|
Twilight (The Flamingo Hotel)
Monday, 29 January 2007
6:30 PM - 8:00 PM
Twilight (The Flamingo Hotel)
Tuesday, 30 January 2007
4:30 PM - 6:00 PM
Creating a Culture of Safety: The Effect of Hourly Point-of-Care Nursing Rounds on Prevention of Patient Falls
Judith Ann Moran, RN, DNSc, CNA, B, JoEllen Sadowski, RN, BC, MPA, CNA, and Amy Loeb, BSN. Nursing Administration, Huntington Hospital, 270 Park Avenue, Huntington, NY 11743
The purpose of this session is to describe the effect of hourly point-of-care nursing rounds on prevention of falls in hospitalized patients.
Educational objectives are:
Review evidence-based findings related to fall prevention.
Identify nursing interventions which succeed in preventing patient falls.
Summary of Presentation:
A group of direct care nurses concerned with patient falls conducted a review of literature and developed nursing activities aimed at preventing falls. Outcomes indicated that specific nursing interventions, the cornerstone of which is hourly point-of-care nursing rounds, are successful at preventing falls.
Relevant Knowledge:
This session will increase the knowledge of nurses regarding effectiveness of fall prevention nursing activities. An implication for practice is that direct care nurses making hourly point-of-care rounds on their respective units will achieve success at preventing falls.
National Patient Safety Goal #9, “reduce patient harm resulting from falls”, is a major healthcare concern, especially for nurses working in hospitals. Falls are the most common adverse event reported in acute care facilities. Of those patients who fall, 20-30% suffer moderate to severe injuries that reduce mobility and independence, and increase the risk of premature death. By 2020 the cost of fall injuries is expected to reach 32.4 billion dollars. These facts are particularly alarming for healthcare institutions inNew York State . Due to high labor costs and decreases in insurance reimbursements many New York hospitals are facing severe financial difficulties resulting in hiring freezes, staffing reduction and hospital closures.
Evidence on patient falls published in professional journals indicates that clinicians have focused attention in the following areas: 1) identification of factors which predispose “at risk” patients to fall, 2) development of predictive fall assessment inventories, 3) implementation of fall prevention programs, and 4) education of nursing staff related to fall prevention. Nevertheless, findings indicate that little research has been conducted in the area of outcome measurement. For example, which nursing interventions contribute, in statistically significant ways, to the prevention of falls in hospitalized patients?
Direct care nurses determined that hourly bedside visits to their patients was a key element in preventing falls. Assessments included identifying patient’s needs and providing appropriate nursing care interventions. Findings indicated that common patient needs were for pain management, repositioning, toileting, water/snacks, placement of call bells and tissues within reach, reorientation to time and place, and words of reassurance from the nurse.
After hourly point-of-care nursing rounds were implemented no patient falls were experienced on the unit for a two month period. The program has been so successful that it has been expanded to a 24/7 basis, without an increase in nurse staffing on the unit. Other outcomes being measured are the impact of hourly point-of-care nursing rounds on skin care, patient satisfaction, and employee satisfaction indicators.
Educational objectives are:
Review evidence-based findings related to fall prevention.
Identify nursing interventions which succeed in preventing patient falls.
Summary of Presentation:
A group of direct care nurses concerned with patient falls conducted a review of literature and developed nursing activities aimed at preventing falls. Outcomes indicated that specific nursing interventions, the cornerstone of which is hourly point-of-care nursing rounds, are successful at preventing falls.
Relevant Knowledge:
This session will increase the knowledge of nurses regarding effectiveness of fall prevention nursing activities. An implication for practice is that direct care nurses making hourly point-of-care rounds on their respective units will achieve success at preventing falls.
National Patient Safety Goal #9, “reduce patient harm resulting from falls”, is a major healthcare concern, especially for nurses working in hospitals. Falls are the most common adverse event reported in acute care facilities. Of those patients who fall, 20-30% suffer moderate to severe injuries that reduce mobility and independence, and increase the risk of premature death. By 2020 the cost of fall injuries is expected to reach 32.4 billion dollars. These facts are particularly alarming for healthcare institutions in
Evidence on patient falls published in professional journals indicates that clinicians have focused attention in the following areas: 1) identification of factors which predispose “at risk” patients to fall, 2) development of predictive fall assessment inventories, 3) implementation of fall prevention programs, and 4) education of nursing staff related to fall prevention. Nevertheless, findings indicate that little research has been conducted in the area of outcome measurement. For example, which nursing interventions contribute, in statistically significant ways, to the prevention of falls in hospitalized patients?
Direct care nurses determined that hourly bedside visits to their patients was a key element in preventing falls. Assessments included identifying patient’s needs and providing appropriate nursing care interventions. Findings indicated that common patient needs were for pain management, repositioning, toileting, water/snacks, placement of call bells and tissues within reach, reorientation to time and place, and words of reassurance from the nurse.
After hourly point-of-care nursing rounds were implemented no patient falls were experienced on the unit for a two month period. The program has been so successful that it has been expanded to a 24/7 basis, without an increase in nurse staffing on the unit. Other outcomes being measured are the impact of hourly point-of-care nursing rounds on skin care, patient satisfaction, and employee satisfaction indicators.
See more of Using Quality Indicators to Achieve Quality Improvement
See more of The NDNQI Data Use Conference (January 29-31, 2007)