“Catch a Falling Apple!” Falls VLC Session # 4 Rapid Fire closing “Catch a Falling Apple!” Name of Organization: Venta Care Centre Name of Speaker: Ashleigh Middleton O.T.

Who We Are 13525 – 102 St. Edmonton, AB T5E 4K3 148 bed Long Term Care Facility Average age of residents is 85.1 years Multiple co-morbidities/ Frail elderly Majority of population has dementia 17 bed behavioral unit 2 floors with one Care Manager per floor 1st floor – 92 beds 2nd floor – 56 beds Private family owned facility – 57 years in operation Multicultural – many Ukrainian, Portuguese, Polish, French etc. speaking individuals

Team Members Team Member Role Ashleigh Middleton - OT Team Leader/Occupational Therapist Cecile Bulva - DOC Team Sponsor Brenda Peachman Resident Care Manager Ilie Vasiu Christine Birzgalis Special Projects Meike Snow OH&S Miles Berry (New Dec/10) Education Coordinator Meaghan Kubsch (left Nov/11) Co-Lead/Physiotherapist Keriata Leavitt Recorder/Coordinator

AIM Purpose: To lead and coordinate team learning, process, and care improvements; to ensure our targeted goals are achieved in falls and injury reduction and that we contribute as active participants in the SHN Falls Prevention VLC. Improvement Aim: Reduce incidence of falls (fall rate) by 40% from baseline by March 2011. Reduce injury from falls by 40% from baseline by March 2011.

Change Ideas List Changes you have tested during Falls VLC PDSA Cycles: Unusual Incident report form redeveloped: for more accurate fall reporting and data collection (currently remains a draft) Low beds: Initially 10 new low beds were purchased. Dec 2010 an additional 28 were purchased Bed alarms: A total of 7 Bed Check bed alarms were purchased and implemented Footwear assessments: One unit had 100% of individuals assessed for proper footwear. We amended our admission information package to include information on appropriate footwear and plan to continue with assessments. Falls Cue Cards: Adapted with permission from the Fraser Health fall prevention cue cards. Reflect Venta and regional universal falls precautions. Were given to staff with an information package on fall prevention and Venta fall stats. Developing an education program for staff: Remains in progress set to roll out in April 2011 Universal falls precautions: Universal falls precautions were distributed and posted at all nursing units Fall Risk Assessment: Regional – the regional Falls risk assessment was implemented for all new admissions. Specific to VCC – we found the Morse scale was not as sensitive as we would have liked and began trialing other falls risk assessments a 1 unit trial of a modified assessment showed excellent correlation with the individuals with the most falls.

Change Ideas (continued) List Changes you have tested during Falls VLC PDSA Cycles: Updated information booklet on falls – previously there was no falls information in the general admission booklet. Family Education Family support group – The OT presented to the group to generate interest and discussion surrounding falls. Newsletter – the apple symbol was introduced through the newsletter to inform families of the meaning. Visual Falls representation (tree and falling apples): A visual way of representing unit based falls was developed to keep interest, help visually represent the impact of falls and initiate some friendly competition Symbol (Apples): The apple symbol was selected to represent falls risk and accompany any fall related education/information with the theme “Catch a Falling Apple.” Red apples symbolize high risk fallers Weekly team meetings: Thursdays from 11:00am – 12:00 noon. Hope to initiate unit huddles as well Started Policy and Procedure document: Remains in progress Care plan library on MDS: The MDS coordinator assisted to place specific and universal falls precautions in an mds care plan library to increase care planning efficiency and accuracy pertaining to falls Don’t Fall for it Slips and Pills: Nurses were provided with this document to help assess if medications could or were likely contributing to falls

Measures

Measures

Measures

Measures

Fall Prevention Cue Cards “SAFE”

Lessons Learned Lessons Learned/Key Insights Sharing of information with similar sites is very helpful Fun approach to a serious problem to get buy in and keep interest Having regular meetings and sticking to schedule is critical. Tracking small bits of information rather than huge projects Prioritizing PDSA cycles were great for this Having a theme helps bring it together PDSA’s should be done at the time – don’t try to do them after the fact Management buy in and allocated time is critical Talk about falls a lot and get info out in different ways e.g. images, written, presenters, newsletters, trivia etc!

Next Steps Key Sustainability Steps/Plan: Target Dates What are some things you will do to sustain the work on reducing falls and injury from falls and by what date? Key Sustainability Steps/Plan: Target Dates Finalize a new Unusual Incident Report Full educational program for staff April/2011 with regularly scheduled reviews. April 15 2011 Bringing in more low beds Ongoing Footwear assessment and grippy socks Continue with regular meetings and staff and develop a format for staff huddles to increase nurses and health care aide involvement Ongoing Incentives to keep the interest of staff Family Education Days – E.G. Healthy Leg Days May 2011

“It is better to keep a friend from falling than to help him up” Contact Information Name: Ashleigh Middleton Email: amiddleton@ventacarecentre.com Phone Number: (780) 377-4414 “It is better to keep a friend from falling than to help him up”