Implementation of a Falls Clinical Specialist Role

Purpose:
To describe the innovative role of a Falls Clinical Specialist to reduce patient falls and injuries in Acute Care, Long Term Care and Mental Health areas.

Significance:
Over a period of eight years, a dedicated full time Clinical Nurse Specialist has implemented a comprehensive Fall Prevention Program which has reduced the number of major injuries in a varied patient population.

Strategy and Implementation:
After an increase in patient falls and major injuries, the facility committed its resources to implementing a comprehensive fall prevention program using a Clinical Nurse Specialist as the coordinator. Selection of an assessment tool, development of documentation templates for the electronic healthcare record and refinement of post fall procedures and a head trauma algorithm were implemented. An electronic consult system was developed. All patients at high risk for falls, repeat fallers and falls with trauma are seen by the Falls Clinical Nurse Specialist to ensure all safety precautions are in place. In addition to in-servicing staff, 1:1 training and publishing of “Facts on Falls electronic Newsletter”, the Falls Clinical Specialist has secured funding for falls technology which includes but not limited to low beds, bed/chair alarms, floor mats and hip protectors

Evaluation:
By measuring the facility's fall & injury rates, there has been a modest decrease in falls, the elimination of restraints in some care areas and periods of 11 and 15 months without any major injuries in all three care areas. Use of NDNQI data has allowed us to benchmark with other like care areas.

Implications for Practice:
The use of a dedicated full time Clinical Nurse Specialist for Fall Prevention is able to coordinate all the necessary elements and benchmark using NDNQI data to continually improve the program, thereby, reducing patient injury and suffering.