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Fall Program Assessment, Evaluation, and Spread

presented by Pat Quigley

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Disclosure Statement:

Financial: Pat Quigley receives compensation from MedBridge for this course. She is also an independent contractor for the following: American Hospital Association, Hospital Research and Education Trust; Washington Hospital Association, Hospital Improvement and Innovation Network; AvaSure, LLC; HD Nursing, LLC.

Non-Financial: Pat Quigley has no competing non-financial interests or relationships with regard to the content presented in this course.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

Accreditation Check:
Analysis of fall prevention programs requires more than examination of aggregated fall rates. Program evaluation is a systematic way to evaluate structures and processes that lead to improvement in outcomes. This session informs rehabilitation nurses about structure and process of fall and fall injury program attributes at the organization, unit and patient levels. This level of program assessment leads to opportunities to enhance practice, clinical skills, and program infrastructure and capacity. As a result, rehabilitation nurses are better positioned as clinical leaders to implement and spread interventions to improve patient and program outcomes.

Meet Your Instructor

Pat Quigley, PhD, MPH, APRN, CRRN, FAAN, FAANP

Dr. Patricia Quigley, PhD, MPH, APRN, CRRN, FAAN, FAANP, Nurse Consultant, is a retired Associate Director of the VISN 8 Patient Safety Research Center of Inquiry and is both a Clinical Nurse Specialist and a Nurse Practitioner in Rehabilitation. Her contributions to patient safety, nursing, and rehabilitation are evident at a national level, with emphasis…

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Chapters & Learning Objectives

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1. Program Evaluation: Preparation Phase

All rehabilitation nurses want to evaluate the outcomes of their fall prevention practices. These outcomes are dependent on each patient’s risk factors, each unit’s context, and overall organizational characteristics. Rehabilitation nurses experience these complexities 24 hours a day, and therefore are vital to the preparation phase to plan for and initiate an evaluation. During this session, rehabilitation nurses will learn basic components of program evaluation and apply these components to fall and fall injury prevention programs, creating a more precise road map at the patient, unit, and organizational level.

2. Formulate Measurable Fall-Related and Fall Injury-Related Outcomes

Understanding changes in outcomes requires that structures and processes be clearly defined, linked, and trended to the correct outcome. Structures and processes must be measured twice as much as outcomes in order to discover, in real time, barriers and facilitators to program improvement. Simply monitoring a fall rate or counting number of days between falls is insufficient to determine fall program effectiveness. In this session, rehabilitation nurses will define and contrast three types of falls and align specific actions to reduce each type of fall, deconstruct structures and processes to reduce serious injuries, and assess baseline program status in order to initiate prioritized actions.

3. Sample Tools for Program Evaluation at Patient, Unit, and Organizational Levels

High-reliability organizations (HROs) commit to a culture of safety and transparency through continuous systems of improvement. These systems rely on valid, reliable, and continuous measurement to track implementation and then evaluation. During this chapter, rehabilitation nurses will utilize post-fall huddle data analysis and organizational self-assessment as two tools to evaluate fall and fall injury programs.

4. Think Out of the Box: Other Opportunities for Evaluation of Your Program

High-reliability organizations (HROs) and organizations of excellence strive to showcase how their organizations compare and outperform like units and organizations. HROs commit to a culture of safety and transparency through continuous systems of improvement. Program evaluation invites inquiry into the uniqueness of each culture, and this inquiry can excite new methods of program evaluation. In this chapter, rehabilitation nurses will be introduced to innovative methods of program evaluation to be considered within their unit and organization.

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Effective education is critical to ensuring that patients have the knowledge and skills to maximize their health, well-being, functional independence, and social integration. Rehabilitation nurses have the unique role to teach, reinforce, and evaluate effective education to promote positive patient outcomes. Health literacy serves as the foundation to increase the probability that patients really learn what they need to as a result of education programs. Effective education is not a one-way process, but rather requires a systems approach and modification for cognitively alert and cognitively impaired patients. During this course, rehabilitation nurses will refresh their knowledge of the domains of learning, health literacy, and tools to examine teaching effectiveness.

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All organizations strive for falls to be “never events” in health care. However, falls remain among the top adverse events patients experience in hospitals and nursing homes. When a fall occurs, interventions must be implemented to decrease the chance of reoccurrence. During this course, rehabilitation nurses will: discuss the role of a post-fall huddle as a group consensus approach to determine the immediate/root cause of the fall; differentiate the post-fall huddle from other post-fall management components (incident reports and medical record documentation); and illustrate a post-fall huddle program evaluation model.

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Rehabilitation nurses have expert clinical knowledge to determine a patient’s fall and injury risk status. This session will build upon current practices and processes to move practice beyond the use of a fall risk score to assessment of multifactorial fall risk factors. Participants will be guided in the assessment of select fall and injury risk factors (postural hypotension, lower extremity sensory neuropathy, fracture risk) as examples of the the difference between a fall risk screening and an assessment as the basis for individualized fall patient care planning. The information will allow the participants to understand the implications of modifying their practice and implementing patient-centered individualized care plans to reduce falls and fall-related injuries.

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