Authors (including presenting author) :
Lee WM, Li KY, Leung CCA, Wong YW, Mo YTF, Chu CK, Chan HYY
Affiliation :
Palliative Care Ward, Department of Rehabilitation and Extended Care, TWGHs Wong Tai Sin Hospital
Introduction :
Patient fall is a leading cause of hospital-acquired injury. It will affect patient’s physical and psychological impact resulting in pain, dependency, reduce quality of life and/or even life threatening. Palliative care ward of TWGHs Wong Tai Sin Hospital found that fall incident rate was increased from 1.3 in October 2018 to 8.22 in November 2018 according to CND Fall Incident Rate. Hence, patient fall was classified as the TOP priority risk. To tackle the issue, SMART fall prevention management project was launched in December 2018.
Objectives :
1. Decrease patient fall incident rate 2. Review current practice on fall prevention management 3. Introduce new preventive initiatives
Methodology :
1.SHARE: Share patient fall incident rate/cases by NO/APN with nurses and supporting staff in a monthly basis. 2.MEASURES: Continue existing fall preventive measures, in addition, new initiatives e.g. fall alarm pad and safety round were introduced. 3.ALERT: For those high-risk case (with Morse Fall Scale > / = 45), special signage was displayed in front of the bed head to alert all nursing staff. Fall prevention leaflet was circulated among patient / family members with relevant explanation and education. Regular performance & compliance check was conducted by NO/APN. 4.ROUND: New initiatives on safety round were started in January 2019. Supporting staff conducted four rounds per shift to observe, inspect and attend patient needs. Education sessions were provided to supporting staff in order to standardize the workflow of the safety round. 5.TEAM: The fall prevention team was formed in Dec 2018 to review, plan, promulgate, reinforce & monitor the fall assessment, prevention and management. Communication among nurses, nursing trainees and supporting staff on fall preventive measures were conducted by fall prevention team members regularly.
Result & Outcome :
After the project launched, there was a significant decrease in fall case reported by the end of June 2020. The fall incident rate was dropped to 0.68 (average of quarter fall incidence rate). It implicated that the SMART project had been successfully implemented in the palliative care ward. The preliminary result also revealed that the project was a success in decreasing the fall cases. It is suggested that regular monitoring of the project will be an ongoing initiative, also to examine the effectiveness of the new preventive measures and sustain the compliance of safety round.
