Authors (including presenting author) :
Wong HY, So WY
Affiliation :
(1) Haematopietic stem cell transplant Centre, Queen Mary Hospital
Introduction :
Fall prevention is a critical area to focus during hospitalization, particularly for patients who are underwent hematopoietic stem cell transplant with pancytopenia status. Impact from fall for these patients can be irreversible and fetal.
Fever are commonly developed for HSCT patients who need to stay isolation room in neutropenia phase, according to past fall history in HSCT unit, around 50% of patients are febrile when fall incidents occurred.
Nurses identified that fever is a factor for fall incident while patients are lack of awareness of prevention of fall during fever stage.
Therefore, a series of measures of fall prevention including education package, regular assessment, use of assistive devices are introduced to febrile HSCT patients to minimize their fall incident related to fever.
Objectives :
We aim to prevent fall incidents for febrile patients and minimize injuries related to fall.
For patient aspect, to increase awareness of patient safety and fall preventions to fever patients.
Education on fall risk assessment, prevention and nursing management to patients would be included.
Increase their cooperation and decrease their misunderstanding during fever stage will also be objectives of this project.
For nurses, focus on identified risk factors and patient needs, plan for most appropriate safety measures or devices to fever patients during their stay in isolation room.
Methodology :
1. Provide education for patient upon their admission including awareness of change of condition during fever stage, seek for help in isolation room, also safety devices demonstration for fall prevention which include call bell and alarm mattress.
2. Patient who developed fever would count as high fall risk cases, and appropriate measures would be introduced.
3. Nurse intervention for patient developed fever i.e. Temp > 38C
a. Perform fall assessment by Morse fall scale every shift until Temp < 38C for 2 days.
b. Repeated reinforcement to alert patient at every shift.
c. Regular round (Q1H) by case nurse to assess patient and provide assistance on physiological activities until Temp < 38C for 24 hours.
d. Strengthen fall prevention measure by using alarm mattress to patients, which alert case nurse who cannot stay in isolation room all the time.
e. Also provide urinal/bedpan for patients for physical needs.
f. Highlight Morse Fall scale during handover
g. Alert supporting staff for high fall risk patients by using red pen on their notice board.
Result & Outcome :
Patient increased alertness and awareness during their fever stage, there are increased seeking for help such as assistance to toilet when they developed fever.
Nurse increase alertness of patients’ change of condition particularly for febrile patients.
Nurse also increase the usage of appropriate safety device for fall prevention.
There are total 4 fall cases in the project period (3Q-4Q/2024),
1 out of these 4 case is febrile patients (T:37.9C) i.e. 25% fall cases related to fever.
which is an improving trend when compare with 1Q-2Q/2024 ( ~50% )
