Authors (including presenting author) :
Wong F(1), Ma O(1), Ng PK(1), Man LS(1), Hung B(1), Chan NS(1), Lau PP(1), Tang WK(1), Lai LT(1), Lai OW(1), Kwan SP(1), Lam CW(1), Ho WW(1), Ling PM(1), Au KM(1)
Affiliation :
(1)Department of Respiratory Medicine & Extended Care Services, Kowloon Hospital
Introduction :
It is well recognized that patient fall is a leading cause of hospital-acquired injury and contributes to a significant burden on the healthcare system leading to additional investigation and treatment, increased length of stay and potential litigation. It is important to ensure that preventive measures are in place to safeguard patients from fall and subsequent injury during hospitalization. At the end of 2018, nursing colleagues observed an increasing trend of patient fall incidents in Department of Respiratory Medicine and Extended Care (RM&E) wards from May 2017 to October 2018. Over 80% of fall incidents occurred at patient’s bedside and the causes were mainly related to patient’s personal needs such as elimination, action to pick up or lean over to pick up things from patient’s locker or floor. Therefore, simulation training was designed and conducted to Patient Care Assistants (PCAs) who perform the special round at regular intervals in RM&E wards of Kowloon Hospital (KH) for prevention of patient fall.
Objectives :
1.To enhance PCAs’ knowledge and raise their awareness to prevent patient fall
2.To reduce the fall incidents in RM&E wards
Methodology :
The simulation training was a 1.5 hour workshop. Multiple identical sessions were held in RM&E of KH. To maximize effective learning, each workshop was limited to 8 PCAs. Each workshop consisted of two concurrent stations which covered three parts: 1. Knowledge assessment. 2. Skills demonstration in performing special round such as to maintain a safe environment, observation, checking and asking about the needs of the patients. 3. Skills assessment through various scenarios. After each scenario, a debriefing session allowed PCAs to discuss what had happened in different scenarios. After the workshop, an evaluation form was given to collect feedback from PCAs about the simulation workshop.
Result & Outcome :
Results:
During the period of 11/2018 to 01/2019, a total of 11 identical fall prevention training workshops were conducted with 54 PCAs attended which contributed 96.4% of staff workforce. A total of 54 evaluation forms were returned. Positive feedback received with 100% of PCAs evaluating that the objectives of the workshop were clearly achieved. 98.15% of PCAs agreed that the method of teaching (simulation training) has enhanced the maximum learning and 96.29% of PCA agreed the content of workshop was applicable
and useful to their clinical practice. Through the debriefing session, the PCAs could reflect on their performance and conceptualized what they had learnt from the scenarios so that they could apply it in the daily operation.
Before the simulation training started, from May 2017 to Oct 2018, there were 75 fall incidents in RM&E and the monthly number of patient fall incidents was 4.16. But it decreased to 1.83, a 56% reduction in the monthly patient fall incident from November 2018 to April 2019 (i.e. during and after the training). Besides, the patient fall rate in RM&E was reduced from 0.52 to 0.21 in the same period which was a 59.6% reduction. Further, the patient fall rate in RM&E (0.21) compared favorably with that of KH which was 0.37 from November 2018 to April 2019. Furthermore, the patient fall rate in RM&E also compared favorably with HA Group 2 hospitals which was 0.45 in 4Q 2018 and 0.44 in 1Q 2019.
Conclusion:
In conclusion, the simulation training on patient fall prevention demonstrated an effective training modality in raising staff awareness of patient fall prevention which was associated with a reduction of fall rate in RM&E, KH.
