1. LAMP FALL PREVENTION Presentation to Patient Care Services Board July 25, 2000

2. LAMP FALL PREVENTION MULTIDISCIPLINARY TEAM Leaders: Terri Crutcher and Susie Leming-Lee Julie Foss Laura Kelley Anne Peterson Debbie Harrell Penny Powers Deborah Robin MD Audrey Kuntz Steve Deppen

3. LAMP FALL PREVENTION FALL: “A person coming to rest unintentionally on the ground or lower level, not as a result of a major intrinsic event or overwhelming hazard.” Salgado et al., Gerontology, 1994

4. LAMP FALL PREVENTION 1. Falls are the second leading cause of unintentional-injury deaths in the United States for persons of all ages. 2. Two-thirds of those falls were people who were 75 years of age or older. 3. Patient falls lead to increase cost and a decrease in patient, physician, and staff satisfaction.

5. LAMP FALL PREVENTION WHAT ARE WE TRYING TO ACCOMPLISH?

6. LAMP FALL PREVENTION AIM: To improve/promote patient safety by reducing patient falls through implementation of a Falls Prevention Program based on the assumption that providing the right care is the “right thing” to do.

7. LAMP FALL PREVENTION HOW WILL WE KNOW A CHANGE = IMPROVEMENT?

8. LAMP FALL PREVENTION Decrease incidence of patient falls Decrease number of fall related injuries Decrease use of restraints Decrease use of sitters Decrease cost of fall related issues Decrease number of fall related claims/lawsuits

9. LAMP FALL PREVENTION WHAT CHANGES CAN WE MAKE THAT WILL LEAD TO AN IMPROVEMENT?

10. LAMP FALL PREVENTION Develop a process to identify patients at risk for falls Develop/implement interventions to reduce the risk Use data over time to evaluate/improve Fall Prevention Program

11. LAMP FALL PREVENTION Important to find the best current evidence Literature focuses on Nursing Homes and Community Nursing Research is the primary contributor

12. LAMP FALL PREVENTION Developed VUMC Program with consideration of research/evidence and the specific needs of VUMC patients and facility. “Best Practice” advocates that we evaluate the effectiveness of our program. We are committed to asking “answerable clinical questions”

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14. FALL PREVENTION Of 13 patients who fell, 10 were assessed to be at risk for fall

15. LAMP FALL PREVENTION Spot check - 39% of patients were assessed to be at risk for fall Indicators most often noted on FRAT decreased mobility weakness unsteady gait

16. LAMP FALL PREVENTION EDUCATION Staff Other Departments Physicians

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19. LAMP FALL PREVENTION LESSONS LEARNED Importance of Multidisciplinary Team Base Decisions on Evidence Importance of a Physician Champion Importance of Staff Feedback Data Over Time shows Trends/Patterns Importance of data collected at the unit level

20. LAMP FALL PREVENTION NEXT STEPS