Falls prevention in a Tabriz general hospital: A collaborative approach
Authors: Dr. Amin Talebpour1, Dr. Mehdi Nouri1, Dr. Sakineh Hajebrahimi1
1. Iranian EBM Centre: A JBI Centre of Excellence
Background
Patient falls are a significant concern in health care settings, leading to increased morbidity, mortality, and health care costs. In hospitals, where patients may be particularly vulnerable due to age, medication effects, or underlying conditions, preventing falls is crucial for maintaining patient safety. Evidence shows that a comprehensive, systematic approach to fall prevention can drastically reduce the risk of falls and improve patient outcomes.
In a general hospital in Tabriz, Iran, a fall prevention program was developed in response to the growing concerns over patient safety and the impact of falls on hospital resources. The program implemented evidence-based strategies to address this critical issue and ensure better protection for patients, especially those at higher risk.
A partnership for implementing fall prevention measures
The Research Center for Evidence-based Medicine (EBM) in Tabriz initiated a collaborative effort with the patient safety department and nursing unit of the general hospital to implement a best practice fall prevention program. This partnership brought together hospital managers, nurses, and patient safety experts to design a program that could effectively reduce falls within the hospital setting.
The EBM Research Center: A JBI Centre of Excellence led the project, identifying the most up-to-date, evidence-based protocols and tailoring them to the needs of the hospital. These protocols included:
1. Routine fall risk assessments: Upon admission and periodically throughout the patient's stay, nursing staff conducted fall risk assessments using a standardized tool such as the Morse Fall Scale. This helped to identify high-risk patients who required special attention.
2. Environmental modifications: To create a safer environment, the hospital ensured that rooms and hallways were free from hazards. This involved removing obstacles, ensuring proper lighting, securing loose rugs, and placing frequently used items within easy reach of patients.
3. Assistive devices and equipment: Proper use of assistive devices such as walkers, canes, and bed rails was emphasized. Staff ensured that devices were available and correctly adjusted for each patient, and alarms were installed on beds to alert staff if high-risk patients attempted to leave their beds unsupervised.
4. Patient and family education: Patients and their families were educated on the importance of fall prevention, including strategies for safe mobility, the appropriate use of assistive devices, and the need to ask for assistance when moving.
5. Staff education and training: Continuous education sessions were held for health care staff, particularly nurses and caregivers, to raise awareness of fall risks and provide practical training in fall prevention techniques, including safe patient handling.
6. Medication reviews: As medication-related side-effects, such as dizziness or drowsiness, can increase fall risk, pharmacists regularly reviewed patients' medications, particularly for older adults or those on polypharmacy, to identify and adjust medications that may heighten fall risks.
7. Post-fall protocols: In cases where a fall occurred, the hospital had a detailed post-fall protocol to evaluate the incident, assess the patient, and adjust care plans as needed to prevent future falls. This also involved conducting root cause analyses to identify systemic factors contributing to falls.
The nursing staff and patient safety department played a crucial role in implementing these protocols on the ground, ensuring that every member of the health care team was educated on fall prevention strategies. Educational workshops, training sessions, and continuous monitoring were key components of the program.
Results and impact
The fall prevention program led to a significant reduction in the rate of patient falls. Specifically, within the first year of the program, the hospital saw a 35% decrease in the overall fall rate. The key interventions included routine fall risk assessments, improving the environment to minimize hazards, patient education, and ensuring proper use of assistive devices. Multidisciplinary teamwork and continuous feedback from health care workers facilitated the successful application of the program.
Key results of the program
The fall prevention program led to notable improvements in several areas, including:
- Overall fall rate: There was a 35% decrease in the overall fall rate within the hospital.
- Staff awareness and training: Surveys conducted before and after the program showed that 85% of health care staff reported improved confidence in identifying and mitigating fall risks, compared with 55% before the program.
- Leadership engagement: Hospital leadership’s involvement increased by 40%, with more frequent monitoring and follow-up on patient safety issues, which sustained improvements in patient safety practices.
Conclusion and learnings
This interdepartmental partnership for fall prevention yielded several important lessons:
- Leadership engagement was critical to the success of the safety initiative, ensuring that resources were allocated and priorities set for patient safety.
- Continuous education and training for health care workers proved essential in maintaining fall prevention practices, as staff became more proficient in identifying risks and applying best practices.
- Tailoring evidence-based practices to the specific needs of the hospital environment was key to achieving the best outcomes, allowing for a more focused and practical application of fall prevention strategies.
Through this collaborative effort and a shared commitment to patient safety, the hospital was able to create a safer environment for its patients, resulting in a 35% reduction in fall rates and overall improvements in the quality of care. The teamwork between hospital leadership, patient safety experts, and nursing staff demonstrated that a multidisciplinary approach could significantly reduce patient harm and promote sustained safety improvements
To link to this article - DOI: https://doi.org/10.70253/KSRJ7274
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