Fall Risk Prevention Team Kelly Chadnick Michelle Elsener

Fall Risk Prevention Team Kelly Chadnick, Michelle Elsener, Jessica Spiridigliozzi, Kelli Licursi, Hope Tralli, Rina Tomanelli, Shanique Amaning, Brianna Appel Pace University Lienhard School of Nursing ABSN BACKGROUND • According to the CDC, falls are the leading cause of fatal and non-fatal injuries among patients 65 and older, and 10, 000 people in the United States turn 65 everyday (2016. ) • Consequences (CDC, 2016): • Increased length of stay • Increased cost • Unnecessary burden on the patient, provider, and hospital POPULATION INTERVENTION COMPARISON OUTCOME (PICO) • Evidence shows that there is much in store for the future of fall risk prevention in the clinical setting. This research supports the use of patient and nursing education to increase patient safety (Lee, Pritchard, Mc. Dermott, For patients 65 years and older, what is the effect of the fall prevention team on fall rate occurrence in an acute care setting, as compared to standard practice. • The evidence regarding this topic indicates that interventions have been put in place to reduce falls but have been mainly unsuccessful in the long term (Spiva, Robertson, Delk, Patrick, Kimrey, Green, Gallagher, 2014). • Multidisciplinary programs and engagement of nurses are found to decreases the prevalence of falls (Nuckols, Needleman, Grogan, Liang, Worobel-Luk, Anderson, . . . Walsh, 2017). EVALUATION PURPOSE • By comparing statistics monthly, the data can be evaluated to see if the goal is being met. A t-test will be completed to measure and evaluate the collected data. • The never event of “Patient death or serious injury associated with a fall while being cared for in a health care setting. ” is the main focus of this study. SEARCH STRATEGIES AND LITERATURE REVIEW • Evidence was obtained through search engines such as CINAHL, Pub. Med, and Google Scholar, where we obtained research articles and systematic reviews. MAJOR EBP RECOMMENDATIONS • According to the CDC, “In 2015 the total medical cost for falls totaled more than $50 billion”. Due to rising costs, the need for a fall risk prevention team is crucial to ensure patient safety. • There is a direct correlation between staffing communication and falls. The purpose of the FRP Team and the anticipated outcome is to develop a declining trend of inpatient falls. • The data will be collected once an incident report is completed, explaining the accident that occurred. • Universal staff education, will increase knowledge, awareness, skillfulness, and organization among nurses and other hospital staff. • BMAT is a type of communication (assessment tool) to determine patient’s risk for falls. Each level is associated with a list that determines the type of care that the patient would require that is universal across all shifts. • If the fall rate increased, proper implementation must take place and protocols will be adjusted. • Successful falls prevention strategies included staff education about the fall-injury risk assessment tool, post-fall assessments, alarm device usage, side effects of medications, hourly rounding, and offering toileting frequently” (Tzeng & Yin, 2012. ) PROPOSED PRACTICE CHANGES • The practice being proposed is the implementation of a fall risk prevention team that incorporates all members in a hospital. • We limited the search by, date within the last 5 years, specific journal types, MESH, age, and the English language. Some of the key words that we used in our search were: • Geriatrics • Prevention • Falls • Education • Acute and intervention • It is the fall risk prevention team’s responsibility to educate the nursing staff and ensure that all of the staff is following through with the hospitals policies. • Studies were chosen if they included research on fall education within the staffing team and how it impacts the rate of falls. We also included studies that measure the impact of a variety of different interventions on fall rates within the acute care setting. • • Once acquired, the information will be kept on file and evaluated to determine the rate of falls per year. • We obtained the clinical care guidelines for fall prevention from the AHRQ website. • We located 18 articles that included two systematic reviews, one clinical practice guideline, and the rest are research articles. • While there is still so much more room for improvement in terms of patient safety, the FRP team is a proactive step in the right direction (Godlock, • The active process to ensure patient safety is one of trial and error that is most effective when involving a multidisciplinary approach (Tzeng & Yin, 2014). • In-hospital fall injuries can add up to 6. 3 days to a patient’s hospital stay and the average cost for a fall with an injury is $14, 000 dollars (Joint Commission, 2015. ) • The goal of the PICO is to reduce the rate of falls through the implementation of interdisciplinary staff education; as well as, promotion of better, more frequent staff communication regarding falls and fall risk. Haines, 2014). Christiansen, Fieder, 2016). • According to the Joint Commission, in the U. S hundreds of thousands of patients fall in hospitals and 30 -50% result in injuries (Joint Commission, 2015. ) • Falls can be prevented through proper education and communication. REVIEW OF LITERATURE • • • At orientation, each staff member, whether it be a nurse, doctor, or ancillary staff, will have go through a technological based interactive learning module before starting at the facility. The current faculty will be required to complete the modules once a year in order to keep up with their certification on fall prevention education. These modules are meant to keep the nurses up to date with the new polices and statistics on falls. • The reason for the falls, the risk of the patients, and safety measures must be evaluated. • Following thorough data analysis, the FRP Team will have a designated meeting to discuss the findings and determine a plan to fix the corresponding issue. REFERENCES 1. CDC (2016) Cost of falls for older adults. (2016, August 19) Retrieved March 20 th, 2018, LEVEL II 2. CDC (2017) Important facts about falls. (2017, February 10). Retrieved March 17, 2018, LEVEL I 3. Godlock, G. , Christiansen, M. , Fieder, L. (2016). Implementation of an evidence-based patient safety team to prevent falls in inpatient medical units. Continuous Quality Improvement, 25(1), 17 -23. –Level VI 3. Joint Commission (2015). Preventing falls and fall-related injuries in health care facilities. Sentinel Event Alert, 55 (1 -5). LEVEL I 4. Lee, D. A. , Pritchard, E. , Mc. Dermott, F. , Haines, T. P. (2014). Falls prevention education for older adults during and after hospitalization: A systematic review and meta-analysis. Health Education Journal, 73(5), 530 -544. Level V Each unit will have a “champion”. The champion’s role is to educate the staff members on the polices and risks for falls. Every morning before the shift change, there will be morning “huddles”. In the huddles, nurses and staff will discuss any incidents from the shift regarding falls or simply to discuss the high risk fall patients on the floor. There will also be post-fall huddles after every fall that does occur. This intervention will help with the communication between each team of nurses as well as the other staff on that floor. 5. Nuckols, T. K. , Needleman, J. , Grogan, T, R. , Liang, L. , Worobel-Luk, P. , Anderson, L. . Walsh, C. M. (2017). Clinical effectiveness and cost of a hospital-based fall prevention intervention: The importance of time nurses spend on the front line of implementation. The Journal of Nursing Administration, 47, 571 -580. Level III 6. Spiva, L. , Robertson, B. , Delk, M. L. , Patrick, S. , Kimrey, M. M. , Green, B. , Gallagher, E. (2014). Effectiveness of team training on fall prevention. Journal of Nursing Care Quality, 29(2), 164 -173. Level IV 7. . Tzeng, H. , & Yin, C. (2014). Most and least helpful aspects of fall prevention education to prevent injurious falls: A qualitative study on nurses’ perspectives. Journal of Clinical Nursing, 23(17/18), 2676 -2680. Level II