Because patient falls in hospitals can lead to longer stays and higher costs, hospitals across the country have developed and implemented fall prevention programs. Shore Health System is getting impressive results through the use of a multidisciplinary approach to fall prevention.
According to Ruth Ann Jones, EdD, MSN, RN, NEA-BC, director of acute care services for Shore Health System, “The Department of Nursing recognizes that patient falls is a complex issue with many facets. While the way we practice nursing has a direct effect on the number of patient falls, Shore Health System involves individuals from all disciplines that provide patient care to ensure patient safety.”
The implementation of a multidisciplinary Fall Prevention Team to address the issue of falls that occur during a hospital stay has made a significant difference in keeping patients safe at The Memorial Hospital at Easton and Dorchester General Hospital. Staff nurses, nursing technicians, clinical nurse specialists, pharmacists, physical therapists, risk management and performance improvement specialists from both hospitals participate on the team. Together they examine the incidences of patient falls, identify where and why falls are most likely to occur, and determine strategies for fall prevention.
To strengthen Shore Health System’s fall prevention program, the Fall Prevention Team reviewed literature on evidence-based practices and benchmarked with other hospitals to determine what initiatives were making a difference in fall prevention. Shore Health System also collects and submits patient fall data to the National Database of Nursing Quality Indicators to compare its experience with other hospitals and units of similar size.
In addition to selecting an assessment tool to evaluate a patient’s fall risk upon entering the hospital, the Fall Prevention Team meets to analyze the data and make suggestions for system-wide improvements. Recent improvements included looking at environmental factors, such as lighting, placement of furniture and walking pathways to assure safe movement. The team also implemented “fall huddles,” which are short meetings of nurses, physical therapists and pharmacists, who monitor patients at risk for falls on the surgical unit at Memorial Hospital.
Shore Health System purchased high-low beds on the neuroscience unit at Memorial Hospital. These beds can be lowered closer to the floor than a standard hospital bed to minimize injuries from falls. Other safety steps taken include installation of patient monitors at both hospitals to better monitor patient movement and the use of sitters to supervise patients who are at high risk for falling.
According to Teresa Blem, PT, director of shore rehabilitation services, “The rehabilitation staff is part of the multidisciplinary team, serving as a resource to nursing for identifying patients at risk for falls, developing strategies for safely moving patients with limited mobility and developing safe use of adaptive equipment.”
The Shore Health System Fall Prevention Team has taken steps to increase patient and family awareness about fall risks and prevention. According to Jones, “Recent literature on fall prevention suggests that improved communication with patients and their families is one of the most effective strategies to prevent patient falls. Because patients and family members play key roles in fall prevention we have begun to include them as part of our fall prevention strategy. It’s all about keeping patients safe.”
Shore Health System’s Nursing Shared Leadership Global Team produced a safety brochure, “Stay Safe…Communicate,” for patients at both hospitals. The brochure educates patients and their families on patient safety issues, including fall prevention, infection protection and medication safety. Jones adds, “By forming a partnership with patients and their families, Shore Health System can continue to reduce fall rates in the hospital setting. This is just one of many efforts underway to achieve this goal.”