Authors (including presenting author) :
Yeung KC(1), Lee SC(1), Sze YM(1), NG WP(1), Lam CM(1), Woo LC(1), Cheung SY(1), Yuen MY(1), Chiu ST(1), Chan OF(1)
Affiliation :
(1) Medicine and Geriatrics, Shatin Hospital
Introduction :
Fall prevention was essential in geriatric care as subsequent injuries brought a tremendous impact on patients. Restraint reduction culture has been established in Shatin Hospital for falls prevention. Fall data in 2017 showed that 18% of patients falls were accompanied by carers and were associated with an ineffective use of fall preventive devices respectively. Therefore, carers and front-line staff were targeted to further enhance their awareness on fall prevention.
Objectives :
To enhance both patients and staff’s engagement on fall prevention.
Methodology :
1. Produce fall prevention video to enhance patients’ awareness on fall prevention. Patient was arranged to watch the video on admission and it would be broadcasted during visiting hours.
2. Implement safety ambassador ward round by PCAs to check:
• call bell and patient’s belongings within easy reach
• bed side environment was risk-free
• functionality of safety alarm devices
• raising up of bedside rails for bed bound patients
• wearing of hip protectors for high fracture risk patients
3. Conduct training to PCAs on proper use of safety devices and reinforce person-centred care for fall prevention.
Result & Outcome :
1. Compliance of fall prevention measures
• Cross ward audits were conducted by APN/WM in January 2019 on the compliances of fall prevention video broadcasting and ambassador safety ward round.
• 20 nursing staff and 20 PCAs were audited and the results showed 100% compliance in both 2 audits.
2. Monitoring of patient fall rate
• There was a drop from 0.4 (17/18) to 0.17 (18/19) in the fall rate after the commencement of this program.
• The fall rate of SH M&G was found to be lower than the figures of HA Group 2 hospitals which was 0.45 in both 17/18 and 18/19.
3. Effectiveness of education program
• The education program was conducted in December 2019 with 34 PCAs participated.
• Pre-and-post questionnaires shown there was an enhancement of knowledge regarding the proper use of fall prevention safety devices. Participants also showed positive towards restraint reduction culture for falls prevention.
• Re-evaluation was conducted in January 2020 by random selection of 20 PCAs. It showed that staff’s perspective towards restraint free culture was sustainable.
This program reduced the patient fall rate of SH M&G wards and it showed the effectiveness of our fall prevention program. Staff engagement on fall prevention with restraint reduction culture was sustainable. The education program was also effective to enhance PCAs’ knowledge in particular to the proper use of fall prevention safety devices.
