Joint Departments Program: Looking Forward to "No Fall Day"

Introduction

Fall prevention is always a big challenge in our surgical units. Not only elderly, even the young adult fell due to their illness status or medication side-effect. The fall incident rate was rising as only in the 1st quarter(1Q) of 2018 was 0.59. (n=5), while the fall rate was 0.4 (n=3) in 1Q 2017. On-going series of fall prevention strategies has been introduced and implemented after reviewing and analysing the past fall incidents each year. According to the fall incidents, fall audit and spot check results last year, there were some rooms to improve over the existing preventive interventions.

Objectives

To promote patient safety and minimize the fall rate in the surgical department and orthopaedic & traumatology (O&T) department. To improve the existing fall preventive practice.

Methodology

(1) Analyse the past fall incidents, audit and spot check result to plan the improvement work in the departments. (a) Design eye catching pictures on the existing patrol record. b) Revise the red flag system of surgical department to increase staff alertness. (c) Proactive utilise the assistive device e.g. Alarm Mat on fall prevention to the high risk cases. (d) Count the number of “NO fall day” with reward in every 100 days without fall incidents in ward / department to encourage staff’s day-to-day work on the fall prevention. (2) Provide program briefing and education / refreshing the use of alarm mat to staff (3) Evaluate the program by conducting the spot check on the compliance of fall scheduled round and nursing audit on fall prevention.

Results & Outcome

After program implemented in 2 surgical wards and 1 orthopaedic ward for 4 months, the fall rate of the departments reduced from 0.44 to 0.19. The usage rate of alarm mat increased from 51% to 73% in the department. The maximum days without fall in an individual ward was 256 days and 71 days in departments. The staff compliance rate was 98% in the department. To sum up, the results showed the positive outcome as the fall rate was reduced. The longer the no fall periods, the lesser the number of fall incidents. We are looking forward to the number of “NO fall day” keep rising.