General Fall Prevention

Transcription

1 Slide 1 General Fall Prevention Determining Risk, Implementing Interventions and Managing Falls Senior Vice President of Patient Care Services Hello, I am Anne Panik, Senior Vice President of Patient Care Services for Lehigh Valley Health Network. I am pleased to provide the introduction to the Fall Prevention annual training course. Fall prevention continues to demand much attention in our network. Our inpatients incurred 906 falls, 11 of which were serious. In our outpatient areas, the total number of falls was 481. Some clinical units were successful in reaching our goal of either a 10% reduction in their fall rate or a 10% reduction in the total number of falls. Congratulations to these units! I think we are all motivated to achieve the reduction goal for FY 13. How can this happen? When we are engaged with our colleagues to: promote patient safety, provide accurate assessment, communicate clearly to all involved care givers, and implement interventions that meet and are individualized to the patient needs, then we improve our opportunity to reduce falls. Am I forgetting to share anything? Yes: the patient and their family! We must engage in meaningful and timely education to the patient about what factors put them at risk for a fall. To make this meaningful, we must be sure to reinforce this education as well as explain what interventions we have implemented to keep them safe; and then we must assess how well the patient understands what we have taught. Please remember, if we are unable to partner with the patient and he/she refuses to accept our interventions, document that refusal in the medical record. This module will explain our best practice and our fall prevention program at LVHN. Please learn how keeping our patients safe from falls and any injury from a fall will help you to Be at Your Best.

2 Slide 2 General Fall Prevention Determining Risk, Implementing Interventions and Managing Falls Engage with our colleagues to: Please promote remember, patient safety, if we are unable to FY12 provide accurate assessment, Please We partner must learn with engage the how patient keeping meaningful and our he/she patients and communicate Inpatients 906clearly falls to all involved safe timely refuses care from education - 11 givers, to falls accept and to our any the interventions, injury patient from about a fall were serious will what document implement help factors you that put to interventions refusal Be them at Your at risk the that Best. medical for meet a fall. and Outpatients are individualized 481 falls to the patient needs record. then we improve our opportunity to reduce falls. Hello, I am Anne Panik, Senior Vice President of Patient Care Services for Lehigh Valley Health Network. I am pleased to provide the introduction to the Fall Prevention annual training course. Fall prevention continues to demand much attention in our network. Our inpatients incurred 906 falls, 11 of which were serious. In our outpatient areas, the total number of falls was 481. Some clinical units were successful in reaching our goal of either a 10% reduction in their fall rate or a 10% reduction in the total number of falls. Congratulations to these units! I think we are all motivated to achieve the reduction goal for FY 13. How can this happen? When we are engaged with our colleagues to: promote patient safety, provide accurate assessment, communicate clearly to all involved care givers, and implement interventions that meet and are individualized to the patient needs, then we improve our opportunity to reduce falls. Am I forgetting to share anything? Yes: the patient and their family! We must engage in meaningful and timely education to the patient about what factors put them at risk for a fall. To make this meaningful, we must be sure to reinforce this education as well as explain what interventions we have implemented to keep them safe; and then we must assess how well the patient understands what we have taught. Please remember, if we are unable to partner with the patient and he/she refuses to accept our interventions, document that refusal in the medical record. This module will explain our best practice and our fall prevention program at LVHN. Please learn how keeping our patients safe from falls and any injury from a fall will help you to Be at Your Best.

3 Slide 3 Course Information Course Title: Regulations/Standards: Approximate Time to Complete: Content Version: Intended Audience: General Fall Prevention (Non-Nursing) Joint Commission Requirements 15 minutes Clinical Non-Nurse All staff with direct patient contact Technical Specifications: Contact Information IE 5.0 or higher, Flash Player 8.0 or higher, Sound card, Speakers or headphones are recommended but not required Date Revised: February 1, 2013 Please forward any content questions or concerns to the Subject Matter Expert: Mary Ellen O'Connell Please call the Help Desk at with any technical issues. The Fall Prevention course fulfills the training requirements set by The Joint Commission. The course should take approximately 15 minutes to complete. If you have any questions, please contact the appropriate number listed on this screen. Remember, all technical questions should go to the Help Desk at To review the navigational features of the course, click on the Navigation tab at the top of the screen.

4 Slide 4 Objectives Identify patients who are at most risk for fall and injury from a fall List patient-related and environmentrelated factors that put patients at risk for falls Describe appropriate interventions that can prevent falls and minimize injury Upon completion of this course, you will be able to: Identify patients who are at most risk for fall and injury from a fall. List patient-related and environment-related factors that put patients at risk for falls. Describe interventions that can prevent falls and minimize injury.

5 Slide 5 Reasons for Patient Falls Patient-Related Conditions Environmental Hazards How can we prevent patient falls? The first step is to understand the reasons why a patient may fall. Studies have identified two factors that account for most falls: Patient-related conditions, and Environmental hazards. Let s first take a look at the patient-related conditions that increase the potential risk for a fall.

6 Slide 6 Elimination needs Confused, Impulsive or Disoriented Assistive devices Elderly Medication History of falls Post-Op Weakness Balance/Gait Vision Problems Male Who in our patient population is most at risk for a fall? Patients who need assistance with toileting Patients who are confused, impulsive or disoriented Patients who use an assistive device (walker, cane, or wheel chair) Elderly patients Patients who take medication for pain, blood pressure, anxiety or sleep Patients with a history of falls Patients of any age who are post-operative Patients who are weak or have been in bed a long time Patients who have balance and/or gait disturbance Patients with vision problems Research shows that on average, male patients have a higher incidence of falls.

7 Slide 7 ABCS Screening Tool Who in our patient population is most at risk to have an injury if they fall? Think of the ABCS screening tool A = Age Patients over the age of 85 B = Bones C = Coagulation S = Surgery Any patient with osteoporosis, a fracture, or bone metastasis Any patient on blood thinners or who has coagulopathy Any patient that has had recent surgery The ABCS screening tool will help identify who in our adult patient population is most at risk to have an injury if they fall. This screening is utilized to inform the RN what interventions to implement. Think of the ABCS screening tool acronyms of: A = Age Patients over the age of 85. B = Bones Any patient with osteoporosis, a fracture, or bone metastasis. C = Coagulation Any patient on blood thinners or who has coagulopathy. S = Surgery Any patient that has had recent surgery.

8 Slide 8 Altered Mental Status 1. Perform patient rounding 2. Orient the patient: Provide visual cues White board up-to-date 3. Observe the patient Here are some safety tips that you should keep in mind when caring for a patient with an altered mental status: 1. Perform patient rounding. 2. Help orient the patient: Provide visual cues, like a clock or family pictures by the bedside. Keep the white board in the patient room up-to-date. 3. Frequently observe the patient for example, use bed and chair checks and/or lap buddies as reminders. Notify staff if the patient is attempting to get out of bed without asking for assistance.

9 Slide 9 Environmental Hazards Environmental hazards are primarily found in the patient s room There are also hazards within the hospital that can place a patient at risk for a fall. Some environmental-related hazards are in the patient s room. Let s enter this patient s room to see just how hazardous the patient s environment can be.

10 Slide 10 PROPERTIES Allow user to leave interaction: Show Next Slide Button: Completion Button Label: Anytime Don't show Next Slide A hospital environment may contain hazards which could cause a patient to fall. Perform patient rounding to ensure the environment is free of fall hazards. Several of the hazards are shown here in this patient room. Click on each marker to learn information about the potential hazards.

11 Slide 11 Fall Prevention Interventions Follow these fall prevention musts: 1. Perform patient rounding 2. Make sure call bell is within reach 3. Keep all personal items nearby 4. Make sure bed alarm is functioning properly 5. Check for Orthostasis 6. Patients who are at risk for falls should not be left alone in the bathroom or on the commode We have learned that falls can be the result of patient-related and environment-related conditions. Now we will identify the interventions that can help reduce patient falls. To protect the safety of your patients, follow these fall prevention musts: Perform patient rounding on all patients; assessing patients for the three P s - pain, personal needs, and positioning. Make sure the call bell is within reach and the patient can use it. Keep all personal items nearby to prevent the patient from having to reach for them. Reaching for things has been identified as a cause of falls at LVHN during root cause analysis. If the patient requires the use of a bed alarm make sure the alarm is plugged in and functioning properly. At each change of shift, be certain the bed alarm is tested. If required reset the alarm after patient movement. Check for orthostasis. Orthostasis is a sudden drop in blood pressure upon standing, or any change in position which results in dizziness. Educate the patient to rise slowly and sit on the end of the bed for a few minutes. There are many medications that may cause a patient to experience orthostasis. Don t leave patients who are at high risk for falls or injuries alone in the bathroom or on the commode. Make sure you speak with the nurse to check if the patient can be left alone in the bathroom.

12 Slide 12 Always Remember to: To prevent patient falls: Identify at risk patients Remind patients to call for assistance to get out of bed Follow Physical Therapy recommendations Use assistive and adaptive devices Use the call bell Answer call bells promptly Apply non-skid slippers or the patient s own shoes Assist patients with ambulation and transfers Properly reset bed alarms as needed Questions about operating our beds? Contact our Product Nurses. To prevent patient falls, always remember to: Identify at risk patients. Frequently, remind patients to call for assistance to get out of bed (often patients are over confident in their ability to ambulate safely). Follow Physical Therapy recommendations for safe transfer and ambulation. Use assistive devices, such as canes and walkers, gait belts and adaptive devices, such as glasses and hearing aides. Make sure patients know how to use the call bell and are physically able to use it. Answer call bells promptly and perform patient rounding. Apply non-skid slippers or the patient s own shoes for walking. Assist patients out of bed and with ambulation. Use ceiling or stand alone lifts to safely transfer and move patients (use gait belts as indicated). Remember to follow the proper procedure for resetting bed alarms, specifically after movement of patients in Care Assist beds. For any questions about how to operate the various bed models in use, please contact our product nurses.

13 Slide 13 Falls can be a result of hazards in the patient environment: Place call bell within reach Check wheel Clean locks up spills Perform patient Toilet rounding patients Ask Eliminate clutter Check for for help cords after meals Remember, falls can occur as a result of hazards in the patient s environment. You can help to prevent patient falls by: Performing patient rounding assess the patient for pain, personal needs and positioning. Checking locks on beds and wheel chairs. Cleaning up spills promptly. Eliminating clutter from patient walkways and hallways. Checking for any loose equipment cords and securing them to the bed frame. Placing the call bell and patient items within reach of the patient. Toileting patients. Establish a toileting schedule as appropriate. Asking for assistance. Get help if you feel a patient is in any danger of falling. Use ceiling lifts, gait belts and stand alone lifts to reposition, transfer or move the patient.

14 Slide 14 Review Safety Tips Use the call bell Rise slowly and sit on the edge of the bed for a few minutes Wear your own shoes from home or non skid socks Engage and partner with the family Educate the patient and their family on fall prevention Review safety tips with the patient and family. Safety tips include: Use the call bell before getting out of bed or off of the toilet. Rise slowly and sit on the end of the bed for a few minutes. Wear footwear from home or non-skid socks when out of bed. You should also engage and partner with the family to keep the patient safe. Educate the patient and family on fall prevention. Instruct the patient and family to watch the patient safety topics on the Patient Education channel during their hospital stay.

15 Slide 15 Fall Risk for Outpatients Ask patient in outpatient areas: 1. Do you use anything to help you walk? 2. Do you feel unsteady on your feet? 3. Have you fallen in the past year? Did you know that patients are screened for fall risk in the outpatient areas as well? Patients in the outpatient areas are also at risk for falls. In fact, in FY outpatients fell at LVHN. Outpatients are asked 3 fall risk screening questions: Do you use anything to help you walk? (Cane, walker, etc.) Do you feel unsteady on your feet? Have you fallen in the past year? One positively answered question indicates potential risk for falls.

16 Slide 16 Outpatient Interventions As appropriate, interventions will be implemented for outpatients identified at risk for falls and may include: Assist patient with ambulation to test/treatment area Monitor patient frequently during test/treatment Assist/accompany patient to examination area Consider use of assistive devices as needed (ie. Wheelchair, walker, other transfer device Remain with patient during study/treatment Assure environment is hazard free If a patient is identified as at risk, the staff in the outpatient department provides for the patient s safety. As appropriate, interventions for outpatients identified at risk for falls include: Assist patient with ambulation to test or treatment area. Monitor patient frequently during test or treatment. Assist or accompany patient to examination area. Consider use of assistive devices as needed (ie. Wheelchair, walker, other transfer device). Remain with patient during study/treatment. Assure environment is hazard free.

17 Slide 17 You Make the Difference Be conscious of patient-related and environmentrelated factors Implement interventions Communicate fall risks to all caregivers Patient falls can be prevented. You are responsible for protecting the safety of your patients! Your responsibilities include: Be conscious of patient-related and environment-related factors that put patients at risk. Implement fall prevention interventions to keep our patients safe at all times. Provide close attention to the patient who has fallen by following the post-fall interventions. Communicate fall risks to all caregivers. Hand over communication of fall risk and fall prevention interventions are a 24 hour responsibility of all caregivers. Our patients conditions change frequently and it is up to us to ensure their safety. Interventions in place to prevent a fall may change during a shift. Hand over communication is also important because the physician may write a new medication order and transporters need this information to do their job safely.

18 Slide 18 Test Your Knowledge You should be able to: Identify patients who are most at risk for fall and injury from a fall List patient-related and environment-related factors that put patients at risk for falls Describe interventions that can prevent falls and minimize injury To successfully complete this course, you must earn a score of at least 80% on the final test. Click the Test button to start the final test. Thank you for participating in the Fall Prevention module. You should now be able to: Identify patients who are at most risk for fall and injury from a fall. List patient-related and environment-related factors that put patients at risk for falls. Describe interventions that can prevent falls and minimize injury. Click the Test button to continue on to the final test. In order to pass this course, you must earn at least 80% on the test. You can go back and review any section of this course by selecting the Outline tab, then selecting any of the topics listed. If you do not pass the test on the first try, you can go back and try again. Good luck.

19 Slide 19 PROPERTIES On passing, 'Finish' button: On failing, 'Finish' button: Allow user to leave quiz: User may view slides after quiz: User may attempt quiz: Close Window Goes to Slide After user has completed quiz At any time Unlimited times

20 Slide 20 Congratulations! You have successfully completed the General Fall Prevention course. You can close this window to exit the course.