From left, Richard Oliver, BSN, RN; Amelia McCaffery, BSN, RN; Kimberly Mello, BSN, RN; and Ashley Bonaccorso, BSN, RN, round on Oncology units with a candy cart.

With patient safety top of mind, the Oncology division committee members took advantage of the change of seasons to create a compelling patient falls prevention campaign, complete with autumn imagery and clever plays on words.

“Educating people about falls is a key priority for us because Oncology patients face a high risk of injury if they fall,” explained Cathleen Rowland, MSN, MPH, RN, OCN, BMTCN, professional development manager for Oncology. “Because of low platelet counts, our patients are at high risk for bleeding, and patients with metastatic bone disease are at higher risk for fractures.”

The comprehensive campaign was geared toward staff and patients alike to enhance safety.

Educating Patients and Families

To help patients better understand their risk for falls and the potential consequences, staff placed posters in patient bathrooms — the most common place Oncology patients fall —with a picture of a tree and the phrase, “Leaves are supposed to fall, not people.” Each branch and leaf featured a reason that a patient could fall, such as rushing to the bathroom, experiencing side effects of medication and lacking familiarity with room surroundings.

The poster also included four eye-opening scenarios about patients of different ages, including a 25-year-old, who experienced falls with injury.

“Patients were really surprised at the scenarios used in the falls poster,” said Alice Realejo, RN, OCN, of Braunwald Tower 4B. “The age of the patients and the severity of injury were alarming to them. Many were of similar ages and couldn’t fathom a fall resulting in injury.”

She noted that many patients told her they don’t want to “bother” staff with a request for assistance to the bathroom or getting out of bed. “I reinforced that is what we are here for: to ensure their safety and get them through their stay until they are ready to go back to their own environment,” Realejo said. “I always joke when reviewing fall precautions that patients have enough to deal with without the complications of a fall.”

In addition to the posters, the Oncology Division committee offered patients bracelets reminding them to ring the call bell for assistance when getting up.

Enhancing Staff Communication

One of the ways the council sought to raise awareness among staff was by developing a course for patient care assistants (PCAs), co-taught by a nurse and a PCA. Throughout the month, 65 PCAs attended one of 15 classes offered on day and night shifts. These courses will continue to be offered for the evening shift.

“PCAs were extremely eager to join the classes and had valuable insights to share,” said Casey Bowser, a PCA in the Hematology/Oncology Float Pool. “The classes helped PCAs better understand the impact of various blood levels, including hematocrit and platelets, when a patient falls.”

Feedback provided by PCAs during the courses highlighted an important opportunity for improvement in increasing communication between nurses and PCAs about each patient’s fall risk and the need for quick responses to call bells and bed alarms.

Nurses and patient care assistants on the divisional council also took the campaign unit to unit, drawing staff in with a candy cart. “We spoke to more than 320 staff members during rounds on all shifts throughout Oncology units,” said Rowland.

Realejo, who participated in six of the thirteen rounding sessions, said peer-to-peer communication was an effective element of the campaign. “The cart was a great way to gather staff and engage in conversations about falls,” she said.

The comprehensive campaign was geared toward staff and patients alike to enhance safety.