Pre-Procedural Patient Education Reduces Fall Risk in an Outpatient Endoscopy Suite

Abstract

The purpose of this article was to determine whether scripted pre-procedural fall risk patient education and nurses' intention to assist patients after receiving sedation improves receptiveness of nursing assistance during recovery and decreases fall risk in an outpatient endoscopy suite. We prospectively identified high fall risk patients using the following criteria: (1) use of an assistive device, (2) fallen two or more times within the last year, (3) sustained an injury in a fall within a year, (4) age greater than 85 years, or (5) nursing judgment of high fall risk. Using a scripted dialogue, nurses educated high-risk patients of their fall risk and the nurses' intent to assist them to and in the bathroom. Documentation of patient education, script use, and assistance was monitored. Over 24 weeks, 892 endoscopy patients were identified as high fall risk; 790 (88.5%) accepted post-procedural assistance. Documentation of assistance significantly increased from 33% to 100%. Patients receiving education and postprocedural assistance increased from 27.9% to 100% at week 24. No patient falls occurred 12 months following implementation among patients identified as high fall risk. Scripted pre-procedural fall risk education increases patient awareness and receptiveness to assistance and can lead to decreased fall rates.

Preventing patient falls

“…In one study at an outpatient endoscopy suite, the incidence of falls among high-risk patients dropped to zero after personnel began using scripts to educate patients about postoperative falls. 11 In a nonrandomized study of 244 patients undergoing total knee arthroplasty, 72 of whom participated in nurse-led preoperative education sessions that reviewed risk factors for falls and the need to call for help when getting out of bed, none of the patients who participated in the education session experienced a fall. 7 These education initiatives establish the expectation among patients that they will require postoperative assistance and encourage them to ask for help even though it may compromise their privacy.…”

“…Some facilities provide yellow wristbands that read "Fall Risk" to alert all personnel to that patient's fall risk; regardless of their degree of involvement in the patient's care, personnel can then act to prevent a fall if they observe the patient ambulating unassisted outside of his or her room. 11 These identifiers also remind family members that the patient may need help getting up or walking.…”

Science and Knowledge Development in the Gastroenterology Nursing Specialty: More Than We Could Have Imagined

“…Reviews of early issues of Gastroenterology Nursing show attention to science in gastroenterology nursing practice began to emerge in the 1980s, just a decade into the recognition of gastroenterology as a nursing specialty. In the second issue of 1981, Gill (1981) shared how Orem's self-care theory could be applied to the outpatient endoscopy suite. Interestingly, in that same issue, the 1978 Guidelines for Cleaning and Disinfection of Flexible Fiberoptic Endoscopies (FFE) Used in GI Endoscopy were also published, but with no references to support any of the recommendations.…”