Authors (including presenting author) :
Cheung WY (1), Poon SC(1)
Affiliation :
(1) Department of Ophthalmology & Visual Sciences , Prince of Wales Hospital
Introduction :
Falls can lead to severe injuries, especially among elderly patients. Eye clinics often deal with patients who may have vision impairments ,thus increasing their fall risk. A total of 30 cases of fall incident was reported in eye centre from 1Q 2021- 2Q 2024. The contributing factors were identified as sub-optimal settings in a high volume ophthalmic clinic, improper patient transfer techniques from wheel-chair due to mobility limitations,visual impairment as well as unknown reason in 10 cases. The most common causes were patient suffered sudden limb weakness (12 cases), felt dizzy ( 1 case) , trip and fell (2 cases) and patient transfer from chair (5 cases). As some of the above factors could be prevented, a new fall prevention program is needed.
Objectives :
To enhance the fall prevention activities through a collaborative approach between patient, all staff and doctors.
To identify risk factors for fall and implement strategies to mitigate identified risks.
To enhance staff awareness of fall risk factors and appropriate interventions to prevent falls effectively.
To evaluate the effectiveness of interventions in reducing fall incidents.
Methodology :
Use the Plan-Do-Check-Act (PDCA) framework provides a structured approach to implementing a fall prevention CQI project in an eye clinic, focusing on safety and quality of care.
Plan:
Review fall incident reports from 2021 onwards and identify risk factor to develop strategies to reduce the fall rate.
Do:
1.Patient empowerment: Display visual reminders to alert patients and families about fall risks and prevention as well as hang-up poster in high-risk area to alert them the tips on safe mobility practices.
2.Service enhancement:
To eradicate any potential hazards such as crowded waiting areas by re-distribute quota allocation from 30 minutes to 15 minutes to avoid congestion in waiting areas.
Streamline the patient’s workflow of pre-consultation investigation in one-stop station to minimize the risk of fall.
Replace all high chair by electric chair to facilitate patient transfer and provide priority seat to fragile patient.
Routine daily inspections in patient waiting area by designated nurse for early detection of fragile patient .
Set regular announcement to remind patient on fall precaution.
3.Staff Training Program:
Provide additional training to ensure all staff are involved on fall prevention strategies.
Standardized fall prevention management that align with existing fall precaution guideline in 2024.
4.Monitoring System
Use Accident Incident Reporting Systems for documenting all falls incident and performing thorough analysis.
Display KPI board in nurse station to facilitate monitoring of fall incidents.
Incident Reviews: Sharing case of fall incidents with all clinic staff in monthly meeting, analyzing what went wrong and how similar incidents can be prevented.
Result & Outcome :
The CQI project lead to significant improvements in fall prevention in the eye clinic. These integration fosters collaboration, enhances communication, patient empowerment and ultimately leads to a safer environment for both patients and staff.
The fall rate on decreased trend and no more fall recorded in Q3 2024 onwards.
By tracking KPIs on a dashboard in nursing station, all staff can easily to monitor the effectiveness of fall prevention strategies and make data-driven decisions to enhance patient safety. Regularly reviewing and analyzing these indicators will help foster a culture of safety and continuous improvement in fall prevention efforts.
All staff are happy and satisfactory with the training in fall precaution program.
