By Gregory Freeman, Author
This summary of the CAPTURE Falls program is provided by Katherine J. Jones, PT, PhD, associate professor in the Division of Physical Therapy Education at the University of Nebraska Medical Center in Omaha.
CAPTURE Falls includes the idea that there are eight “rights” of fall risk reduction. A good risk reduction program must include:
• The right frame of reference. The CAPTURE Falls solution depends on collaboration and proactive teamwork to improve the structure and coordination of organizational processes, as well as to standardize definitions for reporting and benchmarking. This approach views fall risk reduction as an organizational goal that multiple teams coordinate to achieve.
• The right team. The Coordinating Team typically consists of a quality improvement leader, a nurse champion, a certified nurse anesthetist, a pharmacist, a physical therapy or occupational therapist, and a senior organization leader. This team manages resources, coordinates the fall risk reduction program and interventions, and holds the core team accountable for reliably implementing evidence-based interventions. The team should span locations, status/hierarchies, and knowledge boundaries across disciplines.
• The right coordination of the program. The Coordinating Team oversees other component teams of the program that: achieve proximal goals and organizational goals; develop and coordinate the fall risk reduction program; conduct and implement targeted and universal interventions at the bedside; and make real-time adjustments to the care plan. The nursing team, for example, assesses fall risk based on observations and implements interventions at the bedside, while the pharmacy team assesses fall risk based on medication side effects and medication debridement. The physical therapy and occupational therapy team assesses fall risk based on performance and ensures competency in safe transfers and mobility.
• The right training. Clinicians and others in the organization must be trained in the overall fall risk reduction program (purpose, interventions, outcomes), administration of the fall risk assessment tool, safe transfers and mobility, mechanical lifts, and post-fall huddles.
• The right risk assessment. The program uses these questions to improve risk assessment: Does it facilitate critical thinking about targeting interventions to risk factors? Do you know the sensitivity, specificity, and predictive value of your tool?
• The right event reporting and learning system. CAPTURE Falls encourages the reporting of falls in four categories: unassisted falls that result in injury, unassisted falls that do not result in injury, assisted falls that result in injury, and assisted falls that do not result in injury. Unassisted falls represent a system failure and are more likely to result in injury, while assisted falls that do not result in injury to patients or staff represent system success.
• The right interventions. These include universal, purposeful hourly rounding, toileting schedules, and using gait belts. The organization should make it easier to assist mobility.
• The right response to a fall. The post-fall huddle is the key component of responding to a fall. Members from various teams should conduct a post-fall huddle immediately after a fall to determine what happened, why it happened, and what will be done differently in the future to prevent such a fall. The goals of the post-fall huddle are to decrease the risk of future falls for an individual patient, apply what is learned to decrease risk across the system, build trust, and share knowledge.
More information on the CAPTURE Falls program, including free tools and guidelines for implementing it in any healthcare facility, is available online at: https://bit.ly/2rddVqX.