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Excellence Every Day represents an MGH commitment to providing the highest quality, safest care that meets or exceeds all standards set by the hospital and external organizations.
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A focus on falls — patient specific strategies are the key to success.
Susan O'Donnell, RN

AN MGH NARRATIVE by Susan O'Donnell, RN, staff nurse, Lunder 10 Oncology


"Mrs. B is a 59-year-old woman who was active and working
with no history of falling prior to being admitted. She had a
history of multiple myeloma and was admitted for autologous stem-cell transplantation. She and her husband knew (and it was reviewed again) that she would be undergoing intense chemotherapy with uncomfortable side-effects. We would be using medications that could cause diarrhea and make her drowsy."
read more...

Pevious Fall Prevention Narrative by Christina Connors RN, Staff Nurse, Bigelow 11, General Medicine read more...

THE DATA
Fall Rates
Fall with Injury Rates

MGH Fall Rates
(falls/1000 patient days)

TREND: Majority of unit types (3/4) outperform the NDNQI comparative benchmarks for the most recent quarter 
CLICK HERE for additional data

Jul-Sep13
Adult
MGH
NDNQI
Critical Care
0.35
1.04
Medical
2.99
3.23
Med-Surg
3.38
3.08
Surgical
1.56
2.33

 

Apr-Jun13
Adult
MGH
NDNQI
Critical Care
0.91
0.94
Medical
3.35
3.29
Med-Surg
2.19
3.11
Surgical
2.18
2.45

 

 

 

 

 

 

 

 

 

 

MGH Fall Rates
(falls with injury/1000 patient days)

TREND: All unit types outperform the NDNQI comparative benchmarks for the most recent quarter 
CLICK HERE for additional data

Jul- Sep13
Adult
MGH
NDNQI
Critical Care
0.00
0.17
Medical
0.54
0.71
Med-Surg
0.18
0.60
Surgical
0.26
0.42

 

IMPROVEMENT INITIATIVES
FYIs

Let's Eliminate All Falls (LEAF™)

This is a comprehensive, evidenced-based, fall prevention program that has been developed by MGH and implemented on all inpatient nursing units. Aspects of the program have also been adapted for use by other clinical areas to meet the specific needs of the patient population being served.

LEAF™ is being updated in 2013 to reflect the current literature and analysis of the MGH falls data for the past 2 years. This update includes new assessment, intervention, and communication tools, focused information on the needs of middle-aged patients related to fall risk, and a new post-fall response algorithm. (see MGH LEAF Toolkit right)

 

 

Policies, Procedures & Guidelines:

Fall Risk Assessment Standard for The Adult General In Patient Care Units

(internal access only)

IN TROVE, SEARCH:
"patient at risk to fall"

(internal access only)

Practice & Quality Subcommittee:
Fall Prevention
-
meets the 3rd Thursday monthly from 1:00-3:00pm in the Trustees Room, Bullfinch 225A

Inter-Disciplinary Team
presents poster

Diane Carroll, RN; Ann Hurley, RN; John Dykes; and Blackford Middleton, MD, presented their poster, “Validation of Icons to Communicate Fall Risk and Tailored Interventions to Prevent Patient Falls,” at the 22nd Annual Scientific Sessions, Celebrating Diversity in Nursing Science, in Providence, March 25, 2010.
MORE FALL PREVENTION RESOURCES
PATIENT EDUCATION

Preventing Falls in the Hospital and at Home - an MGH brochure (Can be ordered through Standard Register, item #84167)

Fall prevention videos for patients:(viewable via MGH in-house TV) Dial 4-5212 on the bedside phone. Follow the voice prompts and enter video number into the system. Tune the television to the channel as instructed. The video will start playing within 30 seconds.

Fall Prevention (#104)

  • What hospitals do to prevent falls
  • Causes of dizziness
  • Hospital safety features
  • Non-cluttered environmentWhat patients can do
  • Techniques for safety at home

Fall Prevention(#211)

  • Patient scenarios of how falls happened
  • Recommendations to prevent them using the same scenarios
  • Higher risks for falls
SPOTLIGHT ON PRACTICE
fall prevention graphic

“When we identify patients at risk for falls, we have our staff assist them at all times to the room, bathroom, etc. We also place a LEAF on the IV pole as a visual alert to staff. A yellow leaf means that the patient requires assistance with ambulation. A red leaf is used for patients that should not be ambulating at all. We encourage our staff to both document the answers to fall related questions on the flow sheet and to verbally notify the treating RN."

"We also had a fall icon added to our patient tracking system to denote fall risk that all staff has access to. This is activated at the front desk after the patient answers questions related to fall risk. In addition, there is now a section in our LMR assessment form that deals with fall risk and plan of care going forward.

Mimi Bartholomay, RN, Yawkee 8, Infusion

EXTERNAL REVIEWERS

Joint Commission logo

"Racial and ethnic health disparities are linked to poorer health outcomes and lower quality care…In order to decrease health disparities, hospitals need to take action to understand the needs of their patient populations and employ practices that help to address those needs…" (2008)

(From The Joint Commission's "One Size Does Not Fit All: Meeting the Health Care Needs of Diverse Populations")

Magnet Recognition

Magnet_logoThe American Nurses Credentialing Center (ANCC) requires Magnet-designated organizations to track nationally-benchmarked nursing sensitive indicators (NSIs) to continually inform improvement efforts related enhance patient outcomes. Examples of NSIs include, but are not limited to: patient falls, hospital-acquired pressure ulcers, blood stream infections, ventilator-associated pneumonia, and restraint use.

GLOSSARY OF TERMS
click here...

There are numerous terms and acronyms in healthcare that may be unfamiliar. Please click here to visit a Glossary of Terms that may be helpful. And please email any suggested additions.

This month's featured term: Patient fall
A patient fall is a sudden unintentional descent, with or without injury that results in the patient coming to rest on the floor, on or against some other surface.

Excellence Every Day represents an MGH commitment to providing the highest quality, safest care that meets or exceeds all standards set by the hospital and external organizations.

If you have questions or suggestions related to the EED portal, please contact Georgia Peirce at (617) 724-9865 or via email at gwpeirce@partners.org.

updated 1/6/14

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