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 | The Christiana Care Way We serve together to reduce variation in our fall prevention approach
By Denise Lyons, DNP, APRN, AGCNS-BC, LSSGB, Co-Chair, Systemwide Fall Prevention Team
Each day at Christiana Care, a system report noting patient falls within the previous 24-hour period helps carefully monitor efforts to provide the safest possible environment for our patients. For the second day in a row, as I sit down to write this message, I’m looking at a report that shows zero falls. This report is proof-positive that when we say “we serve together, guided by our values of excellence and love,” it makes a difference. I’m feeling positive about the work that we’re doing. I also know that for the safety of our patients, there is always more we can and must do on our journey to zero falls.
Falls can lead to long-lasting adverse outcomes. In addition to causing physical harm, a fall can rob any patient of confidence and lead to a loss of independence, diminished quality of life, decreased socialization, increased risk of nursing home placement and increased caregiver burden. As many as 1 million hospitalized patients fall in the United States each year, and nearly one-third of those falls result in moderate to major injury.
In Fiscal Year 2018, we reformatted the systemwide Fall Prevention Team to include a designated nursing leader from each of our nine service lines. The team is co-chaired by Patricia Curtin, M.D., FACP, CMD, and colleagues
from Clinical Engineering, Pharmacy, Rehabilitation Services and the Visiting Nurse Association. This team gives us structure and helps us standardize interventions and care-management guidelines systemwide. Every week, in every service line, nurse managers review falls in their respective practice areas to identify risk trends and opportunities, and to highlight efforts that work well. Every other month, the systemwide Fall Prevention Team gathers to share successes and opportunities for improvement, and to update our care management
Sguidelines based on the latest evidence.
ervice lines and essential services collaborate to reduce variation in our fall-prevention approach and ensure that the same guidelines are in place in both ambulatory and acute care practice
areas. Clinical nurses and frontline staff partner on fall-prevention strategies, as do nursing students on clinical rotation in our hospitals. Patients and their family members are also key team members. We include them in care plan meetings and bedside shift reports to make sure they understand fall risks and safety interventions.
   We have streamlined guidelines to include use of non-skid footwear and gait belts, and to ensure that a staff member is within arm’s reach of any high-risk patient using the bathroom or bedside commode. We verify that chair and bed exit alarms, bed brakes and side rails are in use and batteries are checked regularly as part of hourly rounding. We encourage patients to stay in bed or sit in a chair to reduce the risk of a fall from sitting on the edge of the bed, and we now use video surveillance as an extra set of eyes on high-risk patients who may attempt to get out of bed without assistance.
for Fiscal Year 2018. In the coming year, we will
his collaboration puts us on track to exceed our targeted goals to reduce both our overall fall rate and the number of falls with major injury
add to our success with a focus on mobility — getting patients up and moving around — to help them safely maintain their strength and balance.
All of us at Christiana Care are committed to reducing preventable patient harm. We are exceptional today, indeed — this latest fall report proves it — but our goal in fall prevention, as in every patient encounter, every time, is to be even better tomorrow. By working as a team — when we demonstrate excellence with structured, standardized, evidence-based practice and exhibit
love when we keep our patients and their safety at the forefront of everything we do — I am confident that we will continue to find innovative and more effective ways to keep our patients safe from falls.
I look forward to many more reports of zero falls. I know we all do. It’s The Christiana Care Way. 
 FOCUS • MAY 2018 5

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