ABSTRACT
Background: During the COVID-19 pandemic, our community oncology practice, with over 150 providers at 33 locations, incorporated infection control guidance from the CDC into our Pandemic Emergency Plan, including visitor restrictions at all locations. There was an increase in patient fall events in our clinics after visitor restrictions were implemented in March 2020, as there were fewer care-givers available in the clinics to assist patients. Methods: Using our adverse event reporting system, we abstracted and trended all safety events that involved patient falls from March 2019 through May 2020. We compared patient fall events during the period of visitor restriction (March-May 2020) to the same period in 2019, and to the 3 months preceding March 2020 and the implementation of COVID-19 restrictions. We report patient fall events per 1,000 patient visits. Results: Prior to COVID-19, patient fall events averaged .207 falls per 1,000 patient visits for March thru May 2019 and .137 falls per 1,000 patient visits for Dec 2019 thru Feb 2020. Following the implementation of visitor restrictions in March 2020, patient fall events increased to .271 per 1000 visits, with a vast upward trend resulting in .435 patient fall events per 1,000 visits in May of 2020 when the restrictions were tightened, more than double previous averages prior to COVID-19. Conclusions: Family members and care-givers play an important role in the patient's care team. We are confident that the significant increase in patient falls in May 2020 is attributed to visitor restrictions. These findings support the vital role of family and care-givers in patient safety. They not only provide transportation, emotional support and information on patient health status, but assist with ADLs, ambulation and transfer needs during the patients' visits to the clinics. Healthcare facilities are often under-resourced and under-staffed to fully address patients' physical needs. Limiting care-givers during a pandemic may reduce the transmission of infection, but also may lead to other unexpected adverse events. Using these findings, we will be implementing standard fall prevention procedures. The practice's emergency pandemic plan on visitor restrictions will also be amended to take this into account.