Authors (including presenting author) :
Chiu J(1),Lai W(1), Ng R(1),Lai D(1),Cheung SY(1),Woo L(1), Chan OF(1),Lam CM(1),Sze YMS(1),Wong CS(1),Lau KF(1)
Affiliation :
Medical & Geriatric Department,Shatin Hospital
Introduction :
Restraint reduction culture on fall prevention has been established in M&G wards/SH since 2008. Fall incidence rate slightly increased from 0.42 in 2016 to 0.47 in 2017 in SH M&G, and compared with HA / NTEC / Group 2 Hospitals overall patient fall rate respectively 0.43, 0.41 and 0.43. When reviewing fall data in 2017, it found that 44% of patient who fell was sound minded with AMT 8/10, 18% of falls were accompanied by carers and 18% was related to ineffective use of fall monitoring safety device.
Objectives :
The aims of this CQI is to enhance fall prevention targeted for carer and patient with good cognition and staff awareness on use of fall alarm device.
Methodology :
A workgroup was formed to look for further enhancement on existing fall prevention measures in February 2018. Cause and effect diagram was employed to identify enhancement measures. Firstly, according to the fall cases analysis, knowledge & skills of patient and carer/relatives should be enhanced. Hence, a fall prevention video was produced focusing on patient/ carers’ over self-estimation of self-care aiming to enhance their safety awareness. The video was broadcasted in ward during visiting hours and all newly admitted patient and carer would arrange to watch the video using DVD/ tablet computer upon admission. Secondly, wear and tear"s safety alarm devices were replaced. Checking of in-use safety device
was conducted by PCA in each shift to ensure its proper functioning and effective use. Thirdly, ward routine and staff meal break schedule was reviewed to ensure adequate manpower for patrolling and attending patients’ need during ward busy hours such as bathing session and staff meal break to enhance surveillance of high risk patient. Also, safety ambassador ward round conducted by PCA in each shift duty was implemented in May 2018 to ensure:
a. Proper use of alarm seat belt / bed pad alarm and its functioning
b. Bedside rail was raised up for MFAC 1 – 2 of patients to prevent them rolling down from bed
c. Call bell was placed within easy reach by patient
d. Hip protectors were in place for high risk patients
e. Tidiness of bedside furniture and the floor is clean and dry
At last, integrated lockers with bedside table were used for the extra beds to allow enough space for patient’s mobility at bedside
Result & Outcome :
1st outcome measures : Fall incidence rate was reduced from 0.47 in 2017 to 0.3 in 2018.
2nd outcome measures : Compliance audit will be performed in January 2019 include: 1.Safety ambassador checklist 2.Fall prevention video to evaluate the compliance on the above mentioned fall prevention enhancement measures.
Co-location with:
