Authors (including presenting author) :
Chan WMJ, Yuen YME, Cheung CMB
Affiliation :
Department of Medicine, Queen Mary Hospital
Introduction :
Fall prevention is always a challenge in acute hospital setting. The onset of acute illness, medications, unfamiliar ward environment are some of the risk factors contributing to fall in hospitalized patients. The consequence of fall can also have deep impact on patient’s outcome, from lengthy hospital stay to decrease rehabilitation potential, or even death because of severe injuries.
In 2022, there was a significant increased in fall incidents in medical wards of Queen Mary Hospital (QMH). To improve the situation, a department-based fall prevention program was introduced in Department of Medicine. It involves the establishment of Fall Prevention Workgroup and implementation of a series of fall prevention interventions. Besides, a multidisciplinary approach is adopted with an aim to enhance fall prevention through collective effort from various disciplines.
Objectives :
1. To reduce the number of fall incidents.
2. To enhance nurses’ competency on performing fall assessment and able to implement appropriate fall prevention measures.
3. To promote fall prevention culture.
Methodology :
The Fall Prevention Workgroup is led by DOM and Gerontology nurse consultant (NC), with Geriatrician as advisor. The core members include two ward managers and one associated NC. All ward managers and fall prevention ambassadors are group members. The fall prevention ambassadors are two nurses selected from each ward, who work together with their ward manager and responsible for:
• Sharing of fall prevention tips to all staff.
• Identify ward situations that might put patients at risk and implement measures to rectify.
• Provide fall prevention-related training to all staff.
• Report and share the learning points from fall incident with other fall ambassadors in HA chat within 2 days post-fall.
The leaders and core members of the workgroup are responsible for:
• Monitoring of department fall incident statistics.
• Strategic planning of fall prevention measures.
• Conducting ward rounds to identify environmental risk factors
• Conducting post-fall visits to investigate the cause of fall and provide feedback.
• Conducting regular fall prevention audit for all wards or competency test for all staff.
• Arrange half yearly meetings with fall ambassadors to share learning points from past incidents and ward rounds.
• Arrange educational talk by physiotherapist or pharmacist.
Result & Outcome :
In 2024, the number of fall incidents from 1Q to 4Q showed a decreasing trend, with a maximum reduction of 47% from 3Q to 4Q. Comparing with 2023, the total number of fall incidents in 2024 also decreased from 99 to 77 with an overall reduction by 22.2%.
A scenario-based fall assessment competency test was conducted in November 2024 for fall ambassadors. The competency test consists of 4 scenario questions. Participants are required to identify the fall risk by calculating the Morse Fall Scale (MFS) score and choosing relevant fall prevention measures. The competency test will be further introduced to all other nursing staff in Department of Medicine in 2025.
