2.50
Hdl Handle:
http://hdl.handle.net/10755/162671
Type:
Presentation
Title:
Development of a Fall Prevention Strategy for the Emergency Department
Abstract:
Development of a Fall Prevention Strategy for the Emergency Department
Conference Sponsor:Emergency Nurses Association
Conference Year:2007
Author:Ross, Mary J., RN, BSN, CEN
P.I. Institution Name:Clarian Health Partners/Methodist Hospital of Indiana
Title:Senior Partner, ED Charge Nurse, Safe Passage Committee Chairperson
Contact Address:1701 N. Senate Blvd., Indianapolis, IN, 46202, USA
Contact Telephone:(317) 962-8880
Co-Authors:Beverly K. Giles, RN; Mary K. Hendershot, RN, MSN
[Clinical Poster] Clinical Topic: Reducing the risk of harm from patient falls has been a JCAHO National Patient Safety Goal (NPSG) since 2005. With the 2006 NPSGs, the implementation of a fall reduction program was mandated. Studies of falls in the inpatient setting are common, but very little literature exists on identifying fall risks in outpatient settings. The goals of this project were to: 1) identify emergency department (ED) patients at highest risk of falling; 2) increase ED nurses' awareness of patients at increased risk of falling; and 3) develop a plan for ED patient fall reduction.

Implementation: A retrospective review of ED records and incident reports for all falls that occurred in the emergency department between October 1, 2003 and September 30, 2005 was conducted. This institution uses the Hendrich-II (H-II) scale to evaluate the fall risk of all inpatients. The H-II scale measures eight separate risk factors as a means of identifying patients at high risk of falling, and has been shown to have 74.9% sensitivity and 73.9% specificity in the inpatient setting. These risk factors are: confusion, depression, altered elimination, dizziness, gender, prescribed antiepileptics or benzodiazepines, and altered mobility. ED records were audited and, retrospectively, the H-II risk criteria were applied to this same group. In addition to collecting the H-II data, an attempt was made to identify other potential common factors among the ED patients that might have signaled a higher risk of falling.

Outcomes: A total of 56 patient records (57 falls) were reviewed. The average age of the ED fall patient was 50.3 years and 66% were male. 66% (37/56) were admitted to the hospital, unrelated to their fall. 55% of patients arrived in the ED intoxicated or received potentially sedating medications during their visit. 34% sustained minor injuries related to their ED fall. The H-II scale correctly identified only 37.5% of these ED fall patients. The most common predictors identified by the H-II scale among ED fall patients were gender (male) and confusion. It should be noted that this study was limited by its retrospective design, as the H-II scale is always administered interactively at the bedside. Study results were disseminated to ED staff via staff meetings, email, and unit posters. A fall reduction plan was developed and implemented: 1) identify fall risks: confused, disoriented, intoxicated/medicated, and acutely ill/likely admissions; 2) communicate the identified risk to all ED staff, the patient, and their family: development of "fall risk" signs to be posted in rooms and an icon to be launched beside the patient's name on the electronic tracking board. Red slippers are provided to fall risk patients; 3) implement "common sense" safety precautions: assist patients to the bathroom, use side rails when appropriate, make call lights available. The use of the signs and tracking board icons is slowly being adopted by the ED staff, but the red slippers have been wholeheartedly embraced. As a result of their success in the ED, red slippers for fall-risk patients has recently become the standard for all nursing units across our 3-hospital system.

Recommendations: The uniqueness of the ED patient population, when compared to the inpatient population requires a modification in the methods used to identify those at high risk of falling. The strategies used in this emergency department to identify and communicate fall risks can be implemented in other emergency departments, to increase patient safety and prevent undesirable outcomes. ED patient falls are continually monitored with monthly feedback provided to staff on the effectiveness of the fall reduction program.
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.titleDevelopment of a Fall Prevention Strategy for the Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162671-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Development of a Fall Prevention Strategy for the Emergency Department</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">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Ross, Mary J., RN, BSN, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Clarian Health Partners/Methodist Hospital of Indiana<br/></td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Senior Partner, ED Charge Nurse, Safe Passage Committee Chairperson</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1701 N. Senate Blvd., Indianapolis, IN, 46202, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(317) 962-8880</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">mjross@clarian.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">Beverly K. Giles, RN; Mary K. Hendershot, RN, MSN</td></tr><tr><td colspan="2" class="item-abstract">[Clinical Poster] Clinical Topic: Reducing the risk of harm from patient falls has been a JCAHO National Patient Safety Goal (NPSG) since 2005. With the 2006 NPSGs, the implementation of a fall reduction program was mandated. Studies of falls in the inpatient setting are common, but very little literature exists on identifying fall risks in outpatient settings. The goals of this project were to: 1) identify emergency department (ED) patients at highest risk of falling; 2) increase ED nurses' awareness of patients at increased risk of falling; and 3) develop a plan for ED patient fall reduction. <br/><br/>Implementation: A retrospective review of ED records and incident reports for all falls that occurred in the emergency department between October 1, 2003 and September 30, 2005 was conducted. This institution uses the Hendrich-II (H-II) scale to evaluate the fall risk of all inpatients. The H-II scale measures eight separate risk factors as a means of identifying patients at high risk of falling, and has been shown to have 74.9% sensitivity and 73.9% specificity in the inpatient setting. These risk factors are: confusion, depression, altered elimination, dizziness, gender, prescribed antiepileptics or benzodiazepines, and altered mobility. ED records were audited and, retrospectively, the H-II risk criteria were applied to this same group. In addition to collecting the H-II data, an attempt was made to identify other potential common factors among the ED patients that might have signaled a higher risk of falling. <br/><br/>Outcomes: A total of 56 patient records (57 falls) were reviewed. The average age of the ED fall patient was 50.3 years and 66% were male. 66% (37/56) were admitted to the hospital, unrelated to their fall. 55% of patients arrived in the ED intoxicated or received potentially sedating medications during their visit. 34% sustained minor injuries related to their ED fall. The H-II scale correctly identified only 37.5% of these ED fall patients. The most common predictors identified by the H-II scale among ED fall patients were gender (male) and confusion. It should be noted that this study was limited by its retrospective design, as the H-II scale is always administered interactively at the bedside. Study results were disseminated to ED staff via staff meetings, email, and unit posters. A fall reduction plan was developed and implemented: 1) identify fall risks: confused, disoriented, intoxicated/medicated, and acutely ill/likely admissions; 2) communicate the identified risk to all ED staff, the patient, and their family: development of &quot;fall risk&quot; signs to be posted in rooms and an icon to be launched beside the patient's name on the electronic tracking board. Red slippers are provided to fall risk patients; 3) implement &quot;common sense&quot; safety precautions: assist patients to the bathroom, use side rails when appropriate, make call lights available. The use of the signs and tracking board icons is slowly being adopted by the ED staff, but the red slippers have been wholeheartedly embraced. As a result of their success in the ED, red slippers for fall-risk patients has recently become the standard for all nursing units across our 3-hospital system. <br/><br/>Recommendations: The uniqueness of the ED patient population, when compared to the inpatient population requires a modification in the methods used to identify those at high risk of falling. The strategies used in this emergency department to identify and communicate fall risks can be implemented in other emergency departments, to increase patient safety and prevent undesirable outcomes. ED patient falls are continually monitored with monthly feedback provided to staff on the effectiveness of the fall reduction program.</td></tr></table>en_GB
dc.date.available2011-10-27T10:32:10Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:32:10Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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