Team approach to fall reduction in paediatric ward of national referral hospital, Thimphu, Bhutan: a quality improvement initiative

BMJ Open Quality

article

Kalpana Chhetri¹  Ugyen Rinchen¹  Gitanjali Lamichaney¹  Bhutan Kinley¹  Sangay Dorji¹ 

[1] Pediatrics , Jigme Dorji Wangchuck National Referral Hospital

关键词: healthcare quality improvement;    paediatrics;    patient safety;    PDSA;    quality improvement;   

DOI  :  10.1136/bmjoq-2022-001892

学科分类：药学

来源: BMJ Publishing Group

【 摘 要 】

Falls are common and preventable adverse events that occur in a hospital setting. Falls can cause pain, damage, increase cost and mistrust in the health system. Inpatient fall is a multifactorial event which can be reduced with multistrategic interventions.In this project, we aimed to reduce the fall rate in paediatric ward of Jigme Dorji Wangchuck National Referral Hospital, Bhutan by 25% from the baseline over a period of 6 months by focusing on fall risk assessment, staff education on fall prevention measures and devoting more attention to patients at high risk of fall.We tested three sets of interventions using the Plan–Do–Study–Act approach. For the first cycle, emphasis was on staff education in terms of proper use of fall risk assessment form, risk categorisation and fall prevention advice. In the second cycle, in addition to the first we introduced the ‘high risk of fall package’ and the third cycle focused on early and easy identification of high-risk patients by continuous fall risk assessment and use of high risk of fall sticker.We observed that at the start of the quality improvement project despite our intervention the fall rate of our ward went up but as we continued adding more ideas focusing on high risk patients, we could achieve a fall reduction of 49.3% from the base line by end of third cycle. Our ward saw fall free days of almost 90 days at the end of project.We conclude that inpatient falls occur due to multiple factors therefore a multi-pronged strategy is needed to prevent it. One of the prime preventive strategy is identifying patients who are at high risk of fall and concentrating attention to those patients.healthcare quality improvementpaediatricspatient safetyPDSAquality improvementData availability statementAll data relevant to the study are included in the article or uploaded as online supplemental information. ‘Not applicable’ data are included within the article.http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

【 授权许可】

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