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Fall prevention: The little things can make a big difference
American Nurse Today has published a case study on fall prevention which was funded by an unrestricted educational grant from Posey. In this article, Angela Dubuc MSN, RN System Director of Clinical Practice at Central Maine Healthcare Lewiston, Maine shares how they have reduced falls and fall related injuries. Since implementing their program, Central Main Medical Center in Lewiston has reduced falls to 2.20 in 2016 compared to 2.95 in 2015. Their non-assisted falls with injury rate was .69 in 2015 and decreased to .44 in 2016. Below are the strategies that were implemented in 2016:
In 2016, the task force developed the following strategies to prevent patient falls.
• Fall-safety agreement. We now use a fall-safety agreement to educate patients and family members about the patient’s individualized fall risk. Staff complete this education on admission, asking patients to sign the agreement indicating they will abide by the request to ring the call bell for assistance before getting out of a bed or chair.
• Post-fall huddle. A post-fall huddle occurs immediately after a fall, as soon as the patient is safe. The goal is to determine why the patient fell and what can be done differently to prevent future falls. The patient’s plan of care is adjusted to reflect the newly identified interventions.
• Bedside alarms in med-surg units. Posey alarms were installed at each patient’s bedside in the medical, surgical, and rehabilitation units. This eliminated the problem of not having enough alarms. We created standard work (easy-to-follow, point-of-care instructions) that outlined how to use the alarm with the manufacturer’s chair pad and bed pad.
• Monthly unit fall-review meetings. These meetings, which began with the acute rehabilitation unit, are attended by frontline staff members and facilitated by the nurse manager. The goal is to review falls that have occurred on that unit and identify trends and opportunities for improvement. Currently, four of our nine inpatient nursing units have fall-review meetings.
• Shower shoes. In November and December 2015, four CMMC patients fell while showering. As a result, the task forced evaluated our showers and the showering process for environmental safety issues. We determined that our shower stalls varied in construction but essentially had the necessary safety items—grab bars and floor grips. However, patients didn’t always wear shoes. We found shower shoes we believed would help prevent slipping and required patients to wear them in the shower. Since implementing that standard we haven’t had a patient fall in the shower.
The article is now available online at: https://www.americannursetoday.com/fall-prevention-little-things-can-make-big-difference/