Project Safe Stay: A Falls Prevention Program

Purpose:
Project Safe Stay was designed to promote understanding by staff and patients of strategies to decrease the risk of falls in a hospital setting. The goal of the project was to increase patient safety by providing a safe environment in which falls and injuries would be significantly reduced.

Significance:
Hospitalized patients are at risk for falls. It is imperative that efforts & resources be dedicated to decrease the number of falls. Fall rates directly reflect the quality of care and patient outcomes. Processes that affect & improve fall rates would improve the quality of care & patient outcomes.

Strategy and Implementation:
Project Safe Stay is a multifaceted nurse-led interdisciplinary program incorporating evidence based strategies as well as monitoring equipment to provide optimal safe environment for the hospitalized patients. Nursing implemented an hourly rounding protocol, as well as use of monitoring equipment. Ancillary staff was essential members of the team. If ancillary staff were unable to fulfill the patient's request, they stayed with the patient until the nurse was able to come to assist. Additional strategies include: patient/family education, posters placed on the ceilings over the patient and communication boards. An evidence based protocol was developed that incorporated RRT summons, SBAR communication, immediate baseline head CT for actual or potential head injury and administrative review of falls. Implementation was rapid cycle change with 1:1 education for all staff that emphasized a consistent approach to fall prevention.

Evaluation:
With the implementation of Project Safe Stay, the quarterly Falls Index fell from 3.2% in 3Q 2009 to 1.6% in 4Q 2009, a 50% reduction. We have maintained our focus on fall prevention and continue to see our Falls Index remain well below our goal for a Fall Index of 2.5%.

Implications for Practice:
Proactive assessment and prevention strategies can decrease fall rates. An interdisciplinary approach provides for an optimal safe environment through out the facility. Involvement of all staff, patient and family as part of the care team allows for a consistent approach to fall prevention.