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Learning Objective 1: Identify components of a fall prevention program
Learning Objective 2: Implement a systemwide falls prevention program.
The development of a multidisciplinary falls committee included members from both hospitals and led to several falls initiatives including hourly rounding, a post fall debriefing form, use of bed alarms and a Failure Modes Effects Analysis (FMEA) on bed alarm usage. Patient and family education has been refined. Our Labor and Delivery Unit in Ronald Reagan Hospital has developed a fall risk assessment tool that is currently being validated. The Pediatrics area is in the process of identifying an appropriate falls assessment tool. Other interventions include the use of constant observation aides and restraint alternatives when other interventions are inadequate. Reports generated from our electronic charting system allow the opportunity to focus on the patients who are designated at high risk for falls, initiate timely interventions to prevent falls and help correct inadequate documentation.
Our results indicate that there are a decreased number of falls especially on the “high fall” units (liver transplant and hematology/oncology). We are also better able to identify those patients who are at high risk for a fall.
The combining of two falls programs has been challenging since each facility had their “own way” of identifying patients at risk for a fall. Using the Relationship Based Care Model of I2E2 as the formula for leading change, we were able to engage the staff at both institutions and to fully integrate the change within the culture of the organization.
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