Chadron Community Hospital and Health Services (CCH&HS) has a tradition of working with staff and patients to provide the safest care possible. In an effort to further reduce inpatient fall risk, the hospital joined with 17 hospitals across Nebraska and researchers at the University of Nebraska Medical Center (UNMC) to increase focus on the problem of inpatient falls. The result has been that the Chadron hospital has not had an inpatient fall that resulted in injury for over a year.
Inpatient falls are costly and serious adverse events in hospitals. They have a negative impact on patients’ health and quality of life in addition to being costly. Decreasing patient falls is a priority for the many agencies, all hospitals, and perhaps most importantly, patients and their families. In August, 2012, the hospital joined the CAPTURE Falls Project: Collaboration and Proactive Teamwork Used to Reduce Falls. The long-range goal of this project has been to reduce inpatient falls in Critical Access Hospitals, which serve many rural older adults who are at high risk for falls. UNMC researchers found that the risk of falls in Nebraska hospitals is highest in Critical Access Hospitals (those with fewer than 25 beds, like CCH&HS), and those that do not use an inter-professional team to improve and learn from previous falls.
By applying a culture of safety and teamwork to a fall prevention program, a CCH&HS team of physical and occupational therapists, nurses, leaders, nurses’ aides, and pharmacists were able reduce falls by:
- Applying yellow wrist bands to help identify patients at risk for fall
- Improving all staff’s education and awareness about patients at risk for falls
- Increasing use of bed alarms that are built into every bed
- Improving communication between nursing, rehab therapies, and pharmacy about patient safety issues
- Increasing camera monitoring to every patient room when needed
- Purchasing improved slip resistant socks
- Installing communication dry erase boards in each room to help improve communication about each patient’s safety needs
- Encouraging frequent nurse rounding for patient safety checks
- Increasing frequency of nursing assessment of each patient’s risk for fall
In the past decade, Chadron Community Hospital has made significant improvements to increase patient safety and minimize the occurrence of patient falls. These improvements include design decisions for the new hospital, special equipment to help move and monitor patients, training for staff about fall prevention, and medication management with a focus on how to reduce falls.
Through this two-year CAPTURE Falls project, funded by the Agency for Healthcare Research and Quality (AHRQ), Chadron Hospital team members received education and support in implementing a customized plan to improve how we manage fall risk. This partnership has made a significant contribution to patient safety in the hospital by supporting the adoption of proven fall risk reduction interventions.