The problem: Preventing inpatient falls has been a problem for the acute sector for many years and is associated with high risk for both the patient and the organisation. Approaches to risk reduction are complex because of the many factors involved and the published advice is plentiful. The challenge is to develop an approach which is both effective and sustainable.
Aintree’s solution: Our approach was multi-disciplinary, inclusive (with a focus on engagement) and locally owned by empowered staff; this we achieved through the Aintree Falls Prevention Collaborative. Launched in April 2014, the Collaborative included a multi-disciplinary team (MDT) of nurses (from Health Care Assistants to Matrons), occupational therapists, pharmacists, physiotherapists and doctors. A cohort of Falls Link Nurses and Champions were recruited from existing staff in clinical areas. A series of four meetings were planned over 12 months with key objectives for each and a timeline to develop a ‘Change package’.
The Collaborative used the Model for Improvement to provide a clear aim, structure and Driver Diagram to guide improvement work. The teams were empowered to identify steps to success which reduced falls; these steps were developed and tested using the ‘Plan-do-study-act’ (PDSA) approach. This led to the development of the ‘Aintree Change Package’, implemented in June 2015 and which comprises ‘7 steps to success’;
1: Patient activity boxes – a way of increasing activity for particularly elderly frail patients which enables cohorting when undertaking the activities and supervision
2: The use of Slipper Socks
3: The use of ‘Call Don’t Fall’ signs as reminders to prompt the use of call bells
4: Dignity v Safety – staff are proactive in asking patients about the level of supervision required at toileting
5: Hourly Comfort Rounds
6: The fixing of falls alarm bracket in patient bathrooms – encourages patients to carry the alarm with them at times of high risk activity
7: Education and Awareness of patients, carers and staff
Results: In 2014/15 we achieved a full year reduction in falls with harm of 11.5%
We had an aspirational goal to achieve a 15% reduction in falls with harm by the end of March 2016; by December 15 we achieved a 10.4% reduction and we are hopeful of reaching our stretch target by the end of March 2016.
http://www.fabnhsstuff.net/2016/03/28/aintree-falls-prevention-collaborative-change-package/