Activity Wristband Pilot to Reduce the Number of Inpatient Falls Introduction Ward 1, St Andrews Community Hospital had one of the highest falls rate per 1000 Occupied Bed Days in NHS Fife Community Services. Aim The aim was to reduce the rate of falls with harm in the ward consistently to less than 5 per month by September 2015 Method • A PDSA design was used • All patients admitted to the ward offered assessment • Following assessment, the appropriately coloured wristband was applied to the patients’ wrist and walking aid relating to mobility - Red- Assistance - Amber- Supervision - Green- Independent • Falls run charts including All Falls and Falls with Harm data were collected monthly • Patient, staff, relatives/ carers and visitors to the ward were given the opportunity to give feedback about the project. Claire De Angelis, Band 6 Physiotherapist, Intermediate Care Team [email protected] & Caroline Peffers, Senior Charge Nurse, Ward 1 caroline.peff[email protected] To maintain the rate of falls with harm in the ward to less than 5 per month by end of September 2015. To introduce the use of coloured wristbands to identify safe level of mobility. • A reduction in the overall number of patient falls per month • A reduction in the overall number of patient falls with harm per month • A reduction in the overall falls rate per 1000 Occupied Bed Days • A reduction in the overall falls with harm rate per 1000 Occupied Bed Days. P lan D o S tudy A ct Aim: What are we trying to accomplish? Measures: How will we know if the change is an improvement? Change: What changes can we make that will result in improvement? Results 80% of patients admitted to the ward participated in the project. During the project implementation period, the number of falls with harm on the ward was maintained consistently below 5 per month except in August 2015, when two inpatients fell more than 3 times each on the ward. Assistance with mobility, with or without a walking aid/equipment. Supervision with mobility, with or without a walking aid/equipment. Independent with mobility, with or without a walking aid/equipment. NHS Fife call to action 1 NHS Fife call to action 2 New falls paperwork 1st planning meeting Introduction of wristbands 2 patients fell more than 3 times Ward meeting I couldn’t wait to tell my family that I was allowed to get up and walk about by myself. Knowing I will soon get my green band means I know I am almost ready to go home. The coloured bands allow staff to know instantly the patient’s ability. Having the band on the walking aid as well is great because it means everyone can see at a glance, including volunteers, domestics, etc. When patients receive a green band, they feel a sense of achievement. It’s more eyes and ears! When the physiotherapist gave me a green wristband, I said “Yippee!” When I first came to the ward I was a red band and the lady in the next bed was amber so I wanted to get to green first. The bands are a great idea! When my relative gets her green band it means she is good to go. Patient/relative/carer comment Staff comment Discussion/ Conclusion The project contributed to the reduction in inpatient falls with harm on the ward, whilst supporting the work being done by NHS Fife to reduce inpatient falls. Feedback about the project from patients, staff, relatives/ carers and visitors to the ward was both positive and encouraging. As part of the PDSA cycle the project continues to be evaluated and improved. The project is now more inclusive of the Multi-disciplinary team approach, and the wristband colour now correlates to the patients’ level of function rather than just mobility. The project has been rolled out to other community hospital wards in NHS Fife, and is also being piloted on one of the acute wards.