985 A QUALITY IMPROVEMENT PROJECT ON CALL BELL IN REACH IN AN ACUTE OLDER PERSON MEDICINE WARD (AGE > 85 YEARS)

Abstract

Abstract Introduction Call bell within reach of patients is an important part of quality care and standard in the National Inpatient Falls Audit. Initial data collection showed 56% of patients had call bell in reach indicating potential for improvement Understanding the problem: Discussion with stakeholders included: Healthcare support worker, nurses & doctors of all grades, physio, and occupational therapist. Aim We aimed to improve call bell reach-ability from 56% to 95% or more for patients on the ward. Method Data were collected from 2 bays (Total 10 beds) on the ward three times a week for 2 weeks after implementation of each change assuming it should roughly reflect the whole ward. Balancing measure Inpatient falls on the ward (weekly data for the ward). Changes 1st Change: Stickers in medical notes as a reminder 2nd Change: Teaching session to staff nurses 3rd Change: A short video posted in a closed social group of ward 4th Change: Make a component in the safety huddle & reminder in daily nursing handover. Results After the 4th PDSA cycle, the call bell in reach was 93.88% which was sustained improvement. Inpatient fall did not show any specific correlation with call bell reach-ability and specific fall data for those 10 beds was not available separately Learning: • Teaching is effective but it may not be able to involve all the staff especially when staffing is not consistent. Despite attending the teaching, implementation of gained knowledge from the teaching session may not sustain. • Social media can be used to improve patient care provided that it’s closed media & no patient confidentiality is hampered but again may not be a solution. • Reminding the staff of the importance was our most effective change, possibly because of its proximity to patient care immediately being delivered afterward.