Falls are falling, thanks to Kearney Regional’s ‘No Fall’ program


Kearney Regional no falls

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Shari Freeman keeps track of patient falls on visual management boards like this in each department at Kearney Regional Medical Center. The board also records how many days each department has been fall-free.

18 days. 30 days. 84 days. That’s how long Kearney Regional Medical Center’s medical surgical unit has gone between patient falls in the last eight months, thanks to a new No Falls program throughout KRMC that’s aimed at keeping patients safe.

KEARNEY — 18 days. 30 days. 84 days.

That’s how long Kearney Regional Medical Center’s medical surgical unit has gone between patient falls in the last eight months, thanks to a new No Falls program throughout KRMC that’s aimed at keeping patients safe.

“If a patient falls and is injured, the average additional cost of that is $30,000, plus an increased hospital stay,” said Shari Freeman, KRMC’s medical surgical unit manager.

“We tell patients, ‘We are here for your safety. We don’t want you to get hurt,’” Freeman said. “Many times we’re dealing with an elderly patient, but our younger patients fall, too. They can be confused just being away from home, and we bring them into a foreign environment and give them medication that could cause them to be even more confused.”

Freeman brought the program to KRMC a year ago from a previous job at a hospital in Chattanooga, Tenn. She shared it with Adrienne Olson, KRMC’s chief nursing officer and clinical services executive. Olson liked the idea. It was launched last October.

The program includes changes such as:

– Patients who are at a high risk of falling wear a yellow gown and yellow socks and have a yellow light outside their rooms.

– The fall risk for every patient is listed on the large visual management board at each unit’s nursing station.

– Every 12 hours, the staff fills out a form that rates each patient’s risk of falling. If the risk is even moderate, extra procedures are put in place to keep that patient safe.

– Alarms on beds buzz if a high-risk patient gets up so a nurse can quickly respond.

– A new committee at KRMC dealing with patient falls includes representatives from every department, including dietary, housekeeping, ICE, PCU and maternity.

– A new Clinical Leadership Team Fall Task Force studies new equipment that could reduce falls. For example, KRMC just upgraded sensors on patient chairs that trigger call lights to let staff members know if a patient got up

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– KRMC has ordered 23 new beds with better alarms related to falls. Outpatient unit beds also have alarms since patients coming out of even minor surgical procedures can be groggy and have a higher risk of falling.

If patients are unsettled by the new rules, Freeman talks to them and explains, “We’re here for your safety. We don’t want you to get hurt,” she said. Resentment, however, is rare. Most patients accept it, and their families are grateful.

The hospital’s goal is just 3.5 falls per 1,000 patient days. For a time since last October, KRMC had that down to 1.1. It is now at 2.6, but that’s far below the 5.7 rate before the No Falls program was implemented.

When falls occur, “We bring in all the staff who were involved with that patient. We talk about how that fall could have been avoided and what contributed to it,” Freeman said.

She added that “a number of initiatives” have come out of those meetings, and “our staff has been fantastic about offering information to the higher-ups. They know the boss really cares about their patients.”

Shanna Stofer, director of patient safety and ancillary services at KRMC, said the program was implemented “without spending a large dollar amount.” Other changes have been implemented as well.

KRMC has instituted “personal rounding,” where a nurse or a staff member checks on every patient at least once an hour. They inquire about patients’ pain levels, any unmet needs and more. During the night, nurses and others check sleeping patients every two hours.

“We’ve done that for a long time, but we’ve honed in on it and made it a more formalized process. This helps decrease call lights. Patients always know that someone will be in soon,” Stofer said. “Families relax, too.”

In addition, KRMC has a new Just in Time customer focus, where a designated staff member visits every patient every day to learn whether he or she is satisfied with the hospital stay. Are call lights being answered? What about the food? How is the housekeeping?

Such visits range from two minutes to an hour, “but it makes a patient feel good to see a manager making the rounds,” Stofer said.

“We want to make sure patients are satisfied with their care. We can make sure a patient’s pain is being managed or that they’re being educated on medication. This also lets our managers address patients’ concerns, maybe clear up a question, make something right,” she added.

These new procedures have encouraged open communication among the staff and made the hospital “people-centered,” Stofer added. Also coming in July is a patient brochure that will introduce staff members and outline various procedures.

“If we can make a difference in a person’s stay, we try to do that,” she added.


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