Abstract
Fall Prevention Post Anesthesia
Purpose
The projects goal was to develop a plan for the role of nurses as change agents to improve the prevention of patient falls in the Post Anesthesia Care Unit (PACU). The aim was to establish baseline knowledge and prior training regarding patient safety and fall prevention according to the post-anesthesia recovery unit protocol and educate staff on implementing strategies to reduce patient falls after surgery.
Background
Postoperative falls are rarely considered possible complications that should be accounted for in the clinical care practice after surgery. However, there is a considerable prevalence of postoperative falls in PACU and other post-surgery care units, such as patients' homes. Lam et al. (2016) posit that an overall 1.6% incidence of postoperative falls is based on a review of 5 years records of in-patient surgery procedures. The authors observe that successful management of surgery and anesthesia does not guarantee the absence of adversities and postoperative complications. Further, they observe the scanty studies on postoperative falls and suitable strategies to curb them is due to the low incidence of such cases that could make them statically difficult to detect. Notably, the falls occur in unexpected circumstances and locations after an operation, such as caregivers, at the bedside, and during the daytime. Consequently, 30% of falls necessitate surgical attention and additional medical attention (Lam et al., 2016). Patient falls after surgery is often caused by miscommunication in the handoff from the operation room to the nurses in PACU.
Since the effects of anesthesia post-operation are still unascertained, postoperative falls might also result from the lingering neuromuscular and pharmacological blocking effects of the...
…support system for adopting the new change, such as guidance by the anesthesiologist and the Director of Nursing (DON) in the next three months.Results
According to the post-anesthesia recovery unit protocol Tool and the assistive technologies, adopting the best practices helped create a safer environment for the patients prone to falling. These measures ensure hourly scheduled checkups and remote patient monitoring to ensure their safety, thus preventing falls.
Conclusion
Multi-disciplinary education of the OR and PACU nurses on the current post-anesthesia recovery unit protocol and best practices inclusive of monitoring equipment effectively prevent post-operation falls. This change aimed to eradicate the handoff procedure errors between these teams associated with most falls. Lewins Change Theory of change was critical to align the team's attitudes, perceptions, values, and behaviors as desired for installing the new system for fall prevention and aligning with…
References
Cuttler, S., Barr-Walker, J., & Cuttler, L. (2017). Reducing medical-surgical in-patient falls and injuries with videos, icons, and alarms. BMJ Open Quality, 6(2), e000119. https://doi.org/10.1136/bmjoq-2017-000119
Lam, C., Hsieh, S., Wang, J., Pan, H., Liu, X., Ho, Y., & Chen, T. (2016). Incidence and characteristic analysis of in-hospital falls after anesthesia. Perioperative Medicine, 5(1). https://doi.org/10.1186/s13741-016-0038-z
Marquis, B., & Huston, C. (2020). Leadership roles and management functions in nursing (10th ed.). LWW.
Ortelli, T. (2018). AHRQ Resources for Preventing Falls in Hospitals. AJN, American Journal Of Nursing, 118(5), 63-64. https://doi.org/10.1097/01.naj.0000532835.08637.c7
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