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www.saferhealthcarenow.ca
Falls Facilitated Learning Series
Cambridge Memorial Hospital
Our inpatient departments include:
Medicine OncologyGeneral Surgery Obstetrics Rehabilitation Mental Health
PaediatricsICU
Is a community hospital with a capacity to accommodate 133 acute care patients.
Located in Cambridge Ontario.
www.saferhealthcarenow.ca
Falls Facilitated Learning Series
AIMTo learn and integrate strategies of sustainability into
our organization’s falls improvement plans to ensure we increase the likelihood of sustaining practice change for prevention of falls and injury reduction while holding the gains over time. We will be active participants in data submission to SHN Falls Intervention and network with other enrolled teams in the National Falls Facilitated Learning Series (FFLS).
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Falls Facilitated Learning Series
Team MembersTeam Sponsor: Susan Gregoroff, Chief Nursing ExecutiveTeam Lead: Janine McNab RN, 3BPRO Team Members: Louise Chadsey RN, 3BPRO Sharon Kenkel RN, 5MED Elizabeth Wishart RN, 5MED Violette Strzelbicki RN, 5MED Rosemary Lywood Educator 3BPRO & NRT Charles Bauman, Manager 3BPRO Marlaine Cole, Manager 5MED
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Falls Facilitated Learning SeriesA Review of Falls Change Ideas tested to date at
Cambridge Memorial Hospital
Changes Implemented within Organization
Working/ Not
Working
Facilitators/Barriers Identified
Yellow Arm Band Visual Identifier High Risk Patients
Working Facilitator- Benefits; supports BPG Identifying high risk patientsFacilitator- Attitudes, Networks
Changes to Falls Prevention Policy – not just for the elderly
Work in progress
Barrier- Attitudes, typically low falls areas may be resistant to implementing FRA i.e. Obstetrics, Paediatrics
Meditech Changes to Intervention screens
Working Facilitator- Policy; removing found gaps in FRA through out the facility
4 hour Paid Falls Workshop RN, RPN, Allied Health, DI
To be heldend of March
2012
Facilitator- Relevance of Issue: fits with CMH strategic plan ,Accreditation Canada ROP, ties in 3D’s and pharmaceuticals related to fallsFacilitator- Financial: funding
FRA upon transfer to a new unit/ communicating to another facility FRA
Recently Implemented
Facilitator- closing gaps in communication and FRA
Bed/Chair Alarms trial 5MED/3BPRO ongoing trial
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Falls Facilitated Learning Series
% at Risk with a Documented Falls Prevention Injury Reduction Plan
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Falls Facilitated Learning Series
Lessons Learned on Sustaining Falls Improvement Work during Action
PeriodAdvice to other teams: •A comprehensive Falls Prevention Program involves the Interprofessional team. •Falls prevention and injury reduction does not occur immediately, barriers remain despite interventions.Key Insights: Falls Prevention Programs –•Will not identify all patients who will experience a fall. •Should also include planning for reducing the level of injury sustained from a fall. •Are not just for the older adult patient, nor are they specific only to inpatient units.•FRA tools do not conform to all patient populations or all departments, multiple FRA tools may be necessary within an organization.
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Falls Facilitated Learning Series
What were some barriers?•Financial: unknown until late December if funding available, until that point reduced hours invested in FFLS by Team Lead and Team Members. •Attitudes: Ability to have Team Members present at all CMH FFLS meetings What were some Facilitators? •Relevance of the issue: Impacts on Patient, Family, Health Care, part of CMH Quality Improvement Plan•Political Climate: Accreditation Canada ROP, RNAO partnership in National FFLS•Leadership: Supportive Organizational Leadership and Team Sponsor, committed FFLS Team; leading by example, educating and supporting as we implement sustainable changes •Financial: funding through OHA/ONA Nursing Engagement- Quality Work Environment Strategy Initiative
Challenges to Sustaining Falls Improvement
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Falls Facilitated Learning Series
Challenges to Sustaining Falls Improvement
Moving Forward
• Education continues to be vital in sustaining change as CMH moves forward in Falls Prevention and Injury Reduction.• FRA to be completed in all areas and all patient populations.• A post fall process at CMH needs to be developed to have a better understanding of each individual fall and implementation of patient specific post fall care planning as part of an interprofessional, multifactorial plan.
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Falls Facilitated Learning Series
6 Month Post FFLS Sustainability Plans for Falls Improvement WorkGoal Description
(What is AIM)
Action
(What STEPS are to be taken to achieve)
Timeframe
(When to be done by)
Person Responsible
Metrics: What is to be monitored to identify achievement
1-Sustaining Fall and Injury Reduction
2- Active participants in data submission to SHCN
Monitoring falls data Monthly To be determined
Falls per 1000 patient days
% Falls with injury (level)
Sustaining Documentation and Intervention Changes
Monitoring Falls Risk Assessment on admission,
routine, PRN
Quarterly TBD % of FRA completed on admission,
Sustaining
and holding gains
Falls audit data to be shared with Managers to present at Q&O, staff meetings, share via e-cast, post on individual units quality bulletin boards
Monthly and
Quarterly
TBD Falls per 1000 patient days
% Falls with injury (level)
% FRA completed on Admission
% at risk patients with Implemented standard of care plan
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Falls Facilitated Learning Series
6 Month Post FFLS Sustainability Plan (continued)Goal Description
(What is AIM)
Action
(What STEPS are to be taken to achieve)
Timeframe
(When to be done by)
Person Responsible
Metrics: What is to be monitored to identify achievement
Sustaining gains made in falls reduction and practice changes
Hospital Wide Orientation will include a segment on
Falls prevention
Start April 2012,
Thereafter monthly
Educators Falls per 1000 patient days
% Level of injuries with falls
% FRA completed on admission
Sustaining ability to be active participants in Safer Health Care Now data Submission
Automated electronic audit tool
undetermined Louise Bailey % FRA completed on Admission
% at risk patients with falls prevention implemented care plan
% patients FRA score 65 or> wearing yellow arm band
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Falls Facilitated Learning Series
Name: Janine McNab
Email: [email protected]
Phone Number: 519- 621-2333 ext. 3155
Contact Information