2.50
Hdl Handle:
http://hdl.handle.net/10755/162402
Type:
Presentation
Title:
How Do EDÆs Compare When Trying to Catch a Falling Star
Abstract:
How Do EDÆs Compare When Trying to Catch a Falling Star
Conference Sponsor:Emergency Nurses Association
Conference Year:2010
Author:Robin, Nancy M., RN, M.Ed., CEN
P.I. Institution Name:The Miriam Hospital
Title:ED Nurse Educator
Contact Address:164 Summit Avenue, Providence, RI, 02906, USA
Contact Telephone:401-793-3339
Co-Authors:Darcy Abbott RN, MS, CEN; Denise Brennan RN, MSN
[ENA Annual Conference - Evidence-based Practice Presentation]

Purpose: The National Patient Safety Goal 09.02.01 asked organizations to implement a fall reduction program and evaluate the program. Inpatient nursing collected and reported data based on falls per 1000 patient days. This Emergency Department wanted to see how its number of falls compared to other emergency departments and implement a fall reduction program.

Design: This was a quality assurance project

Setting: Teaching, urban emergency department with 50,000 annual visits

Participants: The ED Director, Nurse Manager and Nurse Educator began to review data. The data was presented it to the hospital's emergency department quality assurance committee.

Methods: A quality indicator needed to be established. Initial fall data was collected in the ED during the October 1, 2007 to September 30, 2008. There were twenty six falls that occurred during this time. The question of setting a goal and threshold was raised. How did this compare to other emergency departments? A literature search was done which revealed that very little comparison data was available. The Emergency Nurse Association 2005 National Emergency Department Benchmark Guide did not have benchmark data for comparison. There was resistance of local emergency departments to share their fall data. The ENA Educators list serve was polled to see if this information could be shared. Five emergency departments under anonymity were willing to share this information. The five emergency departments ranged in annual visits from 24,976 to 70,007 with falls varying from one to sixteen. It was important to establish a method for comparison. Since nothing had been previously mentioned in the literature, falls per 10,000 visits was selected. The average falls per 10,000 visits in this limited sample was 2.82 falls per 10,000 visits. This hospital's ED fall rate was 5.1 per 10,000 visits. Improvements were needed. This hospital ED began by including a fall risk assessment on every patient who presented to the ED. This screening was added to our electronic medical record. Patients were assessed for risk. Those without elevated risk were placed on universal fall precautions. Those who had met any of the criteria for increased risk were placed on elevated risk precautions. Interventions were then initiated that ranged from toileting at frequent intervals to involving a geri-psych nurse consult. This documentation was available at all hand-offs.

Results/Outcomes: Fall data was collected monthly and reviewed at the ED quality assurance committee meeting. Monthly percentages were calculated per 10,000 visits. A target of <4 was set. With interventions in place, fall data for October 1, 2008 to September 1, 2009 showed that this hospital's falls per 10,000 visits reflected 2.30. This was vastly improved from the initial 5.1 falls per 10,000 visits and slightly better than the benchmark of 2.82

Implications: With annual census changing, it is important to have a valid means of evaluation. As emergency departments, it is also important to benchmark with other ED's. ED's need to be more transparent so best practices can be shared.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleHow Do EDÆs Compare When Trying to Catch a Falling Staren_GB
dc.identifier.urihttp://hdl.handle.net/10755/162402-
dc.description.abstract<table><tr><td colspan="2" class="item-title">How Do ED&AElig;s Compare When Trying to Catch a Falling Star</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Robin, Nancy M., RN, M.Ed., CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">The Miriam Hospital</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">ED Nurse Educator</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">164 Summit Avenue, Providence, RI, 02906, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">401-793-3339</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">nrobin@lifespan.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Darcy Abbott RN, MS, CEN; Denise Brennan RN, MSN</td></tr><tr><td colspan="2" class="item-abstract">[ENA Annual Conference - Evidence-based Practice Presentation] <br/><br/>Purpose: The National Patient Safety Goal 09.02.01 asked organizations to implement a fall reduction program and evaluate the program. Inpatient nursing collected and reported data based on falls per 1000 patient days. This Emergency Department wanted to see how its number of falls compared to other emergency departments and implement a fall reduction program.<br/><br/>Design: This was a quality assurance project<br/><br/>Setting: Teaching, urban emergency department with 50,000 annual visits<br/><br/>Participants: The ED Director, Nurse Manager and Nurse Educator began to review data. The data was presented it to the hospital's emergency department quality assurance committee.<br/><br/>Methods: A quality indicator needed to be established. Initial fall data was collected in the ED during the October 1, 2007 to September 30, 2008. There were twenty six falls that occurred during this time. The question of setting a goal and threshold was raised. How did this compare to other emergency departments? A literature search was done which revealed that very little comparison data was available. The Emergency Nurse Association 2005 National Emergency Department Benchmark Guide did not have benchmark data for comparison. There was resistance of local emergency departments to share their fall data. The ENA Educators list serve was polled to see if this information could be shared. Five emergency departments under anonymity were willing to share this information. The five emergency departments ranged in annual visits from 24,976 to 70,007 with falls varying from one to sixteen. It was important to establish a method for comparison. Since nothing had been previously mentioned in the literature, falls per 10,000 visits was selected. The average falls per 10,000 visits in this limited sample was 2.82 falls per 10,000 visits. This hospital's ED fall rate was 5.1 per 10,000 visits. Improvements were needed. This hospital ED began by including a fall risk assessment on every patient who presented to the ED. This screening was added to our electronic medical record. Patients were assessed for risk. Those without elevated risk were placed on universal fall precautions. Those who had met any of the criteria for increased risk were placed on elevated risk precautions. Interventions were then initiated that ranged from toileting at frequent intervals to involving a geri-psych nurse consult. This documentation was available at all hand-offs.<br/><br/>Results/Outcomes: Fall data was collected monthly and reviewed at the ED quality assurance committee meeting. Monthly percentages were calculated per 10,000 visits. A target of &lt;4 was set. With interventions in place, fall data for October 1, 2008 to September 1, 2009 showed that this hospital's falls per 10,000 visits reflected 2.30. This was vastly improved from the initial 5.1 falls per 10,000 visits and slightly better than the benchmark of 2.82<br/><br/>Implications: With annual census changing, it is important to have a valid means of evaluation. As emergency departments, it is also important to benchmark with other ED's. ED's need to be more transparent so best practices can be shared.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:27:36Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:27:36Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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