On Solid Footing: Preventing Falls Through CUSP

Patsy Manson, RN, started in healthcare as a medical assistant but wanted more interaction with patients. She went back to school and became a registered nurse and now works in the Medical/Surgical unit at Northern Light Sebasticook Valley Hospital. “I enjoy talking to patients. I’m maybe overly talkative at times, but I like getting to know all of them,” she says with a smile. Getting to know her patients helps Patsy provide better care and make sure her patients remain safe. “We want people to go home feeling better, doing better, and not having any injuries,” she says.

We want people to go home feeling better, doing better, and not having any injuries. - Patsy Manson, RN

But every year in the United States, hundreds of thousands of patients are injured in hospitals due to falls. Injured patients require additional treatment and sometimes prolonged hospital stays.   Now front-line nurses, physical therapists, and nurse leaders at Sebasticook Valley have dedicated themselves to reduce the likelihood of falls.

“We started this journey to prevent patient harm through our Comprehensive Unit-based Safety Program (CUSP),” explains Tracy Bonney-Corson, RN, vice president, Nursing and Patient Care Services. Tracy took some initiative after attending a course on CUSP at Johns Hopkins University. Following the toolkit provided by Johns Hopkins, she asked staff, “How do you think the next patient is going to be harmed?” The answer was unequivocal—falls.  

Patsy Manson, RN (left) and Physical Therapist Kristy Fogler (right) are both part of the Comprehensive Unit-based Safety Program (CUSP) at Northern Light Sebasticook Valley Hospital.

Physical therapist Kristy Fogler joined the CUSP team and added her expertise on ways to reduce falls and tailored it to a hospital environment, “We noticed was that there was a difference of language between disciplines. Nurses spoke a certain language, therapists spoke a different language, yet we worked with the same patient. We worked on a way to standardize that language,” she explains.

Tracy Bonney-Corson, RN, Vice President, Nursing and Patient Care Services

In addition to standardizing language, the CUSP team implemented a post-fall huddle where they asked several key questions. What was the patient doing when the fall happened? What was staff doing? When was the last time staff did rounds? They used the answers from these post-fall huddles to identify gaps in their safety preparedness. They determined that there were improvements they could make as simple as ensuring that items were in reach, cords were out of the way, and call buttons were within arm’s length of patients. By moving a computer station at the nurses desk, they also addressed issues with nurses having trouble hearing fall alarms and they put whiteboards by the patient’s bed with the patients mobility needs identified and color-coded. Now at shift change, when nurses meet to do a handoff at the patient’s bedside, they go over the whiteboard.

The program is producing results. “We have observed a reduction in falls in our Medical-Surgical unit. As a result of the program, we’ve seen increased awareness for fall prevention interventions and a renewed excitement among our staff to do what it needs to take to keep patients safe,” explains Tracy.

We noticed was that there was a difference of language between disciplines. Nurses spoke a certain language, therapists spoke a different language, yet we worked with the same patient. We worked on a way to standardize that language. - Kristy Fogler, Physical Therapist

These same programs that are leading to improved results at SVH are now being implemented at other Northern Light Health intitutions. “We record the number of days we don’t have a fall,” explains Patsy, “and what we’d like to see is the number of days get bigger and bigger, and when it does get bigger, it is great for morale.”

The ED has gone 143 days without a fall and the Medical/Surgical Unit has had periods as long as 62 days without a fall.