Event Title

An Education Intervention to Increase Rounding and Toileting and Reduce Falls in a Hospital Acute Care of the Elderly (ACE) Unit

Location

Hager-Lubbers Exhibition Hall

Start Date

10-4-2018 3:30 PM

Description

INTRODUCTION: Falls are the most common accident reported in acute care. Patients who are 65 and older are the most vulnerable. Falls lead to physical/emotional injury, reduced mobility/functioning, increased length of stay, increased healthcare costs, and admission to long-term care facilities. In 2008, the Center for Medicare & Medicaid Services (CMS) eliminated reimbursement to hospitals for treatment of injuries resulting from a fall during hospitalization. PURPOSE: This project focused on implementing a regular, intentional rounding and toileting schedule to decrease falls in the elderly population on the ACE unit at a large Midwestern hospital. SUBJECTS: Patients, Registered Nurses (RNs) and Nurse Technicians (NTs). METHODS: Simulation and written education used to introduce steps and frequency of rounding and toileting to RNs and NTs. Observation; survey; discussion with staff; chart audits; and number of fallers, falls with injury, and number of patient falls per 1,000 patient days were evaluated. ANALYSES: Pre-/Post- quality improvement; two-independent sample t-test; Wilcoxon Rank Sum test. RESULTS: Rounding and toileting increased but were not implemented to the fullest extent. Number of fallers decreased from mean of 1.8 (standard deviation [SD 0.98]) fallers to 1 (SD 0) per month post implementation. Falls per 1,000 patient days increased from an average of 3.48 (SD 2.63) in the prior 37 months to 5.47 (SD 0) in the first 30 days post-implementation. No falls with injury occurred post-implementation. CONCLUSION: Simulation was effective at increasing staff knowledge. Intentional rounding and toileting promising intervention to decrease falls in this population when fully implemented.

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Apr 10th, 3:30 PM

An Education Intervention to Increase Rounding and Toileting and Reduce Falls in a Hospital Acute Care of the Elderly (ACE) Unit

Hager-Lubbers Exhibition Hall

INTRODUCTION: Falls are the most common accident reported in acute care. Patients who are 65 and older are the most vulnerable. Falls lead to physical/emotional injury, reduced mobility/functioning, increased length of stay, increased healthcare costs, and admission to long-term care facilities. In 2008, the Center for Medicare & Medicaid Services (CMS) eliminated reimbursement to hospitals for treatment of injuries resulting from a fall during hospitalization. PURPOSE: This project focused on implementing a regular, intentional rounding and toileting schedule to decrease falls in the elderly population on the ACE unit at a large Midwestern hospital. SUBJECTS: Patients, Registered Nurses (RNs) and Nurse Technicians (NTs). METHODS: Simulation and written education used to introduce steps and frequency of rounding and toileting to RNs and NTs. Observation; survey; discussion with staff; chart audits; and number of fallers, falls with injury, and number of patient falls per 1,000 patient days were evaluated. ANALYSES: Pre-/Post- quality improvement; two-independent sample t-test; Wilcoxon Rank Sum test. RESULTS: Rounding and toileting increased but were not implemented to the fullest extent. Number of fallers decreased from mean of 1.8 (standard deviation [SD 0.98]) fallers to 1 (SD 0) per month post implementation. Falls per 1,000 patient days increased from an average of 3.48 (SD 2.63) in the prior 37 months to 5.47 (SD 0) in the first 30 days post-implementation. No falls with injury occurred post-implementation. CONCLUSION: Simulation was effective at increasing staff knowledge. Intentional rounding and toileting promising intervention to decrease falls in this population when fully implemented.