ambulant care falls prevention in bc cancer agency
DESCRIPTION
This presentation was delivered in session F2 of Quality Forum 2014 by: Sue Fuller Blamey Corporate Director, Quality & Safety BC Cancer Agency Lorna Roe Director of Operations, Systemic Therapy BC Cancer Agency Tracy Lust Quality & Safety Leader BC Cancer AgencyTRANSCRIPT
Falls Prevention Putting our Best Foot Forward Taking Steps to Prevent Falls
Quality Forum Lorna Roe, Tracy Lust & Sue Fuller Blamey February 28, 2014
Why Falls Prevention is Important Anyone can fall
1 in 3 over age 65 and older fall once
per year
Falls are the leading cause of death in those 65 and older
Patient fallshospital admission Residential care vs home
# of BCCA Out-patient Falls
0
1
2
3
4
5
6
7
8
9
Aug Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul
# of
Fal
ls
Month
BCCA Number of Out-patient Falls Aug 1, 2012 - July 31, 2013
Falls
Risk for Oncology Patients While anyone can fall, many different factors can
contribute to an Oncology patient’s risk of falling
Medication or Procedures
• Confusion, lethargy, fatigue • Altered electrolytes, anemia • Nausea, vomiting
Other Effects of Disease
Process
• Altered nutrition leading to weakness • Changes to mobility (requiring the use of a cane/walker) • Alterations in elimination (urgent need to urinate)
Environment Factors
• Unfamiliar and overwhelming health care surroundings • Inappropriate footwear, wet floors, obstacles in hallways
BCCA Falls Prevention Program
Patient Self Assessment
From (PRISM) 1. Have you falls
in the last 6 months
2. Do you have balance or
muscle weakness
3. Do you use mobility aides
Referral to Falls Prevention Clinics in
Community
Documentation: Electronically and/or paper
patient record
Falls Prevention Education Strategy
• Situation analysis & planning • In-patient, then ambulatory roll-out
Stage 1: 2009 - 2012
• Mandatory staff annual education • Executive & leadership engagement
Stage 2: Nov 2012 – Nov
2013 • Learning Hub annual staff education • Collaboration & updating of program with
Health Authority Falls prevention leaders
Stage 3: Nov 2013 – Feb
2014
Implementation Results
0
1
2
3
4
5
6
7
8
9
A# o
f Fal
ls
# of BCCA Out-patient Falls
Analysis: Reasons for Falls • People trying to get in/out of
wheelchairs • Falls while walking in hallways • Tripping over obstacles in
hallways • Standing too quickly post
sitting/supine • Following staff to exam areas • Slippery floors/tiles/entrance • Lost balance getting changed • Footwear/socks/shoe laces
untied
Risks and Interventions: Always walk with the Patient X √
Ensure blanket is not tangling X
Observe and remove falls hazards
X
Ensure wheelchair footrests are moved out of the way X
Ensure shoes are back on and laces tied prior to patient walking
X
Keep equipment to one side of hallways – declutter pathways clear
X
Falls Prevention vs Homecare Referral – ensure the correct referral
• Life Expectancy greater than 6 months
• Over age 65 • May have to come to clinic
Falls Prevention
Clinic
• Urgent home care needs • Potentially less than 6
months life expectancy • Daily care needs
Home Care or
Community Care
Falls Prevention is Everyone’s Responsibility
No matter where you work within the BC Cancer Agency, or what you do…
Max’s Story
• Questions • Tracy Lust = [email protected] • Lorna Roe = [email protected] • Sue Fuller Blamey = [email protected]