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217Preventing Falls in the Rehabilitation Setting

Background: Inpatient falls are considered very serious often resulting in distress, injury and sometimes death. Systematic reviews suggest that multifactorial assessment and intervention can reduce falls by 20–30%. A quality improvement initiative was implemented on some hospital rehabilitation units. The initiative involved the implementation of key components of multifactorial assessment and multifactorial interventions. The aim of the initiative was to reduce falls by 20% over 12 months and a further 20% within a 24 months period. Methods: Quality initiative was implemented on four rehabilitation units. The project included the application of Falls Care Bundle to all patients. The falls lead nurses used a PDSA cycle to implement and to sustain the falls care bundle. The care bundle included multifactorial interventions that have been proven by research to be effective in reducing falls. Data on falls was collected from incident reports. Data on falls care bundle compliance was also collected each month by falls lead nurses. Results: In June 2014 the falls rate was 7.1 falls per 1,000 bed days. In April 2015 the falls rate decreased to 4.2 falls per 1,000 bed days and by April 2016 the falls rate decreased to 2.5 falls per 1,000 bed days. Concurrently, the compliance with the fall care bundle in June 2014 was 11%, in April 2015, it was 56% and in April 2016, 73%. Overall, the initiative lead to increased awareness of falls among staff and patients in addition to improved falls risk assessment and falls care planning. Additionally, a Falls Huddle was introduced as a part of the post fall assessment. Conclusion: Introducing evidence-based care bundles of multifactorial assessment and intervention using a quality improvement approach resulted in improved delivery of multifactorial assessment and intervention and a significant reductions in the fall rates.