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Implementation of an oncology specific fall risk assessment tool
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Implementation of an oncology specific fall risk assessment tool

Louis K. Heck III
Master of Science (M.S.), Drexel University
2019
DOI:
https://doi.org/10.17918/czk9-2q83
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Abstract

Nurse administrators Nurses--Supervision of Falls (Accidents) Hospital wards Oncology
Abstract Falls are a concern for all patients, but oncology patients are at increased risk from falls due to treatment including transplantation and aggressive chemotherapies. As part of a quality improvement project, Penn State Cancer Institute piloted a new fall prevention tool on a 39-bed oncology unit to reduce falls. The Cleveland Clinic-Capone Albert (CC-CA) fall risk assessment for cancer patients, developed by Capone, (2012) was chosen. The pilot study design had three phases; a retrospective chart review of falls in 2018, a direct comparison random trial, and a 29-day trial implementation of the CC-CA. The CC-CA and the Hendrich II were compared for their ability to identify at risk patients. Implementation was supported by PDSA rapid cycle improvements by the interdisciplinary care team. The retrospective study results showed that the CC-CA was 2.43 times more predictive then the Hendrich II and had a sensitivity of 74.12 and specificity of 47.82. The two falls that occurred during the trial were both identified by the CC-CA and only one was identified by Hendrich II. The Hendrich II identified an average of 6.1 patients daily at risk for falls where the CC-CA identified 12.96. In the retrospective study 9 patients a day were put on fall precautions based on nursing judgment and after implementation of the CC-CA the average was 2.62. The pilot confirmed the CC-CA predicts and identifies more patients at risk for falling in the cancer population then the Hendrich II and provided nurses greater awareness of previously unidentified risk factors. Keywords: Falls assessment tool, Oncology, Bone Marrow Transplant, CC-CA assessment, Falls, Injuries, Nursing, Quality Improvement, Chemotherapies, Hendrich II

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