Interdisciplinary Communication to Prevent Toileting-Related Falls

Abstract

Background: Toileting and ambulation have been identified as common activities associated with patient falls. Furthermore, miscommunication among health care teams was identified as a key contributing factor in falls resulting in injury.

Objective: To prevent falls through standardized interdisciplinary team communication related to supervision of patients' toileting in an inpatient rehabilitation hospital.

Methods: A fall safety initiative was implemented to display patient supervision needs during toileting. Using the colors of a stoplight as a form of communication, the colors were visible in patients' rooms and allowed for easily accessible interdisciplinary communication of the toileting needs of patients. Initial data demonstrated less than successful results, leading to a revised intervention. With the second intervention, development of a new careboard incorporating a stoplight form of communication, the project was successful.

Results: The use of clearly defined language and interdisciplinary collaboration successfully reduced toileting-related falls. The toileting-related fall rate decreased from 1.154 events/1,000 patient days to 0.720, resulting in a 38% reduction between fiscal year 2023-2024 postimplementation. The hospital's fall rate decreased from 3.143 events/1,000 patient days to 2.50.

Conclusions: Nurse leaders and interdisciplinary teams can reduce toileting-related falls and enhance the culture of safety by standardizing the communication of supervision needed while toileting. A careboard utilizing the colors similar to a stoplight as a form of communication can facilitate effective interdisciplinary communication regarding the supervision level required during toileting.

Keywords: Falls in bathroom; fall prevention; rehabilitation nursing; toileting supervision; toileting-related falls.