P40 - Patient-Family Engagement: A Quality Improvement Project to Reduce Falls

Objective: Decrease falls (unplanned decent of a patient to the floor that may or may not result in physical injury) related to family and/or visitors assisting patients with toileting needs.
Background and situation: Each year, somewhere between 700,000 to 1,000,000 people in the United States fall in the hospital. Research shows that close to one-third of falls can be prevented (AHRQ, 2020). 55% of falls in a 3-month period on a medical- surgical oncology unit were related to family members attempting to assist with patient toileting without calling for help from trained staff members. The unit was unable to reach the NDNQI benchmark during this quarter with highest monthly fall rate of 3.92 falls per 1000 patient days.

Program description: A PICO question was developed, and information was disseminated to staff via SBAR communication tool. Staff scripting was created as an ice breaker to engage families in the fall prevention strategies including calling for trained staff to get the patient out of bed. Charge nurses were trained to note patients with families for more detailed rounding.
Methods: Retro chart review showed a high level of family involvement in care for this population of cancer diagnosis, palliative care, or end-of-life patients. SBAR and scripting signature sign-off sheets were collected showing education was read by the staff.
Results: In a 6-month period, after the patient engagement with the staff, there was 1 fall, and the fall was not related to the family involvement. After the 1st fall, the subsequent 7 months were with a fall rate of 0.00 per 1000 patient days, successfully meeting the benchmark for the next 2 quarters.

Conclusion: Engaging patients' families in fall in individualized fall prevention strategies can reduce patient falls and increase staff comfort with discussing patients' fall risk and fall prevention plan.