JCMC Nursing Annual Report - Mountain States Health Alliance

Falls Prevention Program:
Decision Making by Front-Line Nurses
FALL RISK
Direct-care nurses were asked to use the Hendrich
and Morse fall risk tools on each of their patients for
a two-week period trial in 2008. From their input,
the Morse risk assessment tool was determined to
be most appropriate for our nursing practice. The
Hendrich fall risk assessment tool received a mean
rating of 2.66 out of 4.00 on a Likert scale, while the
Morse tool received a mean score of 3.27.
On July 27, 2009, the new Fall Prevention Program
using the Morse fall risk tool was implemented. This
was a very comprehensive undertaking regarding
the change of policy, forms and practice throughout
MSHA. Using the yellow armband with “Fall
Risk” inscribed on the band was adopted by our
organization as the method of identifying patients at
high risk for falls.
Nationally recognized as the color for high fall
risk patients, the yellow armband is just one of
the colored armbands that identify patients with
special needs. The adoption of a uniform colorcoded
armband system by MSHA in July 2009
presents a clearly defined practice for identifying and
communicating patient risk factors, or special needs,
by standardizing the use of color-coded armbands
to support safe patient care based upon the patient’s
assessed needs and wishes.
JOHNSON CITY MEDICAL CENTER
PATIENT FALL RATES
Rate = falls per patient days x 1000
4.00
3.50
3.00
2.50
2.00
2010
1.50
2009
1.00
2008
0.50
0.00
JAN FEB MAR APR MAY JUN JUL
AUG SEP
OCT
NOV
DEC
New Fall Program
started July 27, 2009
2008
2009
2010
JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC
2010 3.59 3.16
2009 3.37 3.00 2.48 3.04 3.29 2.85 3.55 1.98 3.79 2.89 3.75 2.74
2008 3.30 2.44 2.02 1.59 2.23 2.46 3.39 1.89 2.57 2.60 2.31 3.27
Aquapheresis
A new treatment for congestive heart failure
was made available to our patient population in
2009. Aquapheresis, a pump that filters blood and
removes only water and sodium, was purchased in
2009 with the first utilization starting in August
2009. Congestive heart failure patients are able to
get out of bed during this therapy, which is much
more comfortable for them. Most patients receive
the treatment for 3 days, with most seeing a drastic
weight loss between 15 and 30 pounds in 3 days.
Patients have been able remove their bipap apparatus
or oxygen therapy after the aquapheresis treatment.
Swelling is dramatically decreased in all areas so
patients who have had severe pain secondary to
swelling are able to mobilize more freely.
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