Ambulant Care Falls Prevention in BC Cancer Agency

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Information about Ambulant Care Falls Prevention in BC Cancer Agency
Health & Medicine

Published on March 7, 2014

Author: bcpsqc



This presentation was delivered in session F2 of Quality Forum 2014 by:

Sue Fuller Blamey
Corporate Director, Quality & Safety
BC Cancer Agency

Lorna Roe
Director of Operations, Systemic Therapy
BC Cancer Agency

Tracy Lust
Quality & Safety Leader
BC Cancer Agency

Falls Prevention Putting our Best Foot Forward Taking Steps to Prevent Falls Quality Forum Lorna Roe, Tracy Lust & Sue Fuller Blamey February 28, 2014

Why Falls Prevention is Important Anyone can fall 1 in 3 over age 65 and older fall once per year Falls are the leading cause of death in those 65 and older Patient fallshospital admission  Residential care vs home

# of BCCA Out-patient Falls BCCA Number of Out-patient Falls Aug 1, 2012 - July 31, 2013 9 8 7 # of Falls 6 5 Falls 4 3 2 1 0 Aug Sept Oct Nov Dec Jan Feb Month Mar Apr May Jun Jul

Risk for Oncology Patients While anyone can fall, many different factors can contribute to an Oncology patient’s risk of falling Medication or Procedures Other Effects of Disease Process Environment Factors • Confusion, lethargy, fatigue • Altered electrolytes, anemia • Nausea, vomiting • Altered nutrition leading to weakness • Changes to mobility (requiring the use of a cane/walker) • Alterations in elimination (urgent need to urinate) • Unfamiliar and overwhelming health care surroundings • Inappropriate footwear, wet floors, obstacles in hallways

BCCA Falls Prevention Program Patient Self Assessment From (PRISM) 1. Have you falls in the last 6 months 2. Do you have balance or muscle weakness 3. Do you use mobility aides Referral to Falls Prevention Clinics in Community Documentation: Electronically and/or paper patient record

Falls Prevention Education Strategy Stage 1: 2009 - 2012 Stage 2: Nov 2012 – Nov 2013 Stage 3: Nov 2013 – Feb 2014 • Situation analysis & planning • In-patient, then ambulatory roll-out • Mandatory staff annual education • Executive & leadership engagement • Learning Hub annual staff education • Collaboration & updating of program with Health Authority Falls prevention leaders

Implementation Results # of BCCA Out-patient Falls 9 8 7 A# of Falls 6 5 4 3 2 1 0

Analysis: Reasons for Falls • People trying to get in/out of wheelchairs • Falls while walking in hallways • Tripping over obstacles in hallways • Standing too quickly post sitting/supine • Following staff to exam areas • Slippery floors/tiles/entrance • Lost balance getting changed • Footwear/socks/shoe laces untied

Risks and Interventions: Always walk with the Patient X √

Ensure blanket is not tangling X

Observe and remove falls hazards X

Ensure wheelchair footrests are moved out of the way X

Ensure shoes are back on and laces tied prior to patient walking X

Keep equipment to one side of hallways – declutter pathways clear X

Falls Prevention vs Homecare Referral – ensure the correct referral Falls Prevention Clinic • Life Expectancy greater than 6 months • Over age 65 • May have to come to clinic Home Care or Community Care • Urgent home care needs • Potentially less than 6 months life expectancy • Daily care needs

Falls Prevention is Everyone’s Responsibility No matter where you work within the BC Cancer Agency, or what you do… Max’s Story

• Questions • Tracy Lust = • Lorna Roe = • Sue Fuller Blamey =

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