Abstracts

Rationale: Despite the application of various safety protocols and measures, one of the most common preventable injuries occurring in an Epilepsy Monitoring Unit (EMU) is still falls (1). In October of 2017, our EMU implemented the use of a Hill Rom Golvo® ( a mobile life device), in an effort to reduce patient falls in the EMU. The Golvo is a lift device to assist ambulation and lifting of patients with a mobile frame on wheels that does not require an overhead track.  Patients are secured in a vest that harnesses around the chest, allowing use of the toilet without interference. Since October 2017, all our EMU patients were asked to use the Golvo when ambulating to the restroom. The purpose of this study is to evaluate the usability and efficacy of a mobile lift device to prevent patient falls in the epilepsy monitoring unit (EMU). Methods: The frequency of falls in the EMU subsequent to implementation of a mobile lift device was compared to the number of falls in the months prior to implementation.  Using the designation of falls described by the National Database of Nursing Quality Indicators(NDNQI), a fall was defined as” an unplanned descent to the floor (or extension of the floor, e.g., trash can or other equipment) with or without injury”. The long term goal of this study will be to prospectively track the impact of this device on the fall rate at our institution over the course of the next two years. Data on patient compliance is collected and nurses’ perception of ease of use assessed by survey. Results: Thus far, the mobile lift has been used for seven months. In the seven months prior to implementation of the lift, there were a total of 3 falls (n= 363 EMU days; 82 patients).  All of these falls occurred while patients were ambulating to or were in the bathroom, and all of the falls were due to seizure.  Two of these events resulted in mild trauma to the head, and fortunately none resulted in complications or additional hospital days. In the seven month period following implementation of the mobile lift system there were zero (0) falls (n = 282 EMU days; 64 patients). Two potential falls were averted by being harnessed in the lift; one was an episode of syncope and the other a seizure while patient was ambulating. Sixty three of sixty four EMU patients agreed to use the lift and complied with its use. Nursing perception will be assessed at the one year mark after implementation of the lift. Conclusions: In the brief period of time the mobile lift has been used, there has been a reduction of falls in the EMU. The mobile lift has successfully averted falls, and patients have been compliant with its use. We will continue to track the impact of this device on the fall rate in our EMU and its usability from patient and nursing perspectives. Given that seizures are a necessary component of the EMU, patients are continually at risk of fall and potential physical harm. A mobile lift may reduce falls in patients who have a seizure or other event while ambulating, does not require an overhead track, and thus allows more freedom of movement and may be used in any room and importantly is an approach patients are willing to use.Reference:Spritzer et al. Fall prevention and bathroom safety in the epilepsy monitoring unit Epilepsy & Behavior.  2015;48:75–78. Funding: None