Abstracts

Rationale: Falls and fall related injuries are the most frequently reported adverse events in hospitals. Since procedures and protocols to reduce falls and fall related injuries vary significantly between Epilepsy Monitoring Units (EMUs), a unique patient-centered approach to fall reduction must be adapted for improved patient outcomes.

Methods: This study retrospectively compared the rate of falls from 2015 before the implementation of a new seizure fall prevention plan to fall data from 2018 after the implementation of the new fall prevention plan.

In 2018, a tailored population-specific fall prevention program was introduced in a neurology inpatient unit. Using 4 categories of neurology-specific patient populations (epilepsy, delirium, dementia, and impulsivity), staff implemented unique fall reduction care plans for every patient upon admission or change in mentation.

For epilepsy patients, fall prevention strategies included: continuous use of bed and chair alarms to alert staff when patients attempted to get out of bed, restricting ambulation to having a staff member within arm’s-reach and line-of-site while ambulating and in the bathroom, using yellow fall risk identifiers, patient education about fall prevention strategies prior to planned admissions, and use of a 1-to-1 bedside companion if a patient met two or more of the 4 population categories (i.e. epilepsy and dementia). Existing safety protocols already in place in 2015 included: environment modification (soft seizure pads applied to bedrails, rubber floors in all EMU rooms, and curved edges on countertops), enhanced staff education on patient seizure types prior to admission, and additional safety protocols for patients when addressing toileting needs.

Results: In 2015, 9 falls occurred during 118 admissions (7.6%). 7 falls occurred from the bed during seizure events and 2 falls occurred in the bathroom resulting in patient injury.

In 2018, 4 falls occurred during 177 admissions (2%). 2 falls occurred from the bed during seizure events and 2 occurred during ambulation during a seizure event. No falls resulted in injury. The reduction in falls between 2015 and 2018 was statistically significant (p=0.036, Chi-square comparison).

Conclusions: This study shows that identifying and applying population tailored fall reduction strategies reduces falls with injury and adverse events, specifically when tailored to the EMU. The results of this study reinforce the need for diligent safety standards, adequately trained staff, patient involvement, and patient specific care plans to prevent falls with injury in the EMU.

Funding: Please list any funding that was received in support of this abstract.: None.