Authors (including presenting author) :
Lam S(1), Ho KY(1), Ma YH(1), Lee YYP(1), Ho SW(1)
Affiliation :
(1)Department of Medicine, Tung Wah Hospital
Introduction :
At Tung Wah Hospital (TWH) L2 rehabilitation ward, a rising and consistently high fall rate compared to other Group 2 hospitals necessitated action. Fall incident rates in 3Q and 4Q of 2023 were 0.79 and 1.5 per 1000 inpatient bed days, significantly higher than the rates at TWH (0.22 and 0.52) and other Group 2 hospitals (0.19). Consequently, a fall prevention enhancement project was initiated, involving the implementation of a "3P Safety Shield" strategy aimed at strengthening prevention measures and sustaining standard of care.
Objectives :
1)To maintain a low patient fall rate compared to other rehabilitation inpatient wards. 2) To reduce the high patient fall rate by implementing strategic approach. 3) To enhance patient safety by maintaining and elevating standard of care.
Methodology :
The enhancement project was implemented after 4Q 2023, adopting the "3P Safety Shield: Prevent, Protect, Provide" approach to ensure both immediate and sustained improvements in patient safety. 1)The Prevent strategy involved a thorough analysis of all fall incidents from 2023–2024, focusing on patient demographics, incident timing, and ward activities. Existing protocols were evaluated against best practices to identify and address weaknesses, and proactive measures were implemented accordingly. 2)The Protect strategy aimed to enhance patient safety through improved protocols and environments. A multidisciplinary approach was utilized to tailor fall prevention measures to individual patients' needs, with specific enhancements including manpower allocation during high-risk periods, defining "Level-up" for patients with specific needs, effective communication through the Smart Panel, and the deployment of additional safety devices. 3)Lastly, the Provide strategy equipped staff with the tools and training necessary for effective fall prevention. Comprehensive educational programs were offered to staff, fostering an environment of continuous feedback and engagement to improve and sustain fall prevention practices. This integrated approach comprehensively addressed fall risks, ensuring both immediate safety and long-term preventive measures.
Result & Outcome :
Following the implementation of the "3P Safety Shield" program, significant improvements were observed in both staff engagement and the patient fall incident rate. A staff satisfaction survey for the in-house training revealed that 100% of nurses agreed the training content was practical, clearly presented, worthwhile, and effectively achieved its objectives. In terms of patient safety, the fall incident rate experienced a substantial reduction, decreasing from 1.5 per 1000 bed days in 4Q 2023 to 0.76 in 3Q 2024—a 49% decrease. Remarkably, no fall incidents were reported from August to October 2024. These results highlight the effectiveness of the immediate enhancements and the active engagement of staff in achieving the program's goals.
