1. Name of Presenters: Daryl Dyck & Tracy Thiele

2. Deer Lodge Centre (DLC) Winnipeg, MB
Who We Are
Deer Lodge Centre (DLC)
Winnipeg, MB
Number of Patients/Residents/Clients:
431 bed hybrid facility
235 PCH beds (155 Veteran beds, 80 General Public)
130 Chronic/Extended Care beds
66 Rehabilitation and Assessment beds

3. Aim: Goal: To secure a solidly established base of understanding
regarding the benefits of hourly rounding.
Goal:
To integrate hourly rounding as a tool for staff members to utilize and initiate on any patient/resident that they believe will benefit  especially those deemed at high risk for falls.

4. Team Members
Team Members: Lynda Hermanson (Health Information Analyst), Carly Erenberg (PT), Daryl Dyck (CNS), Dennis St. Laurent (Manger of Patient Care L2), Diane Rawluk (OT), Michele Klassen (Manager of Patient Care T7), Rod Kebicz (CNS)
Team Lead: Tracy Thiele, Project Coordinator
Team Sponsors and Supporters: Sylvia Ptashnik (Director of Resident Care), Jo-Anne Lapointe McKenzie (CNO), Carol Anderson (Clinical Educator)

5. Falls Change Ideas Incorporated to Date
DLC Falls Management Policies and Protocols (since 2008)
Routine Practice for Falls (everyone considered at risk)
Assessment of Risk Tool (completed within 48 hours of admission)
Fall Management Policies
Falls Clinical Practice Guidelines
Falls Program and Equipment Algorithms
Mandatory education for all nursing staff
Quarterly feedback of fall rates provided to Nursing Units

8. Hourly Rounding Check Comfort Toileting Positioning Observations:
Does the resident look comfortable? Call light within reach? Clear pathway to bathroom?
Toileting
Does their brief/incontinent product need changing?
Positioning
Are their feet out of bed; does it look like they are trying to get up?

9. Challenges to Sustaining Falls Improvement
Barriers:
Staff buy-in
Recording Sheet
Results
Facilitators:
A dedicated project lead
Benefits of preventing a fall
Managers/champions/unit staff committed to project

10. Feedback “It hasn’t increased our workload because we do this anyway.”
“Some changes need to be done related to the sheet we sign on – we need somewhere for it to say we are charting more on the progress notes.”
“It is important for the nurses to communicate to the aides that the person is on hourly rounding – otherwise we might not know – especially floats.”
“It is definitely beneficial as a tool to help with falls.”

11. Lessons Learned Advise:
Start slow and work out the kinks before trying to expand.
Don’t get discouraged when you don’t see immediate results.
Conduct ‘Progress Checks’ on the program and address concerns early.
Getting staff ‘buy-in’ requires them to feel involved in the process.
Provide positive feedback and reinforcement in different ways.

12. Sustainability Plans
Celebrate successes, reinforce positives back to staff
Advertise what we are doing
Create ownership by including staff in problem solving techniques (staff input survey, informal and formal progress checks)

13. Moving Forward Incorporate hourly rounding onto one or two more units
Ultimately  Centre wide education and implementation for high risk patients/residents

14. Contact Information
Name: Tracy Thiele, Project Coordinator
Phone Number: