Most Proposed Topic :
Clinical Safety and Quality Service II (projects aiming to enhance clinical safety and outcomes, clinical governance)
Proposed Topic (Second preferred): :
Staff Engagement and Empowerment (motivating staff / teamwork / work revamp tackling manpower issue / staff wellness / OSH / retention)
Authors: (including presenting author): :
Lam MKR(1), Kwok CY(2), Lee TK(2), Mak YK(3)
Affiliation: :
(1)Department Of Ear Nose & Throat, Alice Ho Miu Ling Nethersole Hospital, (2)Department of Psychiaty, Tai Po Hospital, (3)Department of Medicine & Geriatrics, Tai Po Hospital
Introduction: :
Patient falls are devastating for individuals, associated with a serious psychological impact, functional disability, and tremendous burden on healthcare system. In 2021/22, AHNH noted an alarming inpatient fall rate of 0.76. A series of co-designed fall preventive efforts across specialties have been implemented in all inpatient settings in AHNH and TPH.
Objectives: :
Address high fall rate to enhance staff attentiveness, alertness, and awareness (3As) regarding fall prevention.
1. Promote attentiveness in day-to-day care to meet patient needs and eliminate safety hazards.
2. Enhance alertness to unsupervised mobilization among patients at risk of falls through the use of detection devices.
3. Instigate cultural change to raise awareness of fall prevention.
Methodology: :
Attentiveness
•2Q 2021, a fall preventive safety ward round was implemented in all NTEC inpatient wards. With a standardized checklist, collaborative patrols were done by nurses and supporting staff at least once per shift, to ensure implementation of environmental fall preventive measures, including placement of fall alert cards and easily accessible patient belongings.
•3Q 2021, to address toileting-related falls, posters were placed next to call buttons in all washroom cubicles, encouraging patients to seek staff assistance when needed.
Alertness
•3Q 2022, 330 sets of fall alarm mats were distributed to inpatient departments with high fall rate.
•2Q 2023, a pilot project of enhanced fall alert cards was implemented across various specialties. These cards indicate Modified Functional Ambulatory Category (MFAC) and number of assistants needed during mobilization for patients on fall precautions.
Awareness
•3Q 2023, eye-catching foam boards were placed in staff working areas to emphasize the importance of regular fall preventive safety ward rounds and patient assessments.
•Additionally, a 4-hour staff engagement booth was organized to foster cultural change regarding fall prevention in day-to-day patient care. More than 250 multidisciplinary staff participated.
Result & Outcome: :
After aforementioned efforts, fall rate demonstrated a steady decline from 2021/22, 2022/23, to 2023/24 (as of Nov 2023). For AHNH, it dropped from 0.76 to 0.63 and reduced further to 0.48; for TPH it dropped from 0.2 to 0.18, then 0.13. In conclusion, the fall incident status at AHNH/TPH is under control. To sustain a low fall rate, staff engagement is most crucial to bring overall cultural shift in mindset towards fall prevention.
