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Review of Falls Prevention Project

Review of Falls Prevention Project. Key Ideas 2001-2002. Key Premise. Our hospital systems are perfectly designed to produce the rate of falls we are experiencing. To change the rate of falls, we have to change our systems of care. - paraphrase from Don Berwick

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Review of Falls Prevention Project

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  1. Review of Falls Prevention Project Key Ideas 2001-2002

  2. Key Premise Our hospital systems are perfectly designed to produce the rate of falls we are experiencing. To change the rate of falls, we have to change our systems of care. - paraphrase from Don Berwick Institute for Healthcare Improvement

  3. What you told us … The Problem Problem mainly of elderly

  4. What you told us … The Problem Most common when fewer staff available? Shift change? Meal break? Busiest?

  5. Prevention strategies implemented for at 2 risk p atients to reduce falls LECTRA ULCAN OUGAR OUGAR ONDOR (1 = low importance through to 5 = high EMMA IERRA AGLE ELTA IMA importance) V G C C C D E E L S a. Minimise bed rest 5 5 5 5 5 b. Provide exercise 5 5 5 5 5 5 3 5 5 5 5 5 5 5 c. Supervised mobilisation progra m 5 d. Scheduled toileting 5 5 5 5 5 4 4 e. Bedside commodes 5 5 5 5 5 4 5 f. Bed/side rails 5 2 2 1 5 5 5 3 0 g. Physical restraints 4 2 3 5 5 0 h. Call bell systems 5 3 4 5 5 5 5 5 i. Alarm system (e.g. chair or bed ala rm) 5 3 5 j. Electronic beds 4 4 5 5 5 5 3.5 3 What you told us … Prevention Prevention strategies ...

  6. Prevention strategies implemented for at 2 risk p atients to reduce falls LECTRA OUGAR OUGAR ONDOR ULCAN EMMA (1 = low importance through to 5 = high IERRA AGLE ELTA IMA importance) G V C C C D E E L S k. Low bed height 5 5 5 5 5 4 5 5 3.5 5 l. Beds locked with brakes on 5 5 5 5 5 5 5 5 5 m. Carpeting on floor 5 n. Adequate lighting provided 3 5 2 5 5 5 5 2 4 o. Night lights used 2 5 5 5 5 5 4 4 p. Non - slip footwear (e.g. treaded socks) 5 5 5 5 5 q. Walking aids 5 5 5 5 5 5 5 5 3.5 5 r. Hip protector garments 5 5 3 1 s. Identify high risk patients (e.g. arm band) 4 5 5 5 5 5 5 5 t. Education for at risk inpatient s & families 3 4 5 5 5 5 5 u. Education for inpatient care providers 5 5 5 5 5 5 5 What you told us … Prevention Prevention strategies ...

  7. What should a leading hospital do ... Hospital’s duty of care to provide safe environment • Provide safe flooring, lighting, rails, toilets, baths, and beds • Assess patients on arrival • Free up the nursing staff to redefine priorities for each patient • Encourage families to help care for patients • Educate staff to avoid injury • Instruct staff how to intervene if a patient is falling • Require audits of falls at each ward and corrective action

  8. Key Conclusions • Most falls are unobserved • Imperative to increase surveillance, rather than rely on greater vigilence alone • More time for observation • More assistance during key meal, toilet, shower times (which could be altered) • Use family, other carers in addition to nursing staff

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