Wellspring is a program designed to. Wellspring

Transcription

1 Patient Safety Conference 3/23/07 Wellspring: Innovative Falls Management Michele Buscher RN Jacqueline Fleming RN, BSN Jane Haynes RN, BSN Nancy Posey LPN Jennifer Goldsborough MSN, CRNP What is Wellspring? 1

2 Wellspring is a program designed to Enhance quality of resident care Enhance quality of work life (especially for front line workers) Wellspring Culture change through education, empowerment & networking 2

3 Mid-Atlantic Alliance Augsburg Lutheran Broadmead Charles County Glade Valley Homewood at Williamsport Methodist Home of DC Oak Crest St. Catherine s St. Elizabeth s St. Mary s Educational Modules Leadership (3/04, 5/06) Falls/ Restorative (10/04, 11/06) Nutrition (3/05) Palliative Care (9/05) OUOA (5/04, 11/06) Skin (1/05) Elimination (5/05, 2/06) Psychosocial Wellbeing (11/05) 3

4 Benefits of Wellspring Improves skills & knowledge of all workers Promotes collaboration Empowerment to create changes that will improve care Success means an increase in the overall level of clinical knowledge among all employees & significant organizational culture change 4

5 Percent of residents without a recorded fall of any kind What is a fall? Current CMS policy regarding falls includes: (MDS Items Page 3-146) 5

6 Define fall An episode where a resident lost his/her balance and would have fallen, were it not for staff intervention, is a fall. In other words, an intercepted fall is still a fall Define fall (cont.) The presence or absence of a resultant injury is not a factor in the definition of a fall. A fall without injury is still a fall. 6

7 Define fall (cont.) When a resident is found on the floor, the facility is obligated to investigate and try to determine how he/she got there, and to put into place an intervention to prevent this from happening again. Unless there is evidence suggesting otherwise, the most logical conclusion is that a fall has occurred. Define fall (cont.) The distance to the next lower surface is not a factor in determining whether or not a fall occurred. If a resident rolled off a bed or mattress that was close to the floor, this is a fall. 7

8 For example Roll-outs are considered a fall A fall without an injury is still a fall Unless evidence suggesting otherwise, a resident found on the floor has fallen Fall rates 45-70% of LTC residents fall each year (approximately 2,000,000 LTC residents in US) 50% of the residents who fall each year will fall more than once Older adults (LTC) are 2-3 times more likely than older adults in the community to fall more than once (Nurse Practitioner; 3/02; Gruebel, D. Stokesberry, C. Jelley, M.) 8

9 Injury Death Why do we care about fall prevention? Decreased mobility Fear of falling Cost Hospitalization Falls prevention process Assess the problem- try to get to the root cause (facility wide, one wing, one shift, one resident?) Develop a plan of prevention that directly addresses the root cause Implement that plan Evaluate for effectivness 9

10 Basic Fall Interventions: Review Fall Risk Assessments (gives us the chance to intervene before the fall occurs) Reduce environmental hazards Assistive devices/ adjustments Medication reviews Bed/ chair alarms Reduction of restraints What can each discipline do to help prevent falls? Activities- proper timing of activities, busy boxes, expend energy during day to promote rest at HS, exercise groups Therapy- assessments, strength training, environmental modification, equipment (assistive devices) Housekeeping- signage (wet floors) Maintenance- environment, lighting All depts should be aware if resident status changes and notify appropriate personnel 10

11 Innovative Approaches to Falls Management On call systems Fall Tool box Walking Rounds Immediate Fall meeting at time and location of fall Notify staff of their fall rates Incident reports should be useful Augsburg Lutheran Jackie Fleming RN, BSN Augsburg Lutheran Home Director of Nursing previous Wellspring Coordinator, QA/ Staff Development Coordinator 11

12 Charles County Nursing & Rehab Michele Buscher, RN Charles County Nursing & Rehabilitation Center Restorative Nursing Coordinator, Pain Management Nurse & Wellspring Coordinator St. Catherine s Nancy Posey, LPN St. Catherine s Nursing & Rehab Wellspring Coordinator nposey@scncah.org Stacy Woener, GNA (Falls CRT team leader) 12

13 St. Elizabeth s Nursing & Rehab Jane Haynes RN, BSN St Elizabeth Rehabilitation and Nursing Center Director of Education, Quality Improvement, & Wellspring Coordinator (P) (F) jhaynes@cc-md.org Case Study #1 13

14 Case Study #2 Questions & Answers 14