Authors (including presenting author) :
Chiu TY(RN),Leung WH(WM), Lee HW(RN),To PS(APN),Tang CM(RN)
Affiliation :
Endoscopy Center, Yan Chai Hospital
Introduction :
Moderate sedation is one of the most widely forms of sedation used to help patients feel relaxed and comfortable during endoscopic procedures in YCH Endoscopy Center (EC). Between April 2021 and March 2022, 230 sedated day-patients (Home bowel preparation & other GI procedures) were discharged from Endoscopy Centre directly. They were required to stay in EC at lease 1-2 hours for close monitoring till fully awake. It can be predicted that post procedural falls may be occurred due to the residual pharmacologic effects that resulting in bruising, skin abrasion and even more serious bone fracture or head injury. Bed exit is a critical moment, especially for the patient who under the influence of sedatives such as midazolam & fentanyl. Additional to apply the "Universal Fall Prevention" measures, an infrared fall alarming system was used in the aforesaid period for preventing the risk of falls. It uses invisible infrared beams to monitor the movements of patient. It is easily mounted on the wall or headboard and perfectly for infection control with its hands-free and wireless operation. When a patient sits up in bed or attempts a bed exit, an alarm with bed number displayed is transmitted to alert the nurse via a light weighted pager with immediacy in real-time.
Objectives :
To provide a safe environment and reduce the chances of falling in the Endoscopy Centre of Yan Chai Hospital by adopting the Infrared Bedside Sensors.
Methodology :
1. Revise and review the "Universal Fall Prevention" strategy and arrange demonstration for the Infrared bed alarm system to all staff
2. Implement the "Universal Fall Prevention" measures (Fig.1) e.g. Orientate patients and carers to Centre’s facilities; explain sedation procedure as the day-to-day practice.
3. Patients were sedated for GI procedure then transferred to recovery area with infrared bedside sensors were installed in EC for monitoring.
4. All patients were monitored by physio monitoring and instructed to use the call bell when necessaries.
5. Review and evaluate the effectiveness of the system Universal Fall Prevention (Fig.1)
i. Make the patient familiar with the environment.
ii. Explain the procedure and complications of sedation
iii. Demonstrate the use of call bell
iv. Maintain call bell within reach.
v. Weekly check the robustness of handrails.
vi. Place the hospital bed in low position when a patient is resting in bed; raise bed to a comfortable height when the patient is transferring out of bed.
vii. Keep bed brakes locked when patient in bed.
viii. Access the fitness, comfortable and slip resistance of patient’s footweari
ix. Keep floor surfaces clean and dry. Clean up all spills promptly.
x. Keep patient care areas uncluttered and brightness.
xi. Follow safe patient handling practices.
Result & Outcome :
No patient fall was reported during April 2021 to March 2022. Nurses reflected that the Infrared sensors can increase their alertness and awareness. It’s good for monitoring the sedated patient especially in limited manpower. Even though Infrared sensors can improve performance and ultimately reduce the risk of falls, sufficient staff is still required to keep closely monitoring of sedated patients in recovery areas.
