Authors (including presenting author) :
CHAN HC(1), CHAN MY(1), Chan ST(1), CHUNG MF(1), Wong FS(1), Yeung MW(1), KWAN SCW(1), LEE MM(1)
Affiliation :
Nursing Department, Hong Kong Buddhist Hospital (HKBH)
Introduction :
Patient fall is the leading cause of injury or death in people over age 65. Fall prevention is one of the key performance indicators in hospital. From January to September 2021, there were 21 patients sustained a fall incident in HKBH and 20 of them were over 65 years old. Compared with the patient fall rate among Group 2 hospitals in Hospital Authority in 2Q2021 (0.21), HKBH had a similar fall rate (0.22).
Objectives :
To promulgate nurse input in focused patient rounding with PCA so as to reduce patient fall and hospital acquired risk factors.
Methodology :
In September 2021, HKBH fall prevention work group launched a “Fall awareness month” program. Group members conducted fall prevention audits on all Patient Care Assistants (PCAs). During the audit period, 94 PCAs were assessed, focusing on patient safety and comfort by using the 4M1E approach: Man, Method, Material, Machine and Environment. There were several clinical assessment items covering issues like fall prevention, pressure injury prevention, infection control, medication safety and environment safety etc.
Result & Outcome :
The audit compliance rate among all PCAs was 93% in average. There was no fall incident in Sep 2021. it was revealed that 7 out of 15 assessment items got 100% compliance rate e.g. patient’s belongings within reach, bedside rails raised, appropriate clothing size etc. Besides, compared with the audit result of last year, there was an increased number (40%) of PCAs who could address and handle bed exit alarm system signal loss problem. There were 8 out of 15 items got 93.62%-98.94% compliance rate e.g. call bell within reach, adjust bed height to lowest, lock wheels of furniture etc. Those items were being followed up in clinical handovers.
Promulgation of nurse input in proactive patient patrol rounding with PCA could enhance fall prevention. Nurse supervision with timely review of PCAs performance during the round could improve outcomes of patient care. PCAs could meet patients’ needs in a timely manner. During high fall risk periods, especially during night-time and nursing handover, PCAs could play a supportive role by entertaining patient’s need so as to reduce fall risk. This enhanced the patient’s experience of comfort in ward as their needs were fulfilled. Besides, during patrol rounding, other hospital acquired risk factors e.g. 5 moment hand hygiene compliance, medication safety were also acknowledged.
