Introduction of Patient Care Technician to Registered Nurse Report to Improve Fall Prevention and Communication in A Rural Iowa Hospital

Abstract

Purpose: Falls a leading cause of hospital adverse events, leading to rising hospital costs and increased morbidity. While there’s a plethora of research on fall reduction, there is no widely accepted strategy across hospital systems in the United States. This study aimed to improve fall prevention and communication among healthcare team members on inpatient units in a rural Iowa hospital through use of a Patient Care Technician (PCT) to Registered Nurse (RN) reporting system.

Background: The hospital participating in this quality improvement project experienced it’s worst years related to inpatient falls in 2020 and 2021. As PCTs and RNs interact the most with patients, it was proposed that improving communication between PCT’s and RN’s at shift changes could reduce fall rates. It was hypothesized that by having a 95% compliance rate with reporting that the participating floors would see a statistically significant reduction in falls.

Sample/Setting: The study spanned two months in 2022 across two medical units, a surgical unit, cardiac unit, and an inpatient rehab unit. The hypothesis was that a 95% compliance rate in PCT to RN reporting would result in a statistically significant reduction in falls compared to the average falls per month in 2021.

Methods: At each shift change (7am and 7pm), PCTs and RNs were asked to record on paper sheets number of patients, and successful handoff of patients to the next shift RNs.

Results: During October and December 2022, participating floors maintained 33.92% compliance reporting and while there was a decrease in falls compared to the 2021 monthly average, it was not statistically significant for either month (P-value=.2887 and P-value=0.3898.) Conclusion: While fall rates did not see a statistically significant decrease, the decrease in falls compared to the previous year average shows promise in utilizing PCT to RN reporting to decrease falls.