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The Acute Rehab Unit Introduces: The Coach Caution Falls Program

The Acute Rehab Unit Introduces: The Coach Caution Falls Program. Backround. Rehab facilities’ national average falls: 7-12/1000 patient days. Loyola’s Rehab unit average falls: 12.8/1000 patient days (occurred in the first nine months of 2006 fiscal year).

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The Acute Rehab Unit Introduces: The Coach Caution Falls Program

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  1. The Acute Rehab Unit Introduces: The Coach Caution Falls Program

  2. Backround • Rehab facilities’ national average falls: 7-12/1000 patient days. • Loyola’s Rehab unit average falls: 12.8/1000 patient days (occurred in the first nine months of 2006 fiscal year). • Statistics prompted the formation of a multidisciplinary committee to revise the current fall prevention program. • Goal was to have a fall rate equal to or less than 7/1000 patient days.

  3. Fall Data Analysis MYTH #1: Cognitively impaired patients have the highest fall rate. MYTH#2: Most patient falls occur during change of shift. FACT #1: Highest incidence of falls occur due to elimination needs. FACT#2: Patient falls occur at random times.

  4. Coach Caution Fall Prevention Program Developed • All Rehab Unit patients are classified as Level II protocol under Loyola’s hospital policy. • Our Rehab Unit needed to further classify patients that were fall risks. • Committee developed Level III and Level IV protocols, otherwise known as “Coach Caution.”

  5. Implementation of “Coach Caution” • Fall Assessment every shift • Team member signs (Level III & Level IV) • Player’s Guide • Whistle band (multi-colored vs. red) • Toileting flow sheet • Bed alarm monitors • Level II protocols

  6. Program Roll Out • Fall prevention program initiated on April 1st, 2006. • All staff was in serviced on the Coach Caution elements and their role in the program. • A short quiz given to all staff.

  7. Program Evaluation • Five months after implementation: • Rate was 5.3 falls/1000 patient days. • Nine months after implementation: • Rate was 8.1 falls/1000 patient days.

  8. Acute Rehab Fall Program Acute Rehab Fall Program Falls per 1000 Patient Days Falls per 1000 Patient Days UCL = 30.89 30 30 25 25 UCL = 21.49 20 20 "Coach Caution" Program Initiated (4/06) "Coach Caution" Program Initiated (4/06) 15 15 Staff Inservice (1/07) Staff Inservice (1/07) Mean = 12.28 Mean = 12.28 10 10 Mean = 7.77 Mean = 7.77 Project Target = 7 Project Target = 7 5 5 Jul-05 Jul-05 Jul-06 Jul-06 Oct-05 Oct-05 Apr-06 Apr-06 Oct-06 Oct-06 Jan-06 Jan-06 Jun-06 Jun-06 Jan-07 Jan-07 Feb-06 Feb-06 Mar-06 Mar-06 Feb-07 Feb-07 Mar-07 Mar-07 Aug-05 Aug-05 Sep-05 Sep-05 Nov-05 Nov-05 Dec-05 Dec-05 Aug-06 Aug-06 Sep-06 Sep-06 Nov-06 Nov-06 Dec-06 Dec-06 May-06 May-06

  9. Program Adjustment • October 2006 showed an increase in falls and continued to trend slightly upward. • Program interventions and compliance were reviewed and adjustments were made. • Staff was re-inserviced on the “Coach Caution” program. • February 2007 showed a rate of 6.9 falls/1000 patient days.

  10. Continued monitoring The Acute Rehab Unit continues to monitor the Coach Caution Falls Program through QI in order to keep our patients’ safety a priority.

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