2.50
Hdl Handle:
http://hdl.handle.net/10755/182495
Category:
Abstract
Type:
Presentation
Title:
Safety Intervention Model Targeting Fall Prevention
Author(s):
Haviley, Corinne; Payson, Carol
Author Details:
Corinne Haviley, RN, MS, Northwestern Memorial Hospital, Chicago, Illinois, USA, email: chaviley@nmh.org; Carol Payson, RN, MSN, CNA, B
Abstract:
Podium Presentation: BRIEF DESCRIPTION: Eliminating sitters or non-licensed care providers as a means to prevent falls lead a large academic hospital to incorporate safety strategies into a model of care emphasizing critical thinking related to the assessment and treatment of patients with acute mental status changes, decreased mobility and potential medication interactions. ABSTRACT: The purpose of this project was to determine evidence based interventions to prevent falls in high/low risk patients within a large academic hospital. Sitter or non-licensed care providers had been used as one historical means to prevent patient injury. Sitter utilization had increased by 30 % over the past three years without an associated decrease in patient falls. A pilot study was trialed in July and August 07, eliminating sitter use on four inpatient medicine units targeting all patients except those at risk for suicide/homicide and severe alcohol withdrawal. A safety intervention model was developed based upon learning from root cause analyses on patients who fell with injury and best practice published in the literature. The model included a resource guide to assist nursing/physician staff with suggested critical thinking focusing upon identification and treatment strategies for patients at risk for falls, elopement and medical device pulling. Additionally, safety huddles, reinforcement of hourly rounding including the 3 P's (potty, positioning and pain control), bed alarm utilization, and family member involvement were incorporated into the model. Initial study results indicated a successful reduction in sitter use without an increase in restraint use or fall incidence. The model was subsequently rolled out hospital wide in October of 07. Outcomes indicated a decrease in sitter utilization in the hospital from 42.7 FTE's in June 07 to 8.3 FTE's in December 07; the fall rate decreased from 3.2 in June 07 to 1.8 in December 07 and there have been no reportable falls with injury after the hospital adoption of the model. Next steps include incorporation of the evidence based Confusion Assessment Method (CAM) tool into the electronic medical record to assist staff with the assessment of acute altered mental status changes, a detailed mobility assessment tool and forcing functions to identify potential medication interactions that may lead to increased patient risk. Comparison data will be collected to determine the effectiveness of documentation tools and practice outcomes. REFERENCES: Folstein and Folstein. Confusion Assessment Method (CAM) Inouy, S.K., Van Dyck, C.H., Alessi, C.A., Balkin, S., Siegel, A.P., and Horwitz, R.I. (1990). Clarifying Confusion: The Confusion Assessment Method A New Method for Detection of Delirium. American College of Physicians, 113, 941-948. Inouye, S, "The Hospital Elder Life Program: Background and Overview" Yale University School of Medicine, 2000.2. Meade C., Bursell, A., Ketelsen, L., "Effects of Nursing Rounds on Patients' Call Light Use, Satisfaction and Safety". American Journal of Nursing, September 2008, Vol, 106, No. 9.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2008
Conference Name:
ANCC National Magnet Conference
Conference Host:
American Nurses Credentialing Center
Conference Location:
Salt Lake City, Utah, USA
Description:
The 12th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 15-17 October, 2008 in Salt Lake City, Utah, USA.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleSafety Intervention Model Targeting Fall Preventionen_GB
dc.contributor.authorHaviley, Corinneen_US
dc.contributor.authorPayson, Carolen_US
dc.author.detailsCorinne Haviley, RN, MS, Northwestern Memorial Hospital, Chicago, Illinois, USA, email: chaviley@nmh.org; Carol Payson, RN, MSN, CNA, Ben_US
dc.identifier.urihttp://hdl.handle.net/10755/182495-
dc.description.abstractPodium Presentation: BRIEF DESCRIPTION: Eliminating sitters or non-licensed care providers as a means to prevent falls lead a large academic hospital to incorporate safety strategies into a model of care emphasizing critical thinking related to the assessment and treatment of patients with acute mental status changes, decreased mobility and potential medication interactions. ABSTRACT: The purpose of this project was to determine evidence based interventions to prevent falls in high/low risk patients within a large academic hospital. Sitter or non-licensed care providers had been used as one historical means to prevent patient injury. Sitter utilization had increased by 30 % over the past three years without an associated decrease in patient falls. A pilot study was trialed in July and August 07, eliminating sitter use on four inpatient medicine units targeting all patients except those at risk for suicide/homicide and severe alcohol withdrawal. A safety intervention model was developed based upon learning from root cause analyses on patients who fell with injury and best practice published in the literature. The model included a resource guide to assist nursing/physician staff with suggested critical thinking focusing upon identification and treatment strategies for patients at risk for falls, elopement and medical device pulling. Additionally, safety huddles, reinforcement of hourly rounding including the 3 P's (potty, positioning and pain control), bed alarm utilization, and family member involvement were incorporated into the model. Initial study results indicated a successful reduction in sitter use without an increase in restraint use or fall incidence. The model was subsequently rolled out hospital wide in October of 07. Outcomes indicated a decrease in sitter utilization in the hospital from 42.7 FTE's in June 07 to 8.3 FTE's in December 07; the fall rate decreased from 3.2 in June 07 to 1.8 in December 07 and there have been no reportable falls with injury after the hospital adoption of the model. Next steps include incorporation of the evidence based Confusion Assessment Method (CAM) tool into the electronic medical record to assist staff with the assessment of acute altered mental status changes, a detailed mobility assessment tool and forcing functions to identify potential medication interactions that may lead to increased patient risk. Comparison data will be collected to determine the effectiveness of documentation tools and practice outcomes. REFERENCES: Folstein and Folstein. Confusion Assessment Method (CAM) Inouy, S.K., Van Dyck, C.H., Alessi, C.A., Balkin, S., Siegel, A.P., and Horwitz, R.I. (1990). Clarifying Confusion: The Confusion Assessment Method A New Method for Detection of Delirium. American College of Physicians, 113, 941-948. Inouye, S, "The Hospital Elder Life Program: Background and Overview" Yale University School of Medicine, 2000.2. Meade C., Bursell, A., Ketelsen, L., "Effects of Nursing Rounds on Patients' Call Light Use, Satisfaction and Safety". American Journal of Nursing, September 2008, Vol, 106, No. 9.en_GB
dc.date.available2011-10-28T15:26:46Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T15:26:46Z-
dc.conference.date2008en_US
dc.conference.nameANCC National Magnet Conferenceen_US
dc.conference.hostAmerican Nurses Credentialing Centeren_US
dc.conference.locationSalt Lake City, Utah, USAen_US
dc.descriptionThe 12th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 15-17 October, 2008 in Salt Lake City, Utah, USA.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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