The Importance of a Fall Prevention Program in Patients Receiving a Femoral Nerve Block

Purpose:
Using NDNQI data we were able to identify falls per quarter and further investigate how many were related to the use of femoral nerve blocks. The goal of strategy were to eliminate falls, educate staff, patients, and families on fall prevention through a newly developed fall prevention program.

Significance:
It is important that fall prevention be addressed to ensure the safety of the patient. It is also important that consideration of the use of femoral nerve blocks be taken into consideration as an indicator of a high fall risk. Preventative measures should be put into action to eliminate falls.

Strategy and Implementation:
The innovation that was focused on to ensure patient safety was fall prevention. Using NDNQI data we were able to identify falls per quarter and further investigate how many were related to the use of femoral nerve blocks. With the collected data we implemented a fall prevention program,also referenced as a fall bundle. Patients who are considered a fall risk receive a yellow wrist band,fall precaution sign inside & outside of patient room, fall prevention brochure on admission, bed alarm, and chair alarm. Also clips were attached to all emergency call lights to clip on the patient as a reminder. Staff was educated on fall prevention as well as patients and families. A special focus was placed on patients receiving a femoral nerve block. Through evidence based practice adjustments were made to the concentration of ropivicaine used in femoral nerve blocks. Knee immobilizers were placed on patients for two days after day of surgery. Also an interdisciplinary fall meeting is held monthly.

Evaluation:
The innovation showed to be effective in reducing fall rates in patients receiving femoral nerve blocks as well as the general population.Staff became more aware and proactive in fall prevention. Success was measured through NDNQI data collection, tracking board,and fall risk documentation.

Implications for Practice:
Some specific practice implications for a fall prevention program are femoral nerve blocks, gender, age, medications, altered elimination, dementia, and vertigo. In our facility we use the get up and go test as well.