News

Preventing Falls by Staying S.A.F.E.

Date: 2021-10-29

Shining a Spotlight on Falls Prevention during Canadian Patient Safety Week (October 25-29)

Did you know that St. Joseph's Hospital is what’s called a rehabilitative care hospital? It’s a hospital that sees people whose lives have changed through illness, injury or disease. When a person is admitted to hospital, they see a team of healthcare professionals to better understand their current level of function, set rehabilitation goals that are important to the person in their recovery, and develop a plan to achieve those goals together. Quality and safety is always a top priority, and for people working on new ways of being mobile, falls can be a risk.

Reducing the risk of falls within hospitals begins with training. "We use the word SAFE to educate staff and students working at our hospital and other St. Joseph's Care Group sites," explains Linda Belcamino, Manager of Clinical Innovation & Client Safety. "Like cleaning your hands or driving your car, fall prevention should become intuitive to a healthcare professional," she adds. "In fact, it's something that anyone can use to prevent falls."

So what is SAFE? It stands for:

Safe Environment (e.g. pathways are clear of tripping hazards)
Assist with Mobility (e.g. mobility aids are within reach)
Family & Client-Centred Care (e.g. asking "is there anything you need before I go?")
Equipment (e.g. frequently used items are within reach like glasses)

Let's take a look at a potential fall scenario to see how it unfolds:

Bill is at St. Joseph's Hospital recovering from a stroke. He now uses a walker to get around, and a nurse helps him with his bedtime routine.

Without SAFE:
Bill is helped into bed by his nurse Rhonda, and it appears he is ready to fall asleep. Rhonda heads out of his room to assist her next client. Half an hour later, nursing staff respond to his bedside alarm. Bill is on the floor with a suspected hip fracture—he needed to use the bathroom again and fell while trying to get there on his own.

With SAFE:
Rhonda, Bill’s nurse is helping him get into bed and takes off his shoes. Bill’s feet are cold and he doesn’t want his socks taken off. Rhonda suggests a warm blanket for his feet and he agrees to take off his socks. She places his shoes on the floor within reach. She scans the area and sees that his walker was moved to the end of the bed, and returns it his bedside. Before leaving, she makes sure the call bell is within reach and isn’t hidden in the bedding, and she asks if he needs anything before she leaves. He remembers that his glasses are in the bathroom. Rhonda retrieves the glasses and places them on his bedside table. Half hour later, Bill needs to use the bathroom, he uses the call bell and then gets ready by slipping on his shoes and standing up with the help of his walker. His nurse arrives and is ready to help if needed.

Quite a different outcome when we apply SAFE

Planning for safe care is two-fold: future-looking plans aim for prevention by proactively changing our environments and practices. When incidents do happen, we review those as well to learn and make changes.

Jack Christy is a Client & Family Partner, someone who brings the voice and experience of clients and families to organizational planning. Jack contributes to a culture of quality and safety by volunteering his time as Co-Chair of St. Joseph's Care Group's Client & Family Council, as a member of project and planning teams, and as representative on the Board Quality, Safety & Risk Committee. "Giving clients and families a seat at the table to contribute to planning is a concept that St. Joseph's Care Group has embraced. Our input and viewpoints are valued and respected which informs change and improvements at St. Joseph's Care Group."

When a fall does occur (and after the client is cared for), an internal review takes place. "We want to know what contributed to the fall and what can be done to prevent it from happening in the future," says Belcamino. "We use a 'just culture' approach to encourage open reporting of mistakes, errors, and near misses. A focus on learning from errors drives process improvement, enhanced accountability and improved client care."

The best outcome is to never have a fall happen in the first place. Why not take a moment and "Stay SAFE" in your own work and family environments?

To learn more about Canadian Patient Safety Week or find more resources for caregivers, visit healthcareexcellence.ca.