The Fox Chase Cancer Center ICU has not seen a patient fall in the department since the summer of 2020. It is a remarkable feat entirely due to the attention and commitment of the ICU nursing staff, says Kathleen Wolf, MBA, BSN, RN, NEA-BC, director of Magnet/Nursing Quality at Fox Chase.
“Two years with no falls in the ICU is an amazing accomplishment in nursing quality,” said Wolf. “This is a testament to the staff and their emphasis on working together to ensure patient safety.”
According to Wolf, the National Cancer Institute calculates patient fall rates by dividing the number of falls by the number of patient days, multiplied by 1,000, to obtain the fall rate per 1,000 patient days. Over the same time frame as the ICU saw an effective rate of 0.0, the 50th percentile fall rate for NCI-designated hospitals was 0.20.
According to ICU nursing manager Jenna Booth, MSN, RN, PCCN, patient safety is no accident. She took on the management of the team in August of 2020, not too long after a pair of falls in the department. These falls had put a damper on the staff’s morale, and Booth began by bringing the team together to explore what had gone wrong without recrimination.
“At Fox Chase, we put an emphasis on getting patients up and moving as soon as possible with assistance,” said Booth. “The emphasis on our team is to use all the tools we can, from bed and chair alarms to routine rounding on patients, to prevent situations where a fall is possible.”
Effective communication is their primary tool, says Booth, and it helps maintain a culture of responsibility among the ICU medical staff. Early into her time as manager, Booth began pulling together a safety newsletter, delivered both by email and print, to keep her team abreast of goings on in the ICU as well as national trends.
Most importantly, perhaps, is the safety huddle binder, which has become the key text to the daily morning huddles to specifically address patients’ needs and emphasize fall safety. Each week, Booth incorporates what she calls “little safety blurbs” into the huddle binder, such as listing four important notes about the coming week or a simple written reminder to “put on your bed alarms” to greet staff members as they come on shift.
Life in the ICU is non-stop busy, like many nursing floors. While not every nurse can join the safety huddle at 7 a.m., every nurse knows to review the safety huddle binder at the first chance they get at the start of their shift.
While Booth acknowledges it is easy to overwhelm people with communications, she points to how the drumbeat of communication has made fall safety a normal part of their daily routine.
“Patient falls are a topic we discuss openly, and the ICU nurses hold each other accountable for safety in a way that is very positive and mutually supportive, to their credit,” Booth explained. “When you have a good team, it’s easy to be successful.”