Www.saferhealthcarenow.ca Rapid Fire Team Presentation Template Janine McNab Name of Presenter:

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Rapid Fire Team Presentation Template Janine McNabName of Presenter:


Falls Facilitated Learning Series

Cambridge Memorial Hospital

Our inpatient departments include:

Medicine OncologyGeneral Surgery Obstetrics Rehabilitation Mental Health

PaediatricsICU

Is a community hospital with a capacity to accommodate 133 acute care patients.

Located in Cambridge Ontario.



AIMTo learn and integrate strategies of sustainability into

our organization’s falls improvement plans to ensure we increase the likelihood of sustaining practice change for prevention of falls and injury reduction while holding the gains over time. We will be active participants in data submission to SHN Falls Intervention and network with other enrolled teams in the National Falls Facilitated Learning Series (FFLS).



Team MembersTeam Sponsor: Susan Gregoroff, Chief Nursing ExecutiveTeam Lead: Janine McNab RN, 3BPRO Team Members: Louise Chadsey RN, 3BPRO Sharon Kenkel RN, 5MED Elizabeth Wishart RN, 5MED Violette Strzelbicki RN, 5MED Rosemary Lywood Educator 3BPRO & NRT Charles Bauman, Manager 3BPRO Marlaine Cole, Manager 5MED


Falls Facilitated Learning SeriesA Review of Falls Change Ideas tested to date at

Cambridge Memorial Hospital

Changes Implemented within Organization

Working/ Not

Working

Facilitators/Barriers Identified

Yellow Arm Band Visual Identifier High Risk Patients

Working Facilitator- Benefits; supports BPG Identifying high risk patientsFacilitator- Attitudes, Networks

Changes to Falls Prevention Policy – not just for the elderly

Work in progress

Barrier- Attitudes, typically low falls areas may be resistant to implementing FRA i.e. Obstetrics, Paediatrics

Meditech Changes to Intervention screens

Working Facilitator- Policy; removing found gaps in FRA through out the facility

4 hour Paid Falls Workshop RN, RPN, Allied Health, DI

To be heldend of March

2012

Facilitator- Relevance of Issue: fits with CMH strategic plan ,Accreditation Canada ROP, ties in 3D’s and pharmaceuticals related to fallsFacilitator- Financial: funding

FRA upon transfer to a new unit/ communicating to another facility FRA

Recently Implemented

Facilitator- closing gaps in communication and FRA

Bed/Chair Alarms trial 5MED/3BPRO ongoing trial



Measures

Falls per 1000 Patient Days



% Falls Causing Injury Level 2 - 6



% Admission FRA completed



% at Risk with a Documented Falls Prevention Injury Reduction Plan



Lessons Learned on Sustaining Falls Improvement Work during Action

PeriodAdvice to other teams: •A comprehensive Falls Prevention Program involves the Interprofessional team. •Falls prevention and injury reduction does not occur immediately, barriers remain despite interventions.Key Insights: Falls Prevention Programs –•Will not identify all patients who will experience a fall. •Should also include planning for reducing the level of injury sustained from a fall. •Are not just for the older adult patient, nor are they specific only to inpatient units.•FRA tools do not conform to all patient populations or all departments, multiple FRA tools may be necessary within an organization.



What were some barriers?•Financial: unknown until late December if funding available, until that point reduced hours invested in FFLS by Team Lead and Team Members. •Attitudes: Ability to have Team Members present at all CMH FFLS meetings What were some Facilitators? •Relevance of the issue: Impacts on Patient, Family, Health Care, part of CMH Quality Improvement Plan•Political Climate: Accreditation Canada ROP, RNAO partnership in National FFLS•Leadership: Supportive Organizational Leadership and Team Sponsor, committed FFLS Team; leading by example, educating and supporting as we implement sustainable changes •Financial: funding through OHA/ONA Nursing Engagement- Quality Work Environment Strategy Initiative

Challenges to Sustaining Falls Improvement



Challenges to Sustaining Falls Improvement

Moving Forward

• Education continues to be vital in sustaining change as CMH moves forward in Falls Prevention and Injury Reduction.• FRA to be completed in all areas and all patient populations.• A post fall process at CMH needs to be developed to have a better understanding of each individual fall and implementation of patient specific post fall care planning as part of an interprofessional, multifactorial plan.



6 Month Post FFLS Sustainability Plans for Falls Improvement WorkGoal Description

(What is AIM)

Action

(What STEPS are to be taken to achieve)

Timeframe

(When to be done by)

Person Responsible

Metrics: What is to be monitored to identify achievement

1-Sustaining Fall and Injury Reduction

2- Active participants in data submission to SHCN

Monitoring falls data Monthly To be determined

Falls per 1000 patient days

% Falls with injury (level)

Sustaining Documentation and Intervention Changes

Monitoring Falls Risk Assessment on admission,

routine, PRN

Quarterly TBD % of FRA completed on admission,

Sustaining

and holding gains

Falls audit data to be shared with Managers to present at Q&O, staff meetings, share via e-cast, post on individual units quality bulletin boards

Monthly and

Quarterly

TBD Falls per 1000 patient days

% Falls with injury (level)

% FRA completed on Admission

% at risk patients with Implemented standard of care plan



6 Month Post FFLS Sustainability Plan (continued)Goal Description

(What is AIM)

Action

(What STEPS are to be taken to achieve)

Timeframe

(When to be done by)

Person Responsible

Metrics: What is to be monitored to identify achievement

Sustaining gains made in falls reduction and practice changes

Hospital Wide Orientation will include a segment on

Falls prevention

Start April 2012,

Thereafter monthly

Educators Falls per 1000 patient days

% Level of injuries with falls

% FRA completed on admission

Sustaining ability to be active participants in Safer Health Care Now data Submission

Automated electronic audit tool

undetermined Louise Bailey % FRA completed on Admission

% at risk patients with falls prevention implemented care plan

% patients FRA score 65 or> wearing yellow arm band



Name: Janine McNab

Email: [email protected]

Phone Number: 519- 621-2333 ext. 3155

Contact Information

Www.saferhealthcarenow.ca Rapid Fire Team Presentation Template Janine McNab Name of Presenter:

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