Floor no more: Fall prevention in the academic outpatient surgery center

Purpose:
Develop and sustain a Fall Prevention Program in the outpatient peri-operative setting for risk identification and fall event reduction in patients presenting with intrinsic fall risk vulnerabilities and patients receiving extrinsic high risk interventions.

Significance:
Fall prevention in health care settings is essential for institutional and professional commitment to patient safety. While limited evidence exists for peri-operative fall prevention, this outpatient population presents unique challenges not amenable to traditional strategies.

Strategy and Implementation:
Based on trends gathered from Quality Report fall events, University of Virginia Outpatient Surgery Center leadership and Fall Prevention Chair collaborated to develop a unique outpatient peri-operative fall prevention program. Due to limited literature available in this setting, the Fall Prevention Chair provided internal consultation and content expertise by attending multiple staff meetings to identify evidence-based risk factors and specific procedure-related fall hazards. From feedback provided by frontline nursing staff, a robust fall prevention program was implemented to include: yellow ‘fall risk' armband identification based on initial screening/assessment results and/or placement of peripheral lower extremity blocks; official fall prevention intervention signage; education materials for patients and families; and pre-/post-operative interventions to reduce falls events and associated injuries.

Evaluation:
Program effectiveness was evaluated by reduction in total number of falls following implementation January 31, 2011 compared to previous eight quarters. No patient fall events have occurred in this area since program initiation.

Implications for Practice:
By maximizing nurse leadership collaboration and integrating evidence-based practice with staff engagement, nursing process improvements can lead to improved accountability, ownership, and culture of patient safety.