Preventing patient falls and fall-related injuries is top of mind for many healthcare providers, but especially among those who care for the elderly and other vulnerable populations prone to falling. For these patients, just one bad fall can be life-changing, so healthcare facilities across BC are applying what they learn from BC PSLS to implement falls prevention and intervention strategies to keep patients safe.
On 2 South, a 27-bed Geriatric Psychiatry Unit at Royal Jubilee Hospital in Victoria, every patient has a unique combination of falls risks. The majority of patients are 75 years of age and older who have been diagnosed with an age-specific mental illness later in life – dementia, schizophrenia, psychosis and depression are common.
Lorrie Brooks, Manager for the past three years, says, “Patient falls are an expectation. Our patients are quite frail and in the later stages of their life and illness, and they may have mobility issues or be taking medications that predispose them to falls. So our patients are special and we have a wonderful team who understands that.”
The 2 South Geriatric Psychiatry team at Royal Jubilee: (left to right) Michelle Beaulieu, RPN; Liana Lamarre, LPN; Janet McGuire, LPN; Roland Van den Berg, RT; and Danean Herdman, OT.
One of the challenges, Lorrie says, is balancing safety with a patient’s right to independence. The unit does not use restraints, except in rare cases, and daily activities like eating, bathing, or taking medications are not forced. The staff work in pairs and calm patients by holding their hands, singing, or discussing the day; whatever appeals to that patient the most.
“We’ve learned that if a patient pulls back it’s best to wait and go back to them later. When we force patients it leads to bad consequences – that’s when patients may become agitated and that may lead to a higher risk of falling.”
Over the past year, Lorrie and her colleague, Heather Fudge, Clinical Nurse Specialist, have been studying their BC PSLS data to identify key falls risk factors. Lorrie says because her staff are so comfortable with reporting falls and other safety events in BC PSLS, they’ve been able to reduce falls and the severity of fall-related injuries by focusing on four key areas: environment, patient illness, medication use and agitation levels.
Falls prevention on 2 South:
Pull-up style underwear is used instead of sticky pads because they’re a better fit for elderly patients and don’t fall off as easily. Falls on the unit decreased by 25% after just two weeks of use.
Mopping-up spills immediately and effectively
Housekeeping staff are now using mops with better water absorbing material to reduce falls association with slips in pools of liquid, improving safety for patients, staff and visitors.
Wider hallways and handles
Hallways are eight inches wider than standard hospital hallways, accommodating patients who need more personal space. Handles are placed throughout the unit.
Indirect lighting
Appropriate lighting throughout the unit decreases shadows and glaring lights.
Calming colors
Soothing colors provide a calming atmosphere and reduce patient agitation.
Activation Aide
A specialist healthcare worker comes to the unit every day during sundown (approximately 3:00 – 8:00 pm) to provide a positive stimulus for patients, and to reduce aggression, depression or anxiety.
Lorrie says, hip fractures do still happen and are one of those unfortunate end-of-life issues that their patient population experiences. But she and her team are making every effort to minimize those events as much as possible.
“Really, all of this would not have been possible if it wasn’t for our amazing staff. They’re committed to quality improvement and they bring that lens to every investigation we do around patient injuries, staff injuries and family interactions. I’m incredibly proud of them and the quality of care we provide to our patients.”
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To learn more about 2 South’s approach to falls prevention, please contact Lorrie at lorrie.brooks@viha.ca
Learn more about Preventing Falls: From Evidence to Improvement in Canadian Health Care
Learn more about Accreditation Canada’s Required Organizational Practices for Falls Prevention.
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