There was an increase in incidence of client falls on the unit where the licensed practical/vocational nurse serves on the continuous quality improvement (CQI) committee
Several of the incident reports noted that clients fell during the change of shift and other reports noted multiple causes. The unit practiced reporting to the oncoming nurses at the nursing station. Which activity should the CQI committee perform next?
A) Search for the best evidence-based fall prevention protocol that meets the unit's needs and will help to decrease the incidence of falls in the future.
B) Continue to track the number of falls and review the incident reports to determine actions to take in the future.
C) Place signs by the room of a client who is at risk for falls to help all health care personnel to provide added observation when rounding.
D) Change the policy for change of shift reporting to be carried out at the client's bedside to help decrease the number of falls.
Ans: A
Feedback:
The next step the CQI committee needs to take is to search for the best evidence-based fall prevention protocol that meets the unit's needs in helping to decrease the incidence of falls. Not only are the falls a result of no one rounding during change of shift report, but there are other reasons for the falls. If the committee simply tracks the number of falls and reviews the incidence reports, then the committee is ignoring the problem and not addressing it, which goes against the principles of CQI. Placing a sign by the door of clients at risk for falls may help increase rounding, but does not address end-of-shift coverage when all nursing staff are at the nursing station giving and receiving report. Simply changing the policy for change of shift reporting to be at the bedside addresses decreasing some of the falls, but it does not address all of the reasons for the increased incidence of falls.
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