Volunteer program cuts falls 46%

Some of the best ways to prevent falls require personal, hands-on attention to individual patients, but hospitals don't have enough staff to provide as much of that tending as they would like. One hospital has found that volunteers are eager to do the job, and it has cut falls by a whopping 46% as a result.

Overall compliance with fall-prevention protocol has improved significantly since the initiation of the program in April 2008, says Christine Waszynski, APRN, a geriatric nurse practitioner and clinical nurse specialist in the geriatrics program at Hartford (CT) Hospital. The volunteer program, which costs the hospital virtually nothing, started out with only two volunteers from a local job corps academy and has grown to 16 volunteers.

Volunteers are particularly well suited to ensuring compliance with fall prevention protocols, Waszynski says. Many of the volunteers are teen-agers who can be shy about interacting with patients in a way that requires them to strike up a conversation, but Hartford's Fall Prevention-Safety Monitor Volunteer Program provides them a specific set of factors to check with each patient. (For a video showing how the program works, go to http://vimeo.com/user7284985/videos and choose the video titled Safety Volunteer Program at Hartford Hospital.)

The program was developed to monitor and increase staff compliance with fall-prevention protocol measures, reduce patient falls, and increase involvement of patient and family in creating and maintaining a safe environment, Waszynski says. Volunteers are recruited and trained specifically for the program after completing the standard mandatory volunteer orientation. "We teach them to look for measures that should be in place for patients who are at risk for falls, and they correct any oversights they might find," Waszynski says. "They also remind patient and families about the risk of falling and their role in fall prevention."

The volunteers visit all patients who have been designated as a fall risk, which can include up to 80% of patients on some units. On each visit, the volunteer introduces himself or herself to the patient and family, and the volunteer explains that the purpose of the visit is to help reduce falls and keep the patient safe.

Using the hospital's fall safety screening tool, the volunteer confirms that the patient is at risk and then checks to see that all aspects of the fall prevention protocol are being followed. That includes verifying that the patient is wearing the hospital's green fall risk bracelet, there is a green triangle on the door, and the bed or chair alarm is activated. The volunteer also scans the room for fall hazards and improves safety however necessary, such as moving the phone to within the patient's reach, removing clutter, and making sure the patient knows how to call for assistance.

Each bedside check is recorded by the volunteer. At the end of the volunteer's shift, the results are reviewed with the unit's nurse manager or charge nurse. The findings also are sent to the fall-prevention team coordinator, who compiles the results for each unit monthly and presents them as a graph depicting compliance over time.

"We've used this program to help us change culture. When we started this program, the culture was 'patients fall, and there's nothing we can do about it,'" Waszynski says. "Our compliance with fall prevention was 50% at best. By talking about this all the time and using our volunteers, now our compliance is about 90%."


• Christine Waszynski, APRN, Geriatric Nurse Practitioner, Geriatric Clinical Nurse Specialist, Geriatrics Program, Hartford (CT) Hospital. Telephone: (860) 545-5630. E-mail: cwaszyn@harthosp.org.