Catch a falling star: New Falls Prevention Program

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What do yellow wristbands and stars have to do with patient safety? They are actually key visual components of the new Falls Prevention Program recently introduced at Halton Healthcare Services’ (HHS) three community hospitals – one that focuses on patient identification and has caregivers trained to always be on guard to prevent their patients from falling.

“Older adult patients tend to have more complex health issues, weaker eyesight and mobility or balance issues – and these factors make them more prone to falls,” explains Dr. Kirsten Lindner, HHS Hospitalist, Primary Care Geriatrics Consultant and Co-Chair of the HHS Safer Elder Care Committee. “In some cases confusion or agitation related to delirium, medication, and hospitalization, can put these patients at an even greater risk.”

“Recognizing that older adults comprise the majority of our admitted patients, the HHS Safer Elder Care Committee joined forces with our Patient Safety Champions and implemented a Falls Prevention Program in the Spring of 2010. Our ultimate goals were to standardize our screening, identification and falls prevention strategies in order to reduce both the number and severity of falls in our hospitals,” says Jennifer Luckanuck, Co-Chair of the HHS Safer Elder Care Committee.

This comprehensive program involved the implementation of two new clinical screening tools to proactively identify patients at high risk of falling. All adult inpatients – regardless of age – are now screened using a falls risk assessment tool and inpatients over 65 years of age are also routinely screened for delirium.

Visual cues have also proven to be very effective in alerting caregivers to these patients so they can be carefully watched and monitored. “We adopted a yellow falling star to symbolize patients who are considered “high risk” for falls. A poster with falling stars is placed at the head of the bed of these patients so that all members of the health-care team are aware of the risk. Magnets with this symbol also identify these patients on our report board – one way we use to communicate between shifts,” explains Pam Groulx, Oakville-Trafalgar Memorial Hospital Registered Nurse and Safety Champion. “High risk patients also wear a yellow alert wrist band so we can see them at a glance.”

In addition, staff use a number of other proactive strategies when caring for these vulnerable patients. These include:

• checking on them more often to make sure they are comfortable with regard to pain management

• finding out if they are thirsty, hungry or if they need to go to the bathroom

moving the call bell closer to them and setting their bed or chair alarm

• making sure their hearing aid is in and that their eyeglasses, telephone and personal items are easily within their reach

• lowering the bed and making sure the brakes on the bed, chair or commode are engaged

• engaging restless patients in cognitive activities or crafts

“The involvement of patients and their family is also crucial as we consider them partners in care,” continues Ms. Groulx. “We take the time to educate them, and encourage them to ask questions. We also provide them with a Falls Brochure, which has tips on how to prevent falls both in the hospital and at home.”

“Although it’s still early, the results are very encouraging. This program is successfully raising awareness about Falls Prevention on our care units throughout our hospitals. It has armed our caregivers with tools, proactive strategies and interventions and trained them to be even more vigilant with those who are at risk,” concluds Ms.Luckanuck.

The Falls Prevention Program is part of HHS’ comprehensive Safer Elder Care Program which addresses the common inter-related geriatric issues that challenge older adults such as delirium, mobility, restraints and falls.