Nurses play a critical role in Stamford Health’s quality and service culture, and there are many nurse-driven initiatives in support of our commitment to a positive patient experience and ongoing quality improvement.
Reducing Inpatient Falls
The effort to prevent patient falls is important in any hospital setting. Falls can occur for a number of reasons, such as a patient being weak, dizzy or confused after a procedure. Even with the best preventive measures in place, sometimes a patient gets out of bed or a chair quickly and without assistance resulting in a fall.
At Stamford Health, our nurses work collaboratively to develop innovative solutions that address patient needs – among which is a comprehensive Fall Prevention Program. This effort begins with an assessment of all patients to determine their risk of falling. Those considered “at risk” are given specific preventative instructions and assistance.
As part of the Fall Prevention Program we formed a Fall Prevention Committee that meets weekly to review data related to patient falls. The goal is to increase staff awareness, develop intervention strategies and ensure patient safety. Volunteers serve as an extension of this committee to assist in confirming all safety measures are in place.
Other interventions we have developed to support fall prevention include:
- A more comprehensive unit surveillance program that includes staff who are not typically involved in fall prevention.
- A dedicated team to analyze patient falls in real time, which not only increases the communication between disciplines but, more importantly, facilitates the implementation of interventions.
- Environmental visual reminders using the color orange to allow for easy staff identification of fall risk patients.
- The purchase of new beds that are lower to the ground and include safety lighting.
Click Image to Enlarge (Fig. 1)
With the implementation of the Fall Prevention Program in the last 3 years Stamford Health has reduced Inpatient and Emergency Department falls by 19.7%. Figure 1 compares the Emergency Department and Inpatient units Falls per 1000 patient days from 2013 to 2015.
The Hospital now also benchmarks performance on each type of patient care unit as part of the National Database of Nursing Quality Indicators (NDNQI).
Click Image to Enlarge (Fig. 2)
Figure 2 compares Stamford’s medical units fall rate against those of all NDNQI medical units for the most recent two years. As you can see, Stamford Hospital’s fall rate is below the national benchmark.
Interventions to Improve the Patient Experience
Stamford Health’s goal is to provide patients with an exceptional experience. Our journey to improve the patient experience has included the implementation of many initiatives focused on a patient and family centered model of care, consistent with the Planetree philosophy. Our approach is holistic and encourages healing in all dimensions of body, mind and spirit.
The Nursing staff has worked collaboratively to improve our care delivery model and the patient experience by developing and adopting a number of best practices from leading national experts and institutions. More specifically, our best practices include:
- Discharge Phone Calls, which connect nurses with patients to ensure they understand their discharge instructions and medication regimen
- Hourly Rounding, which proactively anticipates the patients’ needs before they request help via their call light
- Leadership Rounding, which connects nursing leadership to staff and patients ensuring a positive experience
- Bedside Shift Report, which involves the patient and the care partner in transition from one nurse going off shift to one coming on promoting safety and involvement in decision making
- A technologically advanced Nurse Call System where patients are directly connected to their care providers
- Patient Directed Visitation, which allows the patient autonomy in decisions related to care partnership, visiting and rest
- Patient Access to a Clinical Pharmacist
- Nurse practitioners and physicians, who specialize in Pain and Palliative Care Services