Nurses serving on the 4-South unit practice council (UPC), Erin Suda, RN & Autumn Manion, RN met with their leader Fran Variava, RN and nursing quality facilitator, Danielle Jordhal, RN to talk about what might be done differently to prevent falls and keep patients safe. Their drive stemmed from compassion for patients and their families, and the knowledge that the injury from an unintended fall while in the hospital can impact a patient’s recovery, and, in some cases, be a life-altering event. Rather than accept the status quo, the UPC members stayed curious, noticing that the way patient mobility was assessed and then used to help patients move safely wasn’t working well. 

They agreed that the assessment tool, the BMAT, was not well understood and didn’t do enough to help the team plan actions for patients to mobilize. They knew that early and progressive mobility helps prevent patients from getting weak or falling and getting hurt while admitted to the hospital. They believed if they partnered with experts from different specialties to change the way the team approached patient mobility on the unit, they could help prevent patients from falling. 

Erin and Autumn convened a multi-disciplinary team including Tammy Carter, CNA, Sadie Rabener Justice, RN, Department Leaders Fran Variava and RN and Alison Norton, RN, Carrie Kronberg, RN in Clinical Education, Danielle Jordahl, RN in Quality, Jessica DiRusso in Physical Therapy, Lon Swan the Caregiver Injury Prevention Coordinator, and Celeste Seimears as a new grad partner. With extraordinary commitment and collaboration, this nurse-led team rolled out a new BMAT2.0 program for nurse-driven, early progressive patient mobility.

They implemented the change in 3 phases. The first focus was on a two-RN admission mobility assessment, next came hands-on training with mobilization devices, and the final focus was on each patient receiving targeted mobility interventions three times daily. The methodical approach allowed the team to better meet bedside caregivers’ learning needs using new tools built with frontline insights and feedback. Hands-on training with mobilization devices and additional education were provided for the unit Nurse Team Leads and UPC members so they could serve as champions. 

Best of all, all the work this team did really seems to have made a difference for our patients. Measurable falls outcomes show that following the initial trial on 4-South, fewer patients were getting hurt from falls. In fact, no 4-South patients were harmed due to a fall in the three months following the rollout of the new BMAT2.0 mobility program. This success led the hospital’s medical-surgical units to also adopt and roll out the program this team developed. A significant, sustained decrease in the hospital’s rate of patient falls with injury was measured. The average number of patient falls with injury per 1000 patient days in July 2022 - October 2022 (after the program was implemented in 4 South and medical-surgical units) was 0.308 compared to the average of the 12 months prior to that of 0.658. 

The BMAT2.0 program this team developed has since been selected for PeaceHealth System-wide implementation. 

Erin, Autumn, and the members of this team would tell you they were just doing their jobs. But, their actions reflect deep compassion for our patients and the desire to provide the safest care. Their willingness to try something new helped the patients not only on 4-South, but across St. Joseph, and even across all of PeaceHealth. The team is in the process of writing about this nurse-led project, which they hope to publish so that hospitals across the country may benefit from their work.