What are the Effects of Oncology Centered Falls Prevention Education and Interventions on the Fall Rates of Adult Surgical Oncology Inpatients?
By Tina Ha, RN
There were 29 patient falls on an inpatient Surgical Oncology unit in Fiscal Year 2016. A comparable surgical unit in the same hospital had 18 falls that year. Eighty Nine percent of patients who fell were not identified as at risk using the Schmid Scale per hospital policy. The majority of falls were in patients ages 51-60 and 39% were not post-surgical. Surgical oncology patients are falling and the standard practice is not effective in preventing these falls.
To educate nurses on the characteristics of oncology patients and their specific psycho-social emotional risk of falls to enable nurses to better prevent falls, while providing patients with a Self-Assessment Tool to enable them to be more self-aware of when and if they should call for assistance.
After review of the literature and unit post fall huddles, an educational session was created for bedside nurses and a Self-Assessment Tool handout was developed for patients. Nurses were briefed on the assessment tool and surveyed on perception of patient compliance with standard fall related interventions prior to and 6 months after the intervention. Patient handouts had surveys attached and were distributed by staff and volunteers.
Mean fall rate on the unit 6 months prior to intervention was 1.56 or 2 falls per month, 6 months into the intervention, the mean fall rate was 0.87 or 1.17 falls per month. Fifteen patients completed and returned surveys. 60% of patients enjoyed the tool, 53% of patients said they became more aware of how they were feeling, 40% said this exercise encouraged them to call for assistance, while another 40% said they are independent or already do. Prior to intervention, nurses perceived that “Patients called for help when asked to do so by staff” most of the time or always, 71.43% of the time, compared with 94.73% of the time 6 months into the intervention. 69.23% of nurses felt that the intervention was moderately or more helpful in patient preventing falls.
Nurses felt that patients were more likely to call after the intervention and most thought the exercise was helpful, and the majority of patients enjoyed the tool and some were made more aware of how they were feeling. There was a slight decrease in falls 6 months after the intervention, however, many factors are involved in patient falls and the decrease cannot be fully attributed to the intervention.
The positive nursing and patient reviews support the continued use of the Patient Self-Assessment Tool. Feedback from patient and nurse surveys will be used to improve upon the tool for future use. The goal moving forward is to have the tool readily available in all patient rooms and to collaborate with the Art for Recovery program to make the tool more visually appealing and enjoyable for patients.