Fall Prevention Quality Initiative: Implementation of a Unit Safety Champion (USC)

Purpose:
Unit Safety Champions (USC)are nurses and staff established as front line safety leader. They are often referred to as super users and share successes and challenges and provide peer support. The purpose of this project was to investigate if implementation of a USC will help decrease patient falls.

Relevance/Significance:
Hospital falls are a nurse-sensitive performance indicator put forth by the NDNQI and the ANA. Health care providers must be made aware of quality indicators that track and report patient falls on a consistent level since they present as one of the greatest quality challenges. In health promotion, focusing on how to prevent falls based on the EBP and advances in research on this topic remains a priority for safety reasons.

Strategy and Implementation:
Following IRB approval this project began in the chosen Medical/Surgical(M/S) nursing unit. The succeeding information was a basic tentative plan for carrying out this QI project. After presenting the action plan to the interdisciplinary team as a starting point full project implementation included: participants caring for the M/S patients received support by the Clinical Specialist for fall prevention tools and resources as well as expertise on this topic. USC participants were 2 RNs (1-day/1-night) on two different shifts. Data collection: a run chart to track trends in fall rates 3-months pre- and post-pilot of a USC and a MANN-Whitney U test which evaluated variable reliability. A 9-question pre- and post-Acute Care Nursing Unit Safety Culture questionnaire was distributed to random RNs and NTs on the pilot unit. The author evaluated project and goal achievement by these test outcomes. Limitations included sample size of USCs and no comparable group and length of study.

Evaluation:
RNs had a higher understanding of fall resources(z=-2.09,p=0.07)than NTs. NTs showed a slight increase in phase-II this area (z=-1.45,p=0.28). There was no difference in RN/NT knowledge-base of location of fall prevention tools. A variance showed a difference (z=-1.63,p=0.15) that could identify a potential gap in NT familiarity of fall tool process. These results were post-pilot of a USC.

Implications for Practice:
Expert support helps maintain a line of communication to help meet front line staff needs for safe, patient care. Outcomes identified with use of a USC could contribute to a social change based on EBR for up-to-date practice changes at a proactive approach in patient experience at the highest level.