Authors (including presenting author) :
Ma MKM(1), Hui CP(1), Mak CW(1), Mok WS(1), Chung PYP(1), Leung KL(1), Pang PY(1)
Affiliation :
(1) Department of Orthopaedics and Traumatology, North District Hospital
Introduction :
In 2021, there were 15 fall incidents occurred, 7 cases related to toilet, 4 cases suffered from severity index (SI) ≥ 4 including 2 fractures (1 in toilet and 1 in bedside), 1 SAH and 1 collapsed spine, in 3 O&T wards in NDH. Our new practice aimed to reduce the number of patient fall incidents in ward-based setting through enhancing patients’ alertness towards fall risks. Traditionally, ward toilet design aims a safe and friendly environment to patients by setting assistive devices like handrail and large call buttons, but it is rare to have eye-catching and attractive signage. Thus, a LED projection signage on fall prevention was installed at toilet entrance to arouse patient and staff awareness.
Objectives :
(1) Reduce patient fall incidents in ward by 50% (2) Decrease fall incident SI ≥ 4 by 90% (3) Raise patients’ alertness toward fall prevention (4) Enhance patient experience and create an environmental safety culture
Methodology :
The projection signage was pilot in one of the 3 O&T wards in October 2021. It is an eye-catching light emitting diode (LED) which projects the signage of “fall precaution and proper use of walking aids” at patient toilet entrance. Staff, visitors and patients who are able to self or assisted mobilize to toilet will pass through the light projection area and be alerted of fall prevention.
Result & Outcome :
In 2022, total 7 fall incidents were reported in the Department, reduced by more than 50% as compared with the number of incidents (15) in 2021. In the pilot ward, number of fall incidents was greatly reduced by 80%, from 5 in 2021 to 1 in 2022. No patient fall was related to toilet. Severity index of all incidents is 1. Fifty self-mobilized patients in pilot ward, who stayed at hospital not less than 7 days and could walk with aids independently, were interviewed. Convenient sampling was adopted and the projection light was evaluated for its attractiveness, readability and location. These 50 patients together with 50 patients from another O&T ward (control group) were evaluated for their fall alertness by using 1 to 10 Vision Analogue Scale (fall risk and importance of proper walking aids use). Overall feedback was positive to the projection light, over 90% of patients agreed that the projection signage was attractive and readable, more than 85% of patients thought that the location was appropriate and more than 95% of patients agreed that the projection light could raise their fall risk awareness. Moreover, patients in pilot ward rated slightly higher score (mean 7.38) of self-estimated fall risks compared to patients in control group (mean 6.54). Rating of perception of proper walking aids use between 2 groups were similar (pilot group mean: 9.68; control group mean: 9.46). The use of projection light was extended to another 2 O&T wards in the Department in Jan 2023. Fall incidents rate will be reviewed by the end of 2023.
