Proposed Topic (Most preferred): :
Clinical Safety and Quality Service I (Projects aiming to improve efficiency and effectiveness of care delivery to meet international standards)
Proposed Topic (Second preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Authors (including presenting author) :
Pun KL (1), Lam, PP(2), Chan, YKJ(3)
Affiliation :
(1) Nursing Services Division, Tung Wah Eastern Hospital, (2) Department of Medical & Rehabilitation, Tung Wah Eastern Hospital, (3) HKEC Information Technology, Pamela Youde Nethersole Eastern Hospital
Introduction :
Patient falls remain a common and debilitating problem in hospitals. Falls became one of three Nursing Quality Indicators in HKEC. According to the recent five-year HKEC Risk Register, Fall is among the top three risks. Over the years, we have utilized digital platforms for fall prevention and management. A consistently low fall incident rate was observed.
Objectives :
To standardize the measures of fall prevention and management through the adoption of digital platforms in the patient journey
Methodology :
A cluster-based fall committee with multi-disciplinary representatives was set up to develop cluster-wide fall prevention & management guidelines and practices. We conducted train-the-trainers workshop with unified training materials to align the practice among the cluster. All admitted patients would be assessed on fall risk in the Patient Assessment Form (PAF) in the Clinical Information System (CMS). For high-fall risk patients, fall prevention measures would be triggered, including signage on the Smart Panel Display System, e-referral to Allied Health for early mobilization training, and an alarm pad for closed monitoring. Once a patient was found to have fallen, the incident must be reported into Advanced Incident Reporting System (AIRS). The Fall prevention working team retrieved fall incident data quarterly for trend analysis and benchmarking for sharing with hospitals to provide reference and for quality improvement.
Result & Outcome :
Digital platforms were well utilized for patients’ fall prevention and management in the cluster. Since 2Q2018 – 1Q2023 (5 years), the inpatient fall rate in HKEC was kept at 0.17 – 0.22 per 1,000 inpatient bed days, much lower than Hospital Authority’s overall fall rate (0.41 – 0.45). Over 80% of patients in fall incidents were classified as having no injury sustained or minor injury. Nursing audits on fall prevention in two time points of 2023 revealed that the compliance rate on fall-related policy and guidelines was 96.85 – 99.75% among cluster hospitals. Cluster unified fall prevention and management practices with the adoption of digital platforms facilitated healthcare workers to prevent and manage patient falls effectively.
