Authors (including presenting author) :
Chu WY(1), Chan WS(1), Ma TC(1), Lam KK(1), Ho CW(1), Chan PT(1), Lai CH(2)
Affiliation :
(1) Tuberculosis and Chest Unit, Grantham Hospital, (2) Central Nursing Division, Grantham Hospital
Introduction :
Patients fall is the highest risk in the Risk Registry of Grantham Hospital(GH) and one of the nursing quality indicator in Hospital Authority throughout years. In recent year, GH patients fall incident rate ranged from 0.08 to 0.72 falls per 1,000 inpatient days. However, there was a surge to 1.01 falls per 1,000 inpatient days on 3Q 2021. Our team analyzed the fall pattern from incident reports during 2Q21 to 1Q22. Fall incidents were commonly found at night time and early morning. Patients usually fell at bedside due to toilet-related activities. In our department, there was no protocol or guideline regarding to ward rounding, including frequency, key elements and documentation.
Objectives :
1. To reduce fall incident rate 2. To increase knowledge and awareness on fall prevention among nurses 3. To improve patient satisfaction.
Methodology :
1. intentional nurse rounding was explored via EBP process. Our study question was "Could Intentional ward round reduce fall incident?". Evidence showed that intentional ward round may help reduce fall. 2. Standardize intentional rounding (Frequency, time , method & documentation) 3. Staff knowledge and awareness (pre & post test) 4. Education session of new intentional rounding protocol to staff 5. Implementation of new protocol 6. Staff satisfaction survey and Patient satisfaction survey
Result & Outcome :
1. Fall incident rate improvement 2. Staff knowledge and awareness improvement 3. Staff satisfaction survey 4. Patient satisfaction survey a. Staff knowledge and awareness - Pre-test Mean score was 2.13 out of 6. - Post-test, Mean score was 5.89 out of 6 (Response rate was 63.3%) b. Effect on fall rate Two months after implementation, fall rate was 0 this year. On the same period, fall rate was 0.95 per 1000 patient bed day last year. The fall incident was eliminated for more than 2 months after implementation. c. Patient feedback - invited alert and conscious patient - received 35 responses from 54 participants. Response rate was 64.8%. - all patients satisfied with our nursing service - scored 8.3 out of 10 averagely for our nursing service d. Staff feedback - 63.3% of staffs responded. All satisfied with the program.
