APNA 29th Annual Conference Session 3016.1: October 30, 2015 Amy - - PDF document

APNA 29th Annual Conference Session 3016.1: October 30, 2015 LaValla 1

Amy LaValla DNP, APRN, PMHNP-BC, PHN

 The speaker has no conflicts of interest to

disclose

 Identify why comprehensive fall risk

assessment policies are needed

 Recognize improvements made within the

described facility and areas for continued growth

 Recognize how to use lessons learned in this

project to organize and improve future implementations and changes

APNA 29th Annual Conference Session 3016.1: October 30, 2015 LaValla 2

 Area of concern identified by The Joint

Commission and Institute for Clinical Systems Improvement (Degelau et al., 2012)

 Falls can lead to:

• Injury (Healey et al., 2014; Lee, Geller & Strasser, 2013)
• Increased costs (Lee, Geller, & Strasser, 2013; Wu, Keeler, Rubenstein,

Maglione, & Shekelle, 2010)

• Increased disability (Ivziku, Matarese, & Pedone, 2010; Oliver, Britton,

Seed, Martin, & Hopper, 1997)

 Individuals in psychiatric hospitals have an

increased risk of falling (Blair & Grunman, 2005; Edmonson,

Robinson, & Huges, 2011)

 Additional fall risk assessment tools

identified

• Suitability based on ages and medical conditions

 Updated policy included:

• Additional assessment tools
• Reassessment parameters

 Visual identification available for those found

to be at risk for falling

 Fall risk reassessment rates

• 10% increase to 16.7% of patients reassessed

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% Before After

Pat Patient ents R Reev evaluate aluated f d for r Fall R Risk B sk Befor

• re an

e and After ter Imp Implementati tion

APNA 29th Annual Conference Session 3016.1: October 30, 2015 LaValla 3

 Visual identification after implementation

• 35.7% of patients correctly identified to be at risk
• 42.9% of patients incorrectly identified

0.0% 10.0% 20.0% 30.0% 40.0% 50.0% Improper Proper

Use o e of Visual I sual Identif entification cation

 Finding appropriate tools  Locating information in literature regarding

policies or reassessment parameters

 Delay in implementation  Accessibility of tools  Improve staff training on new policy and tools  Low accuracy of visual identification placed

• n/above doors

 Need to reinforce new policy via

communication and leadership support

• Incorporation of change tactics (Packard, 2013)

APNA 29th Annual Conference Session 3016.1: October 30, 2015 LaValla 4

 Improvements made  Project shortfalls may be utilized to improve

future developments

 Communication is key!  Blair & Grunman, 2005  Degelau et al., 2012  Edmonson, Robinson, & Huges, 2011  Healey et al., 2014  Ivziku, Matarese, & Pedone, 2010  Lee, Geller, & Strasser, 2013  Oliver, Britton, Seed, Martin, & Hopper, 1997  Packard, 2013  The Joint Commission, 2008  Wu, Keeler, Rubenstein, Maglione, & Shekelle,

2010