Authors (including presenting author) :
Pun KL(1), Aboo GH(1)(2), Chan YKJ(2)(3), Lam YFD(3), Wan S(4), Lau CW(2)
Affiliation :
(1)Nursing Services Division, Pamela Youde Nethersole Eastern Hospital, (2Quality & Safety Office, Hong Kong East Cluster, (3)Department of Medicine, Pamela Youde Nethersole Eastern Hospital, (4)Department of Physiotherapy, Pamela Youde Nethersole Eastern Hospital
Introduction :
Patient falls are extremely common, comprising >50% of all hospital incidents in general. Most falls are minor, but they increase morbidity and could prolong patient’s hospitalization. Major injuries, though rare, could be life-threatening with possible medico-legal consequences.
Objectives :
In the past 8 years, the multi-disciplinary HKEC Workgroup in Fall Prevention (W/G) has been collaborated with fall subgroups to implement different strategies and measures on fall prevention.
Methodology :
The HKEC Quality & Safety Office monitored the trend and severity of fall incidents, compared against internal and external benchmarks. Learning points are shared with staff. The limitation of predictive value of Morse Fall Scale, hospitals adjusted the cut-off values and developed their disease-specific red flag system. We found fall risk was one of major reasons that patients use diaper. We emphasized appropriate diaper use and early wean-off. Nurses could initiate physiotherapy referral for walking exercise for early mobilization. Standardized visual signage is used to alert staff about safe mobilization and handling of fragile patients. Every two years, W/G updates the fall prevention training kit, conducts the Train-the-trainers workshops. Skill training on patient transport with ceiling hoist is held for supporting staff. Sometimes physical restraint use has to be considered as the last resort to prevent fall. This must be made with clinical team, relatives, and review per shift.
Result & Outcome :
The HKEC fall rate decreased from 0.29 (n=225, Year 2011/12) to 0.25 (n=241, Year 2017/18) per 1000 in-patient bed-days. These rates were constantly lower than the HA’s fall rate 0.46. Fall with high severity (i.e. severity of injury 4, fracture or require higher level of care) decreased from 8% (n=18, Year 2011/12) to 2% (n=5, Year 2017/18).
Co-location with:
