Brenda Baker, PhD, RNC, CNS, Mary Ann Ott, MS, RNC, WHNP
Organization:
Virginia Commonwealth University Medical Center
Abstract
Purpose
To determine if in the obstetric patient population, would an obstetric specific falls screening tool identify women at risk for falling and decrease falls in Labor & Delivery (L&D) compared to commonly used falls screening tools?
Background
At an urban academic medical center with approximately 2,200 births per year, ten falls occurred in Labor and Delivery in a twelve month period. None of the patients who fell were categorized as “high risk” for falling leading the nurses to ask was the current falls risk scale useful in our population. The hospital wide falls screening tool had little application in the perinatal population, as most tools were validated in geriatric populations. A review of the literature revealed little evidence as most studies excluded perinatal patients from their work.
Materials & Methods
A review of literature was conducted using CINHAL and Pubmed. Search terms included falls and pregnancy. Nine publications related to falls in pregnancy met search criteria. Findings from this review indicate history of previous fall, visual disturbances, sedentary life style, and edema in feet and ankles during pregnancy as most predictive of risk of falling. Following a review of the literature and analysis of fall events in L&D a practice guideline, Falls Prevention in Labor & Delivery was developed. A screening tool was built in the electronic medical record to facilitate screening. Monthly chart audits were conducted to monitor compliance with the tool and to provide continuing education related to use of the screening tool and falls prevention in the obstetric patient.
Results
In 2008 ten falls were reported. Following implementation of the obstetric falls screening tool two falls were reported in 2013.
Conclusion
A continual decline in patient falls in L&D has occurred since implementation of multiple initiatives including a population specific screening tool. Further plans are to continue to monitor data and provide feedback on falls.
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