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Do No Harm: A Multifactorial Approach to Preventing Emergency Department Falls-A Quality Improvement Project.
J Emerg Nurs. 2020 Jun 04 [Online ahead of print]JE

Abstract

INTRODUCTION

Patient falls in the emergency department are a unique patient safety issue because of the often challenging nature of the environment. As there are a variety of potential causative factors for patient falls in the emergency department, this project employed a multifactorial approach to prevent patient falls in a Level 1 trauma center emergency department (adult only) in an urban tertiary care teaching hospital.

METHODS

This project was a single-unit quality improvement intervention that compared postintervention monthly unit-level data to historic monthly rates on the same unit. The intervention was multifaceted with patient-level, nurse-level, and unit-level interventions employed. A task force was convened to review and identify specific departmental gaps related to fall prevention, complete a retrospective review of departmental patient falls to determine causative factors, and implement interventions to reduce ED falls. A comprehensive program consisting of an ED-specific fall risk assessment tool, remote video monitoring (RVM), stretcher alarms, and a robust patient safety culture, among other interventions, was implemented. Patient falls and falls with injuries were tracked as an outcome measure.

RESULTS

After data driven analysis of causation, selection of key interventions, staff education, and sustained focus for 2 years, the department experienced a 27% decrease in falls and a 66% decrease in falls with injuries.

DISCUSSION

A multifactorial approach was an effective strategy to decrease patient falls in the emergency department.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32507724

Citation

Cook, Nicole S., et al. "Do No Harm: a Multifactorial Approach to Preventing Emergency Department Falls-A Quality Improvement Project." Journal of Emergency Nursing, 2020.
Cook NS, Komansky BJ, Urton MS. Do No Harm: A Multifactorial Approach to Preventing Emergency Department Falls-A Quality Improvement Project. J Emerg Nurs. 2020.
Cook, N. S., Komansky, B. J., & Urton, M. S. (2020). Do No Harm: A Multifactorial Approach to Preventing Emergency Department Falls-A Quality Improvement Project. Journal of Emergency Nursing. https://doi.org/10.1016/j.jen.2020.03.007
Cook NS, Komansky BJ, Urton MS. Do No Harm: a Multifactorial Approach to Preventing Emergency Department Falls-A Quality Improvement Project. J Emerg Nurs. 2020 Jun 4; PubMed PMID: 32507724.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Do No Harm: A Multifactorial Approach to Preventing Emergency Department Falls-A Quality Improvement Project. AU - Cook,Nicole S, AU - Komansky,Brittany J, AU - Urton,Michael S, Y1 - 2020/06/04/ PY - 2019/11/06/received PY - 2020/01/29/revised PY - 2020/03/13/accepted PY - 2020/6/9/entrez KW - Emergency KW - Fall KW - Multifactorial KW - Remote video monitoring KW - Safety JF - Journal of emergency nursing JO - J Emerg Nurs N2 - INTRODUCTION: Patient falls in the emergency department are a unique patient safety issue because of the often challenging nature of the environment. As there are a variety of potential causative factors for patient falls in the emergency department, this project employed a multifactorial approach to prevent patient falls in a Level 1 trauma center emergency department (adult only) in an urban tertiary care teaching hospital. METHODS: This project was a single-unit quality improvement intervention that compared postintervention monthly unit-level data to historic monthly rates on the same unit. The intervention was multifaceted with patient-level, nurse-level, and unit-level interventions employed. A task force was convened to review and identify specific departmental gaps related to fall prevention, complete a retrospective review of departmental patient falls to determine causative factors, and implement interventions to reduce ED falls. A comprehensive program consisting of an ED-specific fall risk assessment tool, remote video monitoring (RVM), stretcher alarms, and a robust patient safety culture, among other interventions, was implemented. Patient falls and falls with injuries were tracked as an outcome measure. RESULTS: After data driven analysis of causation, selection of key interventions, staff education, and sustained focus for 2 years, the department experienced a 27% decrease in falls and a 66% decrease in falls with injuries. DISCUSSION: A multifactorial approach was an effective strategy to decrease patient falls in the emergency department. SN - 1527-2966 UR - https://www.unboundmedicine.com/medline/citation/32507724/Do_No_Harm:_A_Multifactorial_Approach_to_Preventing_Emergency_Department_Falls-A_Quality_Improvement_Project L2 - https://linkinghub.elsevier.com/retrieve/pii/S0099-1767(20)30088-X DB - PRIME DP - Unbound Medicine ER -
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