Authors (including presenting author) :
Chan WC, Yip KT, Ho KF, Sit SY, Wong YK, Tsang SW, Chiang KH
Affiliation :
Physiotherapy Department, Shatin Hospital
Introduction :
In-hospital fall is a significant cause of disability for elderly patients. It has a serious impact on patients’ recovery and hospital resources. There exists a shedload of fall episodes in the public hospitals of Hong Kong. The reasons for falls are multi-factorial, some parts of the fall prevention program are regimes, while some are specific to individual patients. This CQI project was aiming to review the current practice of fall prevention in a local convalescent hospital and to further improve the fall prevention strategies for ensuring patient safety when performing Physiotherapy (PT) training.
Objectives :
1. To review current fall prevention procedures in identifying and monitoring patients with high fall risk. 2. To make recommendations on improvement measures and implement fall prevention strategies. 3. To increase staff awareness, knowledge, and skills in fall prevention and post-fall management. 4. To reduce fall incidents in the PT department.
Methodology :
Root cause analysis was conducted for all the fall incident reports from Physiotherapy Coordinating Committee in 2014 - 2020. The root causes of the fall incidents were classified into 6 categories, including patient, therapist, supporting staff factors as well as communication/ workload, environmental, and equipment factors. Regular In-service training and fall prevention drills were provided to staff as training. New safety devices were purchased based on the analysis of the fall incidents and operation from staff feedback. A flowchart for screening high fall-risk patients, and implementing general and specific safety measures, as well as a post-fall assessment checklist and management workflow were promulgated as references to guide clinical practices. A "Surprise" audit was performed to evaluate staff performance towards fall prevention.
Result & Outcome :
After the start of the fall program, the number of fall incidents in the PT department dropped from four to zero from the period of 2021 1Q-3Q to 2021 3Q - 2022 3Q. Staff reported that they were more confident in fall prevention and management after the CQI program. Staff was more compliant with the safety measures to prevent patient falls, and the improvement can be maintained in the half-year review.
