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Community Memorial Hospital
Community Memorial Hospital, Ventura, CA, telemetry/progressive care unit ensures patients are safe from falls
Essay Submitted by Community Memorial Hosptial Telemetry/Progressive Care Unit
Patient falls on the busy 44-bed telemetry/progressive care unit of Community Memorial Hospital were occurring despite using fall prevention interventions commonly used in many hospitals. We decided that a fresh new approach was needed to address patient falls on our floor. The fall prevention efforts discussed in this essay describe our defining moment of this realization and our efforts, solutions and successes to decrease fall rates.
At the end of December 2010, our unit's average call light response time was identified at 2 minutes 40 seconds. As a department, we felt there was a direct correlation between the call light response time and our patient fall rates. We came up with what proved to be our most effective strategy in fall reduction -- the Call Bell Tech program. This unique program assigns one nurse tech per shift to answer call lights and to provide anticipatory rounding to reduce call bell response times. After full implementation of the program, the average call bell response time has decreased to 30 seconds.
In April 2011, we added a second component to our program, called the Hot List, which identifies patients considered to be at the highest risk for falls. The Hot List is updated on a continuous basis and distributed to staff members at the beginning of each shift. The list enhances hands-off communication and allows the entire floor to work together to prevent falls in a high risk population. In May 2011, we introduced case studies to investigate the details surrounding each fall.
 The use of case studies fosters critical thinking and problem solving among staff. Employees are asked to review the circumstances unique to each fall, and present their own ideas about how to avoid similar falls in the future.
For example, analysis of the fall data during case studies revealed that approximately 62 percent of our patient falls were related to toileting needs. As a result, employees suggested that Hot List patients should not be left alone in the bathroom or on the commode. Once implemented, this suggestion proved very successful in eliminating toileting-related falls.
We also discovered that many patients were simply removing the tab alarms. Therefore, we decided to use bed pad alarms in addition to bed and tab alarms. Using bed pad alarms simultaneously with bed and tab alarms considerably reduced the risk of alarm failure and, consequently, the number of falls.
Meet Regional Best Nursing Teams
In July 2011, we implemented video surveillance, which allows high-risk fall patients to be monitored remotely by the telemetry monitor technician. This option has contributed to reduced patient falls and decreased the costs associated with sitter use. The video monitor was placed adjacent to our telemetry monitors and the telemetry technician observes both screens. Throughout the year, as a result of implementing our fall reduction strategies, falls have decreased by 70 percent. The fall prevention program implemented on the telemetry floor at Community Memorial Hospital has demonstrated our staff's ability to create a culture of safety. The program is cost-effective and is equally supported by staff and management.
Acknowledging staff and celebrating their successes increases their motivation and job satisfaction. It also gives the staff a shared goal, supporting group cohesion and promoting team work. Most importantly, our patient fall rate has decreased and our patients are now safer while under our care.
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