Brubaker, Christine L

Miller, Susan, BSN, RN

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksPatient Care Services / NursingImpact of Fall Risk Assessment Tool Education ona Medical-Surgical UnitChristine L. Brubakerchristine_l.brubaker@lvhn.orgSusan Miller BSN, RNLehigh Valley Health NetworkFollow this and additional works at: http://scholarlyworks.lvhn.org/patient-care-services-nursingPart of the Nursing CommonsThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtBrubaker, C., & Miller,S. (2016, March 18). Impact of Fall Risk Assessment Tool Education on a Medical-Surgical Unit. Poster presented atLVHN Vizient/AACN Nurse Residency Program Graduation, Lehigh Valley Health Network, Allentown, PA.© 2016 Lehigh Valley Health Network Lehigh Valley Health Network, Allentown, Pennsylvania Impact of Fall Risk Assessment Tool Education on a Medical-Surgical Unit  • Falls are the 2nd most frequently reported adverse event, resulting in  – decreased patient outcomes – increased LOS/cost (Fisher et al., 2014)  • Number of falls per FY is a LVHN QI measure  • Variation among individual patient fall scores on 6K  Critical assessments and resulting interventions are being overlooked  Caton, C., Wiley, M. K., Zhao, Y., Moran, W. P., & Zapka, J. (2011). Improving Internal Medicine Residents' Falls Assessment and Evaluation: An Interdisciplinary, Multistrategy Program. Journal Of The American Geriatrics Society, 59(10), 1941-1946 6p. doi:10.1111/j.1532-5415.2011.03555.x   Fisher, S. K., Horn, D., & Elliot, M. (2014). Taking a stand against falls. Nursing, 44(10), 15-17 3p. doi:10.1097/01.NURSE.0000453704.64284.5e   Flarity, K., Pate, T., & Finch, H. (2013). Development and Implementation of the Memorial Emergency Department Fall Risk Assessment Tool. Advanced Emergency Nursing Journal, 35(1), 57-66 10p. doi:10.1097/TME.0b013e31827c6a54   Healey, F. (2010). A guide on how to prevent falls and injury in hospitals. Nursing Older People, 22(9), 16-22 7p.    Kitchen, S. (2014). Improving falls risk assessment among inpatients of the general medical and orthopedic population at a tertiary hospital: a best practice implementation report. JBI Database Of Systematic Reviews & Implementation Report, 12(10), 296-313 18p. doi:10.11124/jbisrir-2014-1895   Lee, S., Staffileno, B. A., & Fogg, L. (2013). Influence of staff education on the function of hospitalized elders. Nursing Outlook, 61(1), e2-8 1p. doi:10.1016/j.outlook.2012.05.006  Liu, H., Shen, J., & Xiao, L. D. (2012). Effectiveness of an educational intervention on improving knowledge level of Chinese registered nurses on prevention of falls in hospitalized older people—A randomized controlled trial. Nurse Education Today, 32(6), 695-702 8p. doi:10.1016/j.nedt.2011.09.009  Murphy, K., & Lowe, S. (2013). Improving Fall Risk Assessment in Home Care. Home Healthcare Nurse, 31(7), 389-396 8p. doi:10.1097/NHH.0b013e3182977cdc   Tzeng, H., & Yin, C. (2014). Most and least helpful aspects of fall prevention education to prevent injurious falls: a qualitative study on nurses' perspectives. Journal Of Clinical Nursing, 23(17/18), 2676-2680 5p. doi:10.1111/jocn.12295  • Fall risks assessed by nursing judgment are unreliable and vary depending on nurse experience level (Flarity, K., Pate, T., & Finch, H., 2013)  • An educated staff and the “transfer of knowledge to practice” is necessary for providing quality care (Lee, Staffileno, and Fogg, 2013)  • Academic detailing and verbal messages were most preferred educational methods (Caton et al., 2011) (Tzeng & Yin, 2014)  • Improved accuracy of fall risk assessment and compliance with policy was found after educational interventions (Kitchen, 2014)  • EMR can be used successfully to provide cues (Caton et al., 2011)   Incorrect scores 32% Correct Scores 51% Scores off by 1pt 17% Post-Education Christine Brubaker, BSN, RN and Susan Miller, BSN, RN BACKGROUND / INTRODUCTION EVIDENCE METHODS & OUTCOMES RESULTS/CONCLUSIONS PRACTICE CHANGE • Chart audits showed fall score accuracy improved  standard deviation (SD) decreased from 4.7 to 1.1  • Pre- and post-education case studies improved  15% to 65% overall accuracy, SD decreased from 2.62 to 1.87   • Accurate fall scores lead to heightened nurse awareness and appropriate use of fall prevention measures    Scores off by 1pt 0% Pre- Education  Incorrect scores 92%  Correct  Scores 8% •     • Utilize “FYI” flag for patients with a history of falls – Add to unit admission checklist for accountability – Utilize FYI TLC education to disseminate network wide • Assess and document fall risk upon return from procedure   PICO QUESTION • Do inconsistent fall scores by Medical Surgical nurses lead to decreased awareness of patients’ risk for falls, leading to missed fall prevention opportunities? • 20 pre-intervention chart audits were completed and a case study was distributed to nursing staff  • Educational review  included: 1:1 detailing reviewing, CPM Fall Risk Tool assessment points, and common high fall-risk medications  • Reference sheets were hung at the nurses” work stations to reinforce education  • 20 post-intervention chart audits were completed, and a follow-up case study was distributed 

Impact of Fall Risk Assessment Tool Education on a Medical-Surgical Unit

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Impact of Fall Risk Assessment Tool Education on a Medical-Surgical Unit

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