Intro: In 2015, a 21-bed acute stroke unit within a Comprehensive Stroke Center at an academic medical facility experienced a stark increase in their falls rate. A monthly average of 4.58 falls per 1,000 patient days was recorded for 2015, which was an increase over the two previous years.
Methods: Various options were discussed to address the high rate of falls based on the unit population and the types of falls. After discovering an increase in falls from the bedside chair it was decided to implement use of a self-releasing safety belt when the patients were out of bed to the chair. The belts incorporated an alarm tied into the call bell system that would be triggered when released. This allowed for an additional layer of alarm to elicit a staff response to the room prior to a patient falling. Nursing and therapy staffs were educated on the utilization of these self-releasing belts when assisting any patient from bed to chair. Every patient admitted with the diagnosis of stroke utilized these belts while out of bed to the chair, even those who were deemed fully independent.
Results: After implementation, the average fall per 1,000 patient days’ rate decreased from 4.58 falls to 3.89 falls per month. The total numbers of falls also decreased from 28 in 2015 to 20 in 2016. Falls from the chair, specifically, decreased from 11 in 2015 to 5 in 2016, representing a fifty percent decrease in falls from the chair with use of the self-releasing seatbelt.
Conclusions: Overall, the falls rate decreased, and the falls specifically from the chair decreased. Data collected reflects all falls on the unit during the period in question and was not limited to patients using the self-releasing safety belts or falls from the chair. The next steps will be to ensure this practice is utilized uniformly and to evaluate similar methods to reduce falls from the bed and drive our rates down to zero falls per month.