WOW No Fall: A Fall Prevention Strategy

Purpose:
Falls with injury among patients have a devastating impact for patients and healthcare organizations. Guided by a Basketball framework of teamwork, strategy and goal, a new initiative, “WOW, No Falls” was piloted on a medical unit to decrease the incidence of falls and falls related injuries.

Significance:
The analogy of a Basketball as a cost-effective, innovative model employs a team approach and empowerment by the staff (teamwork) to position (strategy) their Workstation on Wheels (WOW's)closer to patients allowing faster response time for bed alarms and patient calls to reduce falls(goal).

Strategy and Implementation:
This initiative was triggered by a high falls rate and a sentinel event. The process dimensions of assessment, problem identification, planning, implementation, evaluation, and celebrating small wins was implemented. Staff members created an improvement plan. Daily huddles with direct care staff, ongoing dialogue, and sharing of ideas fostered stakeholders buy-in. The staff implemented the idea of the Basketball model, employing both offensive (current falls prevention protocol) and defensive (new model) strategies in November, 2012 framed under a principle that a good man-to-man defense is a team defense, not just five individuals guarding their own man, but five players working together with a strategy and outcome in mind. This medical unit is staffed by six RN's with patient care associates, with WOW's strategically positioned around the perimeter of the unit. Patients at risk for falls are in the nurse's sight line and hearing distance allowing for faster response time.

Evaluation:
Quantitative and qualitative data on reduction of falls and staff feedback were collected to evaluate the effectiveness of the model. Two months after the implementation of this initiative, there were no incidence of falls.

Implications for Practice:
Implications for nursing practice include exploring the offensive and defensive approach in combination with astute nursing judgement. Refinement of this model, further research, and future space redesign could possibly avert physical, economical and legal consequences.