A Fall Prevention Program through Cubicle Nursing in Accident & Emergency Department of Tin Shui Wai Hospital

Abstract Description

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Authors (including presenting author) :

Authors Mak KH(1) Cheung LM(1) CheungYF(1)

Affiliation :

(1)Accident and Emergency unit of Tin Shui Wai Hospital

Introduction :

It was reported three fall incidents in the Accident & Emergency (A&E) Department of Tin Shui Wai Hospital (TSWH) in 3Q 2017. One of them was a high fall risk case. In order to control the number of fall incidents , the fall prevention program was implemented through the concepts of cubicle nursing.

Objectives :

a)To decrease the fall rate by 10% b)To enhance staff awareness of fall prevention by promotion of cubicle nursing.

Methodology :

Plan Identify the high fall risk group and arrange designated nurses to focus on this group of patients. The fall prevention subcommittee team members were responsible for the fall prevention enhancement program. Do a pilot project was done by implementing cubicle nursing care to this high fall risk group Check Although signage was given, there wasn’t a designated person responsible for the case. Therefore, medical officers could not find a designated nurse to arrange investigations to the high fall risk patient immediately after the point of initial assessment. As a result, cubicle nursing was necessary to solve this problem. Act the framework of this enhancement program for fall prevention by cubicle nursing was divided into three parts. For the triage part, the nurse would be the cubicle nurse to assess the fall risk of the patient and provide education to the patient and relatives for fall precaution before handover to other nurses. For the examination part, the emergency cubicle (EC) nurse would be allocated as the cubicle nurse of the Category 3 high fall risk case. The cubicle nurses needed to keep following up the progress of doctor’s prescription e.g. X-ray examination and make sure the case is transported to observation ward safely. Same theory is applying to the Category 4 high fall risk case. Cubicle nursing could minimize the waiting time of the patient for examination by a direct and closed-loop communication with the case medical officer at the point of initial assessment. For observation part, the nurse in the observation ward could get the information of the high fall risk case from the triage nurse and she/he would become the cubicle nurse of the case and would follow the progress of all examination reports and communicating with the case medical officer.

Result & Outcome :

Results The fall prevention enhancement program was introduced to all staff in the department. The number of fall incidents dropped to zero from 4Q-2017 to 4Q-2018. Conclusion Cubicle nursing in the A&E department in Tin Shui Wai Hospital is necessary to provide a closer monitoring and shorten the length of stay of the high fall risk group in the A&E department. As a result, the number of fall incidents was greatly reduced. A systematic framework for fall prevention is certainly useful and valuable.