NCQC PSO Safe Tables Fall Prevention July 2016
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1 NCQC PSO Safe Tables Fall Prevention July 2016
2 Background Role of a PSO Share Learn Improve Protection under the and Quality Improvement Act of 2005 It s like Vegas
3 Safe Table Objectives Support our commitment to reduce harm to patients Develop a community of learning by sharing our stories Promote discussion about mistakes to gain insight into improvements that are needed within our organizations Share best practices Network and communicate
4 What are you doing to prevent falls? Risk Assessment Model? Bed/Chair Alarms? Video Monitors? Toileting? Behavioral Health Units? Ambulatory Settings? Post-Fall Huddles?
5 The Missing Link in Fall Prevention?
6 Patients & Families in Fall Prevention What should providers know about Fall Prevention? Broaden the systems approach Invite family members to engage Be sensitive to individual patient needs Set expectations and explain why Communicate and educate
7 What Does the Data Tell Us?
8 Falls Submitted to NCQC PSO 60.0% 58.3% NCQC PSO Falls by Level of Harm 50.0% 40.0% 30.0% 33.1% 20.0% 10.0% 8.1% 0.0% 0.3% 0.1% No harm Mild harm Moderate harm Severe harm Death
9 Falls Submitted to NCQC PSO
10 Falls Submitted to NCQC PSO 60.0% NCQC PSO Falls by Age Group 56.9% 50.0% 40.0% 30.0% 20.0% 18.4% 14.9% 10.0% 6.8% 0.0% 0.2% 0.2% Neonate (0-28 days) Infant (>28 days <1 year) 1.7% 0.9% Child (1-12 years) Adolescent (13-17 years) Adult (18-64 years) Mature adult (65-74 years) Older adult (75-84 years) Aged adult (85+ years)
11 Falls Submitted to NCQC PSO
12 Safe Table Event Sharing
13 Some Problems Continue... 92% of falls are preventable - 14% accidental - 78% anticipated physiological falls What does your data show? Where are your risks?
14 Preventing Falls with Injury
15 Digging Deeper 1. Inadequate patient assessment, specifically related to medication regimens 2. Patient assessments not updated following changes in clinical status, including mediation regimens 3. Fall-mitigation policies and protocols not available or not followed 4. Failure to ensure a safe physical environment. Tzeng HM, Yin CY. Nurses solutions to prevent inpatient falls in hospital patient rooms. Nursing Economics 2008;26(3):
16 Potentially Harmful Drugs in the Elderly: Beers List Updated
17 Monitor Medication Alerts for Overrides
18 Risk Mitigation Strategies 1. The Fall TIPS (Tailoring Interventions for ) Program Ensures all stakeholders involved in the patient s care, including the patient, has open communication and access to relevant information, tailoring each patient s care to his/her specific needs, ongoing surveillance and leveraging existing workflows, including effective use of HIT.
19 Example: Tailoring Care 1. Document falls risk assessment online 2. TIPS software identifies core set of evidencebased interventions linked to patient-specific risk factors 3. Nurse further tailors interventions to patient s risk factors & pt knowledge 4. TIPS software processes data and generates: - Bed poster - Plan of care - Educational handout for patients & family members
20 TIPS Program Toolkit Fall TIPS: Strategies to Promote Adoption and Use of a Fall Prevention Toolkit
21 Other Strategies for Reducing Risk 2. Multi-disciplinary approaches to fall risk assessments 3. Move patients at risk to rooms with best access to nurses station 4. Remain with patient while toileting and do not turn the lights off at night 5. Establish elimination schedules, including bedside commode use, if necessary 6. Observe/round every hour
22 Thank You for Sharing! Contact us: Kara Lyven, Nancy Schanz,
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