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Falls Prevention and Management in a Hospice In-Patient Unit: Evidencing Best Practice and Documentation
Background1. Falls prevention and management was integral to care in the Hospice but was not
well evidenced. 2. Documentation of falls risk assessment, prevention and management was
inconsistent3. Staff awareness of falls risk assessment, prevention and management was variable.
Aim• Toevidencebestpracticeanddocumentationforfallsriskassessmentand
management
What did we do? • Identifiedariskassessmenttoolforfalls• Developedacareplanforfallspreventionandmanagement• Identified10qualitystandards
How did we implement this?• Deliveredpractice-basedlearningforallnursingstaff• Pilotedtheriskassessmentandcareplaninoneofthenursingteams• Adaptedthecareplan• Implementedacrossthewholeward• Supplementaryeducationonfallsretrievalforallnursingstaff• IntegratedtheriskassessmentandcareplanintoE-healthrecord(Crosscare)• AdaptedthegenericIncidentReportingFormstocapturefallsriskassessmentand
fall prevention
Audit• ConductedanAudittomeasurecomplianceoneyearafterimplementation• Datawascollectedprospectivelyfor40consecutivepatientsadmittedtoIn-patientUnitbetweenFebruaryandApril2015.
• Eachcasewasfollowedforaneightdayperiod.• Compliancewasmeasuredbyreviewingdocumentationandobservingpractice.
AuditResults
OverallImpact• Theprogrammeoffallsriskassessmentandmanagementisembeddedinthe
process of care.• Staffareawareandproactiveaboutassessing,preventingandmanagingfalls• Documentedevidenceofthiscanbeconsistentlyfoundinthehealthrecord
Next Steps• Improveareasoflowercompliancewithstandards• Developfalls‘champions’acrossthenursingteam(trainedanduntrained)• IdentifytheextenttowhichtheFallsAssessmentandPreventionProgrammehas
reduced the number of falls.• Explorebestpracticeformanagementofspecificriskfactorsi.e.Delirium/cognitivedeficits
Jean Gow 1,ElaineMcManus2,MarjoryMackay 3 1Physiotherapist,StrathcarronHospice; 2PracticeEducator,StrathcarronHospice3 Director of Nursing, Strathcarron Hospice.ContactDetails:[email protected]
Standard 1. Allfallsriskassessmentwillbecarriedoutforall 100% patientswithin24hoursafteradmission. 2. Allfiveindividualriskareasintheassessmenttool 85%
willbecorrectlyidentifiedforallpatients. 3. Everypatientwillhavetheirriskassessedweekly. 95%
ComplianceAll40patients
4. Allpatientswithafallsriskscoreof2ormore 85% will have a falls prevention care plan initiated on thedayofadmission.
14patientswereidentifiedtobeatriskoffalls
5. Allpatientswithascoreof2ormorewillhave 75% theircareplansrevieweddaily. 6. Thecareplanwillidentifyinterventionswhich 92% reflect individual risks. 7. Thereisevidencethatallidentifiedinterventions 92% have been implemented.
8. Everypatientwillbere-assessedforfallsrisk 100% following a fall. 9. Everypatientwillhavethecareplanreviewed 100% following a fall. 10. Anincidentformwillbecompletedwithin24 100% hours for all patients who fall.
12ofthe14patientshadaFallsCarePlan
3 of the patients fell during the audit period
