Activity Wristband Pilot to Reduce the Number of Inpatient FallsIntroductionWard 1, St Andrews Community Hospital had one of the highest falls rate per 1000 Occupied Bed Days in NHS Fife Community Services.

AimThe aim was to reduce the rate of falls with harm in the ward consistently to less than 5 per month by September 2015

Method• A PDSA design was used

• All patients admitted to the ward offered assessment• Following assessment, the appropriately coloured wristband was applied to the patients’ wrist and walking aid relating to mobility

- Red- Assistance - Amber- Supervision - Green- Independent

• Falls run charts including All Falls and Falls with Harm data were collected monthly

• Patient, staff, relatives/ carers and visitors to the ward were given the opportunity to give feedback about the project.

Claire De Angelis, Band 6 Physiotherapist, Intermediate Care Team cdeangelis@nhs.net & Caroline Peffers, Senior Charge Nurse, Ward 1 caroline.peffers@nhs.net

To maintain the rate of falls with harm in the ward to less than 5 per month by end of September 2015.

To introduce the use of coloured wristbands to identify safe level of

mobility.

• A reduction in the overall number of patient falls per month• A reduction in the overall number of patient falls with harm per month• A reduction in the overall falls rate per 1000 Occupied Bed Days• A reduction in the overall falls with harm rate per 1000 Occupied Bed Days.Plan

Do

Study

Act

Aim: What are we trying to accomplish?

Measures: How will we know if the change is an improvement?

Change: What changes can we make that will result in improvement?

Results80% of patients admitted to the ward participated in the project.During the project implementation period, the number of falls with harm on the ward was maintained consistently below 5 per month except in August 2015, when two inpatients fell more than 3 times each on the ward.

Assistancewith mobility,

with or without a walking

aid/equipment.

Supervisionwith mobility,

with or without a walking

aid/equipment.

Independent with mobility,

with or without a walking

aid/equipment.

NHS Fife call to

action 1

NHS Fife call to

action 2

New falls paperwork

1st planning meeting

Introduction of

wristbands

2 patients fell more

than 3 times

Ward meeting

I couldn’t wait to tell my family that I was allowed to get up and walk about by

myself.

Knowing I will soon get my green band means I know I

am almost ready to go home.

The coloured bands allow staff to know instantly the

patient’s ability.

Having the band on the walking aid as well is great because it means everyone

can see at a glance, including volunteers,

domestics, etc.

When patients receive a green band, they feel a sense of achievement.

It’s more eyes and ears!

When the physiotherapist gave me a green wristband,

I said “Yippee!”

When I first came to the ward I was a red band and

the lady in the next bed was amber so I wanted to

get to green first.The bands are a great idea! When my relative gets her green band it means she is

good to go.

Patient/relative/carer comment

Staff comment

Discussion/ ConclusionThe project contributed to the reduction in inpatient falls with harm on the ward, whilst supporting the work being done by NHS Fife to reduce inpatient falls. Feedback about the project from patients, staff, relatives/ carers and visitors to the ward was both positive and encouraging.As part of the PDSA cycle the project continues to be evaluated and improved. The project is now more inclusive of the Multi-disciplinary team approach, and the wristband colour now correlates to the patients’ level of function rather than just mobility.The project has been rolled out to other community hospital wards in NHS Fife, and is also being piloted on one of the acute wards.