Improving compliance of applying fall risk precautions
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Transcript of Improving compliance of applying fall risk precautions
Improving compliance of applying fall
risk precautions for medium/high risk
patients for fall in in patient units
Improvement Project utilizing FOCUS PDCA
Methodology.
Find The Problem
• Based on the data provided by the clinical audit
department it was noted that only 33% of the
observed sample had completely all the fall risk
precautions applied.
• Which meant about 67% of the patient stated to be
at high risk for fall were at risk of fall because
incompliance to the proper fall prevention
precautions.
33%
67%
0%
10%
20%
30%
40%
50%
60%
70%
80%
Complete Incomplete
Perc
en
tag
e
Compliance
Percentage of Compliance For Fall Risk Precautions.
EL-Iman Hospital; Dhulhaj 1434.
N= 115
Find The Problem
• Further data collection was made to determine which
of the fall risk precautions were more frequent to be
not applied.
30%
24%21%
16%
5%3%
0%0%
5%
10%
15%
20%
25%
30%
35%
F sign onDoor/Bed
Low bedPosition
ID Band Side Rails Avoidclutter
Dim Light LeaveDoorOpen
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Precautions
Percentage of Incompliance of Different Fall Prevention Precautions.
El-Iman Hospital; November 2013. N= 115
N(Incompliance)=77
Find The Problem
• The most common fall precautions (vital few) that
showed incompliance (80%) were:
• F Sign on door.
• Low bed position.
• ID band.
Organize The Team
• Team leader: Mrs. Hanan (Nursing deputy manager)
• Facilitator: Dr. Reem (Quality Manager)
• Members:
• Dr. M. Raslan (Deputy Medical Director).
• Mr. Abdullah (Biomedical dep.).
• Mrs. Janet (Nurse Supervisor).
• Mrs. Entesar (Nurse Educator).
FLOW CHART
Incompliance with fall risk
Precautions application
Equipment
Materials
People
Policy
Nurse Busy
Nurse Negligence
Unawareness of the
policy
Escort Interference
F sign not available
Bed Broken
Patient Incompliance
Unawareness of
Required Precautions
Nurse Can’t Use
Morse Scale
Broken Side Rails
ID bands Not Available
Understand The Variation
• A data collection sheet was made to verify the
frequency of the causes generated by the
brainstorming the team performed.
• And a sample size of 115 cases was determined to
detect the frequencies.
25%
20% 20%
11% 11%
5% 5% 5%
0%
5%
10%
15%
20%
25%
30%
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Causes
Percentage of Causes of Fall Risk Precautions Incompliance
Al-Iman Hospital; Muharam 1435.N=52
Vital Few Involved
1. Nurse is busy (Gives other care requirements
higher priority).
2. Escort Interference.
3. F Sign not Available.
4. Broken Bed.
5. Nurse unawareness of the policy.
59%
41%
Percentage of Beds Condition in Inpatient UnitsAl-Iman Hospital; 1434
Broken Beds
Functioning Beds
N= 207
100%
42%
88%
60%
27%
50%
65%
44% 46%
7%
0%
20%
40%
60%
80%
100%
120%
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Area
Percentage of Broken Beds In Inpatient UnitsAl-Iman Hospital; 2013
N= 207
Problem Action Responsible
Person
Due Date
Escort
Interference.
Nurse Education About
Importance of Patient &
Family Education About
Fall Risk and Precautions
Applied. (Every Monday
Nursing Lecture).
Ma’am Comfort
(Nurse Director).
Every
Monday Till
All Nurses
Are Covered.
Nurse
unawareness
of the policy.
Nurses Training &
Education.
Ma’am Comfort
(Nurse Director).
Every
Monday Till
All Nurses
Are Covered.
F Sign not
Available.
Replace The paper made
Signs with laminated F
Signs in all units.
Nursing
Department.
2/1435
Broken Bed. All beds which need spare
parts are to be provided
and fixed.
Biomedical Dep.
Nursing Dep.
3/1435
18%
82%
Percentage of Beds Condition in Inpatient UnitsAl-Iman Hospital; 1435
Broken Beds
Functioning Beds
N= 207
100%
42%
88%
60%
27%
50%
65%
44%
46%
14%
16%
33%
0%
0%
0%
65%
0%
50%
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Male Surgical Ward
Male Medical Ward
Male Specialist Ward
Female Surgical Ward
Female Medical Ward
Gyn. Ward
L&D
Obstetric Ward
Paediatric Ward
Percentage
Are
aPercentage of Broken Beds In Inpatient Units
Al-Iman Hospital; 2013
After Before
33%
84%
23%
77%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
12/1434 1/1435 2/1435 3/1435
Per
cen
tage
Month
Percentage of Compliance For Fall Risk Precautions.
EL-Iman Hospital; 12/1434 : 3/1435.
Invalid Data
Before Bed
Repair