Introduction
Fall prevention remains one of the most challenging patient safety issues in hospital setting. Prevention of fall is complex and multifaceted. Safe environment is one of the crucial factors to reduce fall risk in hospital. Patient Care Assistant (PCA) supporting staffs assist nurses to take care patients. Their knowledge deficit, improper technique and less awareness would affect patient safety. Studies (1, 2) had proved that enhancement training could strengthen their knowledge and practical skill, increase awareness on patient safety, enhance supportive teamwork and improve quality outcomes. Thus, “SMART” Fall Prevention Enhancement Program was introduced to PCA in TWEH.
Objectives
- Strengthen PCA’s updated knowledge and practical skill on fall prevention. - Increase PCA’s alertness on safe environment to prevent fall. - Promote the ‘Patient Safety & Comfort (PSC) Round’ at workplace.
Methodology
The “SMART (Safety, Measures, Alertness, Round and Teamwork)” Program for PCA was designed and implemented in year 2018 as follows: 1. Strengthen “Safety” knowledge on patient fall with lecture, use of fall prevention video show and education leaflet. 2. Enhance fall preventive “Measures” with scenario-based hands-on skill practice exercises. 3. Increase “Alertness” on ward environmental safety and be more sensitive to patients’ need with appropriate care provided such as offer assistance with patient’s toileting, address patient’s special need and ensure patient reach personal item. 4. Educate how to conduct PSC “Round” regularly with practical tips on systematic check from patients’ area to ward environment, hospital bed and patient’s comfort care provision. 5. Engage staff with “Teamwork” through recognition of “SMART” Ambassadors「精靈醒目巡視員」.
Results & Outcome
The “SMART” Program was practical and easily applied by Patient Care Assistants at workplace. The program could increase their alertness as well as strengthen ‘Patient Safety & Comfort Round’ by PCA in clinical setting. Total 48 PCAs completed the training with active participation on skill-based practice exercises. A six-point Likert Scale from (1) very unsatisfactory to (6) very satisfactory for staff satisfaction rating was adopted with 5.4 over 6 achieved. All participants agreed that the program was practical, easy to apply to their daily operations, could enhance their fall prevention knowledge & skill. They learned how to address patient comfort needs proactively, and to conduct ‘PSC Round’ systematically at workplace. Staff compliance audit was conducted with 100% compliance rate achieved.
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