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Outpatient Oncology Fall Risk: A Quality Improvement Project

INTRODUCTION: Patients receiving cancer treatment are at high risk for falls. No current guidelines or standards of care exist for assessment and prevention of outpatient oncology falls. This quality improvement project’s purpose was to 1) describe and evaluate outpatient oncology falls data to dete...

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Autores principales: Hammontree, Stephanie, Potts, Maryellen, Neiberger, Adam, Olds, Danielle, English, Daniel, Myers, Jamie S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: University of Kansas Medical Center 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544871/
https://www.ncbi.nlm.nih.gov/pubmed/37791021
http://dx.doi.org/10.17161/kjm.vol16.20271
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author Hammontree, Stephanie
Potts, Maryellen
Neiberger, Adam
Olds, Danielle
English, Daniel
Myers, Jamie S.
author_facet Hammontree, Stephanie
Potts, Maryellen
Neiberger, Adam
Olds, Danielle
English, Daniel
Myers, Jamie S.
author_sort Hammontree, Stephanie
collection PubMed
description INTRODUCTION: Patients receiving cancer treatment are at high risk for falls. No current guidelines or standards of care exist for assessment and prevention of outpatient oncology falls. This quality improvement project’s purpose was to 1) describe and evaluate outpatient oncology falls data to determine root cause(s), and develop, implement, and evaluate intervention strategies for future policy refinement, and 2) compare fall rates pre/post implementation of a system-wide Ambulatory Fall Risk Bundle. METHODS: Retrospective data were used to describe and categorize fall incidence for the University of Kansas Cancer Center over 12 months. Further analyses were conducted to describe fall rates per 10,000 kept appointments pre/post implementation of an Ambulatory Fall Risk Bundle protocol. Semi-structured interviews were conducted with medical assistants and nurse managers to evaluate the initiative’s impact, staff satisfaction, and recommendations for refinement. RESULTS: The initial 12-month assessment yielded 58 patient falls retained for further analyses. Most patients were receiving chemotherapy (46, 79%). Common contributing symptoms included dizziness/ faintness and weakness (25, 43%). Tripping/falling over a hazard (12, 24%) and falls during transfer (10, 5.8%) also were cited. Subsequent analyses of fall rates indicated no change. Recommendations resulting from the qualitative interviews included: orthostatic vital sign protocol implementation, redesign of the electronic medical record fall risk alert, stakeholder involvement in protocol development, staff training, and related patient education strategies, and the procurement of additional assistive devices/equipment. CONCLUSIONS: System-related policy and culture change, investment in physical and human resource enhancements, and evidence-based protocols are needed to improve outpatient oncology fall rates.
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spelling pubmed-105448712023-10-03 Outpatient Oncology Fall Risk: A Quality Improvement Project Hammontree, Stephanie Potts, Maryellen Neiberger, Adam Olds, Danielle English, Daniel Myers, Jamie S. Kans J Med Original Research INTRODUCTION: Patients receiving cancer treatment are at high risk for falls. No current guidelines or standards of care exist for assessment and prevention of outpatient oncology falls. This quality improvement project’s purpose was to 1) describe and evaluate outpatient oncology falls data to determine root cause(s), and develop, implement, and evaluate intervention strategies for future policy refinement, and 2) compare fall rates pre/post implementation of a system-wide Ambulatory Fall Risk Bundle. METHODS: Retrospective data were used to describe and categorize fall incidence for the University of Kansas Cancer Center over 12 months. Further analyses were conducted to describe fall rates per 10,000 kept appointments pre/post implementation of an Ambulatory Fall Risk Bundle protocol. Semi-structured interviews were conducted with medical assistants and nurse managers to evaluate the initiative’s impact, staff satisfaction, and recommendations for refinement. RESULTS: The initial 12-month assessment yielded 58 patient falls retained for further analyses. Most patients were receiving chemotherapy (46, 79%). Common contributing symptoms included dizziness/ faintness and weakness (25, 43%). Tripping/falling over a hazard (12, 24%) and falls during transfer (10, 5.8%) also were cited. Subsequent analyses of fall rates indicated no change. Recommendations resulting from the qualitative interviews included: orthostatic vital sign protocol implementation, redesign of the electronic medical record fall risk alert, stakeholder involvement in protocol development, staff training, and related patient education strategies, and the procurement of additional assistive devices/equipment. CONCLUSIONS: System-related policy and culture change, investment in physical and human resource enhancements, and evidence-based protocols are needed to improve outpatient oncology fall rates. University of Kansas Medical Center 2023-08-24 /pmc/articles/PMC10544871/ /pubmed/37791021 http://dx.doi.org/10.17161/kjm.vol16.20271 Text en © 2023 The University of Kansas Medical Center https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License. (CC-BY-NC-ND 4.0: https://creativecommons.org/licenses/by-nc-nd/4.0/)
spellingShingle Original Research
Hammontree, Stephanie
Potts, Maryellen
Neiberger, Adam
Olds, Danielle
English, Daniel
Myers, Jamie S.
Outpatient Oncology Fall Risk: A Quality Improvement Project
title Outpatient Oncology Fall Risk: A Quality Improvement Project
title_full Outpatient Oncology Fall Risk: A Quality Improvement Project
title_fullStr Outpatient Oncology Fall Risk: A Quality Improvement Project
title_full_unstemmed Outpatient Oncology Fall Risk: A Quality Improvement Project
title_short Outpatient Oncology Fall Risk: A Quality Improvement Project
title_sort outpatient oncology fall risk: a quality improvement project
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10544871/
https://www.ncbi.nlm.nih.gov/pubmed/37791021
http://dx.doi.org/10.17161/kjm.vol16.20271
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