ABSTRACT
With a nosocomial pressure ulcer rate higher than national benchmarks, leaders convened a quality improvement team to address the issue. The authors discuss the implementation of a new skin "always practice" initiative across the continuum of care and its outcomes.
Subject(s)
Benchmarking/organization & administration , Pressure Ulcer/prevention & control , Skin Care/nursing , Total Quality Management/organization & administration , Analysis of Variance , Chicago/epidemiology , Decision Trees , Humans , Leadership , Nurse Administrators/organization & administration , Nursing Assessment , Outcome and Process Assessment, Health Care , Patient Care Planning , Practice Guidelines as Topic , Pressure Ulcer/epidemiology , Prevalence , Quality Indicators, Health Care , Risk Assessment , Skin Care/methods , Skin Care/standardsABSTRACT
BACKGROUND: An approach to fall prevention was conducted under the assumption that all inpatients are at risk for falls and that all employees within the hospital setting have a role in fall prevention. FALL PREVENTION PROGRAMS: Northwestern Memorial Hospital (Chicago), a 725-bed tertiary care academic medical center, recently updated a longstanding fall prevention program, "Take a Glance," to standardize and simplify its approach to fall prevention. In the "Take a Second Glance" program, all patients were screened for higher-than-standard fall risk on admission and at least every 24 hours. Standard interventions were recommended and integrated into practice for all patients. The training session for managers provided information, materials, and job aids for staff to facilitate implementation. A reduced number (36 to 13) of interventions were prescribed for fall prevention, and important safety measures were to be incorporated into the patient's plan of care. RESULTS: A 20% reduction in total falls (p < 0.0001), a 15% reduction in the average hospital fall rate (p < 0.0001), and a more than doubling of the average days between falls with injuries were found when comparing 11 months of data to the previous year. DISCUSSION: The fall prevention program is now in the control phase after program implementation. Data are monitored closely for variation, and discussions regarding continued rigorous goal setting for further improvements are planned.
