Safety in Numbers

How Mary Greeley's 1-2-3 fall prevention program is helping patients.

Fall Risk Number

A red 3 outside a patient room
indicates a high fall risk.

Walk through a patient floor at Mary Greeley Medical Center and you might see a yellow 1 attached to the door of one room, and a red 3 attached to the door of another.

These numbers are part of a simple but highly effective method to enhance patient safety by helping prevent falls at Mary Greeley Medical Center.

"Falls go against everything we're about," says Matt Aitchison, RN, BSN, a clinical supervisor on 2 South, the Medical/Telemetry Unit at Mary Greeley.

Falls are the most common adverse event reported in hospitals, according to the Agency for Health Care Research and Quality. In February 2011, 2 South staff members—including nurses, patient care technicians, the clinical resource nurse, and supervisors—organized the Fall Prevention Team, which created a new and improved plan to decrease falls at Mary Greeley.

When patients are admitted to the hospital, staff evaluates their risk of falling. They reevaluate the risk every time there's a shift change for the nurses. If patients are at risk for a fall, they are given yellow wristbands. Staff members also know patients' fall risks through the use of a circular Safety Advisory Symbol displayed on the door frame of each room. Safety Advisory Symbols have a color and number scale that indicates fall risk. A yellow 1 indicates a low fall risk; an orange 2 indicates a moderate risk; a red 3 indicates high risk.

Between April 2011, when the program was implemented, and December 2012, fall rates on 2 South decreased by 56 percent. The program is now in use in other areas of the hospital.

"We also realized this is an all-hands-on-deck effort," says Aitchison. In addition to the nurses, education on the program was provided to staff from all departments who spend time on the inpatient floors, including Environmental Services, Facilities, Respiratory Therapy, Laboratory and others.

Hospital volunteers are also involved. Volunteers visit all patients who have been designated at risk for falls. The volunteer documents which fall protocols are in compliance and is trained to correct items that are not in compliance.

"Now we have more eyes on the issue," says Aitchison.

An Easy Approach to Fall Prevention

Here's what Mary Greeley's fall prevention Safety Advisory Symbols mean for patients.

Level 1 (Low)

  • A call light will be within your reach so you can call for help.
  • Your bed will be in the lowest position, and the brakes will be locked.
  • The two bedside rails will be in an upright position.
  • You will wear nonslip footwear for your safety.
  • We will update the marker board in your room to communicate your fall risk among all staff.
  • We will check in with you every hour. As part of our visit, we'll offer to help you to the bathroom.
  • A staff member will help you get in and out of bed and to the bathroom.
  • We will turn on a night light for your safety.
  • We will explain the Fall Prevention Program to you and your family members.
  • When nurses change shifts, they will complete a report with you to communicate information about your safety. This is called a bedside shift report.

Level 2 (Moderate)

These are in addition to Risk Level 1 procedures.

  • An alarm on the bed will signal when you are getting out of bed without help. The alarm will be on whenever you are in bed. Only hospital staff are allowed to turn off the alarm.
  • You will not be left alone in the bathroom or on the bedside commode.
  • If you are unsteady on your feet, nurses and patient care technicians will use a gait belt to help you get up and walk safely.

Level 3 (High)

These are in addition to Risk Level 1 and 2 procedures.

  • To ensure your safety, a nurse or assistant may sit with you in your room.
  • Family members may be asked to stay with you during your hospital stay.
  • Any time patients need assistance, they are encouraged to use their call lights to summon the nurse or patient care technician.