8.00
Hdl Handle:
http://hdl.handle.net/10755/344142
Category:
Abstract
Type:
Poster
Title:
Catching the ED Patient Before They Fall
Author(s):
Bayly, Charles; Boelstler, Arlene
Lead Author STTI Affiliation:
Non-member
Author Details:
Charles Bayly, RN, charles.bayly@stjohn.org; Arlene Boelstler, MA, BSN, RN
Abstract:
Evidence-based Practice Abstract Purpose: The purpose of this project was to improve the safety of our patients by identifying those at risk for falls at the arrival to our Emergency Department (ED). Early detection of fall risk patients can assist in maintaining the safety of the patient in the ED. Utilizing the Hendrich II scale, purposeful rounding and creating specific interventions for fall risks we were able to create a culture of safety for our patients. Design: A team was formed of clinical ED staff for process improvement of identified fall risk patients and specific guidelines for the care of the fall risk patient. This team worked collaboratively to initiate early recognition and interventions for the patient at risk for falls. Setting: The hospital is a 772-bed teaching hospital in Detroit. The ED treats approximately 117,000 patients annually, is a Level ll Trauma Center, Chest Pain Accredited and Stroke Certified as a primary stroke center. Participants/Subjects: The patients included in the project involve both male and female patients from our pediatric and adult patient population. Methods: Well-defined guidelines were developed for the fall-risk patient and multiple fall risk champions were utilized. The fall risk champions collected and tallied all the fall risk data to look for trends regarding certain patient populations that were at risk for falls and possible interventions to assist in the care of the patients. After careful evaluation of the data we developed guidelines for the patients in the ED at risk for falls. The RN performs a Hendrich II assessment on every patient that arrives to the ED; if the patient is at risk, a sign noting: “I Require Intense Surveillance (IRIS)”, yellow socks, a yellow arm band, and a fall risk icon on the electronic tracking board are initiated for the patient. In collecting our data on falls we realized that there was also a pattern of behaviors that patients exhibited that made them more vulnerable to falls and the majority of the falls were toileting needs. With this information we created specific interventions. Patients with ETOH intoxication, overdose, behavioral health and altered mental status are placed near a nursing desk, at all times or with a sitter/video monitor to ensure their safety. We also initiated purposeful hourly rounding in August 2013 which allows for toileting questions every hour. Twice daily huddles were also initiated with all staff identifying those patients at risk for fall, as well as, standardized debriefing after each fall to determine what could have been done to prevent the fall from occurring. Results/Outcomes: Data was collected regarding falls after education and initiation of purposeful hourly rounding. Prior to education July had 7 falls, since then Aug-Dec 2013 total of 8 falls. Implications: A consistent approach to fall risk patients was utilized and specific interventions established with purpose for each encounter. We will continue to monitor and educate staff on the importance of fall safety.
Keywords:
Patient safety; Fall risk at ED arrival
Repository Posting Date:
4-Feb-2015
Date of Publication:
4-Feb-2015
Conference Date:
2014
Conference Name:
2014 ENA Annual Conference
Conference Host:
Emergency Nurses Association
Conference Location:
Indianapolis, Indiana, U.S.A.
Description:
2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Center
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.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePosteren_GB
dc.titleCatching the ED Patient Before They Fallen_GB
dc.contributor.authorBayly, Charlesen_GB
dc.contributor.authorBoelstler, Arleneen_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsCharles Bayly, RN, charles.bayly@stjohn.org; Arlene Boelstler, MA, BSN, RNen_GB
dc.identifier.urihttp://hdl.handle.net/10755/344142-
dc.description.abstractEvidence-based Practice Abstract Purpose: The purpose of this project was to improve the safety of our patients by identifying those at risk for falls at the arrival to our Emergency Department (ED). Early detection of fall risk patients can assist in maintaining the safety of the patient in the ED. Utilizing the Hendrich II scale, purposeful rounding and creating specific interventions for fall risks we were able to create a culture of safety for our patients. Design: A team was formed of clinical ED staff for process improvement of identified fall risk patients and specific guidelines for the care of the fall risk patient. This team worked collaboratively to initiate early recognition and interventions for the patient at risk for falls. Setting: The hospital is a 772-bed teaching hospital in Detroit. The ED treats approximately 117,000 patients annually, is a Level ll Trauma Center, Chest Pain Accredited and Stroke Certified as a primary stroke center. Participants/Subjects: The patients included in the project involve both male and female patients from our pediatric and adult patient population. Methods: Well-defined guidelines were developed for the fall-risk patient and multiple fall risk champions were utilized. The fall risk champions collected and tallied all the fall risk data to look for trends regarding certain patient populations that were at risk for falls and possible interventions to assist in the care of the patients. After careful evaluation of the data we developed guidelines for the patients in the ED at risk for falls. The RN performs a Hendrich II assessment on every patient that arrives to the ED; if the patient is at risk, a sign noting: “I Require Intense Surveillance (IRIS)”, yellow socks, a yellow arm band, and a fall risk icon on the electronic tracking board are initiated for the patient. In collecting our data on falls we realized that there was also a pattern of behaviors that patients exhibited that made them more vulnerable to falls and the majority of the falls were toileting needs. With this information we created specific interventions. Patients with ETOH intoxication, overdose, behavioral health and altered mental status are placed near a nursing desk, at all times or with a sitter/video monitor to ensure their safety. We also initiated purposeful hourly rounding in August 2013 which allows for toileting questions every hour. Twice daily huddles were also initiated with all staff identifying those patients at risk for fall, as well as, standardized debriefing after each fall to determine what could have been done to prevent the fall from occurring. Results/Outcomes: Data was collected regarding falls after education and initiation of purposeful hourly rounding. Prior to education July had 7 falls, since then Aug-Dec 2013 total of 8 falls. Implications: A consistent approach to fall risk patients was utilized and specific interventions established with purpose for each encounter. We will continue to monitor and educate staff on the importance of fall safety.en_GB
dc.subjectPatient safetyen_GB
dc.subjectFall risk at ED arrivalen_GB
dc.date.available2015-02-04T11:27:14Z-
dc.date.issued2015-02-04-
dc.date.accessioned2015-02-04T11:27:14Z-
dc.conference.date2014en_GB
dc.conference.name2014 ENA Annual Conferenceen_GB
dc.conference.hostEmergency Nurses Associationen_GB
dc.conference.locationIndianapolis, Indiana, U.S.A.en_GB
dc.description2014 ENA Annual Conference Theme: Safe Practice, Safe Care. Held at the Indiana Convention Centeren_GB
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.en_GB
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