The Development of the WilsonSims Psychiatric Fall Risk Assessment Tool Gravity, it s not a suggestion. It s the LAW! Presenting author Steven Wilson RN-BC No conflict of interest to disclose And non-presenting authors Kristin Sims, RNC, MSN, NEA BC Disclosure Sondra Fettes, RNC, MSN Oaklawn Hospital, Marshall Michigan Session Objectives Understand why interdepartmental cooperation is important in the implementation of the research findings. Understand how are falls defined and counted on Oaklawn Hospital s Inpatient Psychiatric unit? First, how do we define a fall? Is this a fall? Wilson 1
The Burning Question: How do we know which of our patients is most at risk for falls? As a member of the fall risk committee, I was tasked with finding an assessment tool for use on my unit. I researched the currently available fall risk assessments and found none that fit our adult inpatient psychiatric population. Enter the Quality Work Group I can not do this on my own. But WE can! Maybe we should make our own tool? What would we need to do that? Nursing Staff and Administration come together, each bringing their own unique experience and resources. Wilson 2
One tool that binds them all Cast of characters Psychiatric Unit RN s, Unit Director Help score risk factors Tool design Carry through to the bedside Nursing Administration, CNO Help score risk factors Tool design Oversee implementation Director of Nursing research Reality Orientation Risk Management Supply data from our own hospitals history of patient falls. Information Systems Convert tool to electronic record Psychical Therapy Provides PT/OT assessment & adaptive equipment as needed Maintenance Department Environmental factors The WilsonSims Psychiatric Fall Risk Assessment Tool Oaklawn Hospital Evidence Based, predictive and user friendly for the staff RN s But is this a Valid Assessment Tool? KEY PLAYERS: Steve Wilson, RN BC, Staff Nurse Kristin Sims, RNC, MSN, NEA BC, CNO Sondra Fettes, RNC, MSN, Nursing Research Director Mary B. Billeen, PhD, RN, NEA BC, Consultant Ann Kruszewski, PhD, RN, Consultant Oaklawn Hospital Funding and Support Wilson 3
Has it worked? 12 Falls per 1,000 patient days 10 8 6 4 Goal is less than 3.5 Hospital Wide Inpatient Psych 2 0 2006 2007 2008 2009 2010 2011 2012 We are willing to share this tool for use on your own units. All we ask is that you share any data you may collect with us. Contact information: Sondra Fettes, RNC. MSN 269 789 3861 sfettes@oaklawnhospital.com or Steven Wilson RN BC swilson@oaklawnhospital.com wilsonsrn@gmail.com Key Points This tool was developed by Staff level RNs and Advanced Practice RNs joining nursing practice and theory. International, National and Local data were used to identify risk factors that are unique to an inpatient psychiatric unit. This project was a collaboration of efforts. We included many departments and disciplines working together to produce a product. This unique assessment tool is an example of how nurses of different education, background and areas of practice can have a rapid, effective and lasting impact on patient care and safety. Wilson 4
References Sky Diver in flight 06/28/2009, Image property of Steven and Karen Wilson. Oaklawn Hospital Logo use granted by Oaklawn Hospital Marketing department. Fall definition: Minnesota Hospital Association, 2010; US Department of Veterans Affairs, 2004 Question mark in flame: 123rf.com, Copyright : Mt Kang, Image ID : 11821108 A male robot thinking about something: 123rf.com, Copyright : Sarah Holmlund, Image ID : 9177608 Puzzle pieces: Image credit: <a href='http://www.123rf.com/photo_17811648_growthconnection with two trees in the shape of jigsaw puzzle pieces floating on an oceanmoving to.html'>lightwise Lord of the Rings Cast: http://s1131.photobucket.com/user/tiz_zaliya/media/nsdd7pgzree6gihp7rsgj18ot6l3ydh6.j pg.html?sort=3&o=1 A robot examines a human brain: 123rf.com, Copyright : Linda Bucklin, Image ID : 7972812 Fall Rate Graph by Steven Wilson RN BC, July, 2013. Hands reaching Image credit: <a href='http://www.123rf.com/photo_12915834_handsreaching towards each other.html'>balazschristina Key on wood: Image credit: <a href='http://www.123rf.com/photo_13983355_antique keyon wooden table.html'>akiyoko Content Validity of the Wilson Sims Falls Risk Assessment Tool To Measure Fall Risk of Psychiatric Inpatients. With permission of the authors: Mary B. Billeen, PhD, RN, NEA BC, Ann Kruszewski, PhD, RN, Kristin Sims, RNC, MSN, NEA BC, Sondra Fettes, RNC. MSN, Steve Wilson, RN BC Wilson 5