conclusion:
As demonstrated by this pilot, streamlined communication located at the bedside is thought to increase staff awareness and promote better compliance with patient safety measures.
Implications for Practice:
The student clinical nurse specialist acts in the spheres of consultation and collaboration with the interdisciplinary team to facilitate effective programs for fall prevention.
Section Description
The journal is proud to share the student abstracts accepted for poster presentation at the 2010 National Association of Clinical Nurse Specialists Conference. These abstracts are submitted under a separate, later deadline and therefore did not appear in the journal with the general abstracts. Congratulations to these CNS students and their faculty mentors.