SunCountry Health Region LTC Falls Prevention Program

21-Oct-15Saskatchewan Falls Collaborative2 Background 1980’s – Some Falls Prevention measures were being done but not called “falls prevention”:  Baby monitors, lowered beds, mattress on floor, bells on side rails, and moving residents closer to nursing station – District wide incident reporting process that involved falls.

Background 2004 – Each LTC facility became more responsible for TLR 2005 – TUGS started but did not happen everywhere May 2008 – National Falls Collaborative where one of our facilities took part in a pilot project that reduced our number of falls by 40%.

Background Sun Country Health Region has 18 Long Term Care facilities and 543 LTC beds. Sun Country Health Regions Vision:  “Healthy People in Healthy Communities”

21-Oct-15Saskatchewan Falls Collaborative5 Aim To decrease the number of residents who experience a fall by 20% by March 31 st, 2012 Scope & Boundaries  All residents of LTC who are mobile for transfer or ambulatory, and home Objectives: 1. Educate staff, residents and families about the initiative % of LTC facilities to have inservice on falls program % of facilities will have a Falls Prevention display board put up by October Falls Risk Assessment will be completed on admission, change in status, after a fall and annually % of all new residents will have a Fall Risk Assessment & documented intervention on care plan.

Goals 1. 20% decrease in number of falls and fallers 2. 20% decrease in number of injuries from falls 3. No increase in restraints % of residents are screened % of staff have Fall Prevention inservice 6. Medication audit on high risk residents (pilot)

21-Oct-15Saskatchewan Falls Collaborative7 Team Members Candy Bye - RN Florie Restau – Nurse Manager, Wawota Marnell Cornish – Nurse Manager, Tatagwa View Debbie Obst – Nurse Manager, WSCH Jenniene Greenbank - LPN Laurie Cole – Nurse Manager, Gainsborough Anna Erick – Recreation Worker Sarah Veroba - RN Lillian Ly - Dietician Deb Kennett-Russill – Clinical Coordinator of Therapies Laura Kehrig – Falls & Injury Prevention Coordinator Amy Ryan – Quality Improvement & Patient Safety Manager Felecia Watson – Regional Director, CQI and Strategic Planning

21-Oct-15Saskatchewan Falls Collaborative8 Results  We did a formal format for 3 questions and increased an awareness to staff (was very positive).  Falls Prevention is on our new staff orientation course.  Every LTC facility in our region has a Falls Prevention Display Board that has a new Falls Prevention topic on it every month.  Our collaborative members presented a hip protector inservice for staff and have started Implementing them in our facilities.  Our Region formed a Regional Falls Prevention Working group made up of LTC, HC, AC, Mental Health, OTs, Nutrition, Pharmacy, EMS and Community.

Results A few nurses from one facility made up a new care plan that included falls prevention check boxes in it. One facility made up a handout to give to families to tell them about our region’s goal, this collaborative and what initiatives their facility is doing to prevent falls (ie. Hip protectors, vit. D, 3 questions poster, etc.).

Results: Vitamin D A dietician joined our Sask. Falls Collaborative team. Two collaborative members wrote a letter to the doctors in our region to ask them to start prescribing vitamin D to seniors in our region. Two collaborative members did 3 vitamin D presentations to staff in our region. They were great successes. A vitamin D brochure was made up by our dietician and 5,000 copies are being printed to give out in our region.

Results Number of Falls

Results Number of Injuries from Falls

Results Number of Fallers

Results Number of Restraints

21-Oct-15Saskatchewan Falls Collaborative15 Changes Tested A couple facilities in our region put laminated 3 question posters above the bed in every resident’s room. Sun Country Health Region Fall Prevention Please ask resident these 3 questions before leaving the room: 1. Do you need to use the toilet? 2. Are you comfortable? 3. Can I get you anything else?

Changes Tested One facility trialed a new Falls Tracking Tool. The facilities involved in the collaborative did surveys to see how many residents take vitamin D. The Scott Tool was tested in a few facilities in our region. Our region has started implementing Hip Protectors One facility started testing postural hypotension on all their residents. A few facilities trialed the new care plan with falls prevention in it. One facility started doing post fall huddles.

21-Oct-15Saskatchewan Falls Collaborative17 Lessons Learned Staff in our region liked the 3 question posters and felt they were very useful and relevant. Our region is continually monitoring and training staff in Fall Prevention. Importance of collaborative concept is a new idea for our region. Summer, holidays and flu outbreaks have slowed us down. We need to discuss the benefits of vitamin D with all physicians in Sun Country Health Region.

21-Oct-15Saskatchewan Falls Collaborative18 Next Steps Our region is continuing making Fall Prevention a priority by bringing it up at every staff meeting, and having Fall Prevention presentations. Our region will continue conducting more Fall reviews in our facilities. Most facilities in our region are doing or at least working on the medication review concept to eliminate unnecessary medications that may add to risk of falling. We are continually looking at the right drug in the right dose for the right reason.