| Primary Author: | Linda Searle Leach, PhD, RN |
| Co-Principal Investigators/Collaborators: | Linh Heafner, Nicole Casalenuovo, Anna Gawlinski |
| Organization: | UCLA School of Nursing |
Abstract
Background
Falls pose significant risks to patients. Prevention efforts have focused on geriatric and medical/surgical patients. Most associated risk factors are not salient for obstetric patients nor are existing fall
risk tools. Pregnancy is not an illness and the incidence of falls is low but risks can increase during hospitalization for childbirth. A systematic risk assessment tool specific to the obstetric population is needed to prevent falls in these patients and increase perinatal staff awareness of risk assessment.
Purpose
Pilot testing an innovation using an evidence-based risk assessment scoring system, the Obstetric Falls Risk Assessment System (OFRAS), to improve patient safety by determining fall risk among pregnant women during hospitalization.
Materials & Methods
Evidence from the literature and an expert panel contributed to identifying the fall risk factors in this patient population. These were stratified into six categories: cardiovascular, postpartum hemorrhage, medication, motor/activity, neurological function and prior history and scores for items in each category were assigned. The scoring system was integrated into the electronic medical record. Seven patient falls and fourteen near misses were analyzed retrospectively using the OFRAS.
Results
The analysis revealed strengths and weaknesses of the OFRAS and was used to refine the system. Since OFRAS was implemented, no obstetric patient falls have occurred. Staff vigilance to falls prevention has increased the reporting of ‘near miss’ falls suggesting improved assessment, early risk identification and intervention.
Conclusion
An obstetric falls risk assessment tool using a scoring system to determine the patient’s risk provides a structured systematic approach for RNs to use that is evidence-based and focuses safety efforts on a typically young, healthy patient population. Research to analyze readiness to ambulate among epiduralized obstetric patients post anesthesia using OFRAS is planned and an application for institutional review is underway. Additional implementation sites are needed to evaluate the effectiveness of the scoring system.
© Improvement Science Research Network, 2011