Fall Prevention Program of Post Transurethral Resection of Prostate (TURP) Patients

Abstract Description

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Authors (including presenting author) :

Lam CW(1), Chan CK(1), Yim MS(1)(2), Cheung KL(1), Chak PF(1), Chu SF(1), Ma TK(1)

Affiliation :

(1)P6 urology ward, Princess Margaret Hosiptal, (2)Urodynamic and Endourolgy Centre, Princess Margaret Hospital

Introduction :

Patient underwent Transurethral resection of prostate (TURP) are common in Urology. In year 2018, TURP accounts for about 25% of urology surgeries in Princess Margaret Hospital. It was noted that patients tended to be eager to leave bed immediately after termination of continuous bladder irrigation in post operative day one, or urge to toilet to try voiding after removal of urinary catheter and thus leading to increasing fall risk as patients unawared of physical weakness or limitation especially after complete or prolonged bed resting.

Objectives :

From January to June 2018, there were total 3 patient’s fall incidents in P6 ward while 2 of them were post TURP patients. The fall prevention program for post TURP patients is aiming to minimizing fall incident of post TURP patients with specific fall risks as aforehead mentioned.

Methodology :

Review of post TURP fall incidents patient’s clinical data was done. Those patients have Morse Fall Scale score 20-35 which falls on low to moderate fall risk group and only universal fall preventive measures applied. Literature review on fall prevention and Morse Fall Scale was conducted. Result of literature review reflected that the predictive value of Morse Fall Scale on hospitalized patients is not stable. The sensitivity values ranged from 31% to 98%, and specificity values ranged from 8% to 97% in 14 analyzed studies. Implementing specific fall prevention programs for special groups of patients will increase the effectiveness of fall prevention and not required unnecessary effort on staff and do not increase hospital costs. New education program for nurses and health care assistants based on post TURP specific fall risks is conducted. Nurses are reinforced to educate patient post TURP related specific fall risks after patient post operation arrival to ward. Fall notice board has been redesigned to input post TURP patients bed number to alert ward staff to pay extra attention on those patients. A specific signage for placing in post TURP patient’s bed table with information on post operative management provided to gain cooperation from patient and relatives.

Result & Outcome :

All staff are complying with the new fall prevention program. Specific fall preventive measures are implementing effectively. Staff compliance will be monitored regularly. Positive feedback from staff and patients noted. After implementation of the program since June 2018 till Dec 2018, no post TURP patient fall incident occurred. Post TURP patient’s safety is enhanced with the implementation of the new program.