Name of Presenters: Daryl Dyck & Tracy Thiele

Falls Facilitated Learning Series Deer Lodge Centre (DLC) Winnipeg, MB Number of Patients/Residents/Clients:  431 bed hybrid facility  235 PCH beds (155 Veteran beds, 80 General Public)  130 Chronic/Extended Care beds  66 Rehabilitation and Assessment beds Who We Are

Falls Facilitated Learning Series Aim: To secure a solidly established base of understanding regarding the benefits of hourly rounding. Goal: To integrate hourly rounding as a tool for staff members to utilize and initiate on any patient/resident that they believe will benefit  especially those deemed at high risk for falls.

Falls Facilitated Learning Series Team Members Team Members: Lynda Hermanson (Health Information Analyst), Carly Erenberg (PT), Daryl Dyck (CNS), Dennis St. Laurent (Manger of Patient Care L2), Diane Rawluk (OT), Michele Klassen (Manager of Patient Care T7), Rod Kebicz (CNS) Team Lead: Tracy Thiele, Project Coordinator Team Sponsors and Supporters: Sylvia Ptashnik (Director of Resident Care), Jo-Anne Lapointe McKenzie (CNO), Carol Anderson (Clinical Educator)

Falls Facilitated Learning Series Falls Change Ideas Incorporated to Date DLC Falls Management Policies and Protocols (since 2008) Routine Practice for Falls (everyone considered at risk) Assessment of Risk Tool (completed within 48 hours of admission) Fall Management Policies Falls Clinical Practice Guidelines Falls Program and Equipment Algorithms Mandatory education for all nursing staff Quarterly feedback of fall rates provided to Nursing Units

Falls Facilitated Learning Series

Falls Facilitated Learning Series

Falls Facilitated Learning Series Hourly Rounding Check Comfort Observations: Does the resident look comfortable? Call light within reach? Clear pathway to bathroom? Toileting Observations: Does their brief/incontinent product need changing? Positioning Observations: Are their feet out of bed; does it look like they are trying to get up?

Falls Facilitated Learning Series Barriers: Staff buy-in Recording Sheet Results Facilitators: A dedicated project lead Benefits of preventing a fall Managers/champions/unit staff committed to project Challenges to Sustaining Falls Improvement

Falls Facilitated Learning Series Feedback “It hasn’t increased our workload because we do this anyway.” “Some changes need to be done related to the sheet we sign on – we need somewhere for it to say we are charting more on the progress notes.” “It is important for the nurses to communicate to the aides that the person is on hourly rounding – otherwise we might not know – especially floats.” “It is definitely beneficial as a tool to help with falls.”

Falls Facilitated Learning Series Lessons Learned Advise: Start slow and work out the kinks before trying to expand. Don’t get discouraged when you don’t see immediate results. Conduct ‘Progress Checks’ on the program and address concerns early. Getting staff ‘buy-in’ requires them to feel involved in the process. Provide positive feedback and reinforcement in different ways.

Falls Facilitated Learning Series Sustainability Plans Celebrate successes, reinforce positives back to staff Advertise what we are doing Create ownership by including staff in problem solving techniques (staff input survey, informal and formal progress checks)

Falls Facilitated Learning Series Moving Forward Incorporate hourly rounding onto one or two more units Ultimately  Centre wide education and implementation for high risk patients/residents

Falls Facilitated Learning Series Name: Tracy Thiele, Project Coordinator Phone Number: Contact Information