Authors: (including presenting author): :
Lui SF(1)(2),Ho PS(1)(2),Wong MC(1)(2),Chow MY(1)(2),Chan CY(1), Lam PY Winnie(1), Chan SK(2)
Affiliation: :
(1) Clinical Oncology Department, Tuen Mun Hospital, (2) Clinical Oncology Department, Tin Shui Wai Hospital
Keyword 1: :
Patient Fall Prevention
Keyword 2: :
Periodic clinical audit
Keyword 3: :
increase nurses awareness
Keyword 5: :
continous monitoring
Keyword 6: :
patient safety
Introduction: :
Introduction: Accurate documentation and fall risk assessment are essential for patient safety. Errors in charting, miscalculated Morse Fall Scale (MFS) and reassessment noncompliance undermine fall prevention strategies. Continuous auditing not only monitors compliance but also enhances nurses' awareness and assessment accuracy.
Objectives: :
Objective: The fall assessment audit is implemented in January-June in 2025 with 96 cases assessed. It evaluated the accuracy of fall risk assessment & documentation across three Oncology in- patient units. The focus was on precision of MFS, preventive measures implementation, reassessment compliance and improvements in documentation with half yearly follow-up structured audit feedback.
Methodology: :
Methods: Monthly ward-level data were collected, including demographics, diagnoses, MFS, clinical judgment on high fall risk factors & medication uses. Observational charts & notes were reviewed to identify misinterpretations, calculation errors, missed reassessments, preventive measures inadequacy & documentation lapses. Real-time on-site face-to-face coaching conducted to nurses for discrepancy & reinforcement of standardized protocols, clarification of misinterpretation and advice to use calculator for scoring accuracy.
Result & Outcome: :
Results: • Assessment Compliance: Initial compliance with scheduled reassessments was 82%, with 18% of cases missing Day 1 or Day 3 reviews. After six months, compliance improved to 96%, with missed reassessments reduced to < 5%. • Accuracy of Scoring: Calculation errors were observed in 12% of cases during the first quarter. Following reinforcement of calculator use, errors decreased to 3% by mid-year, representing a 75% reduction. • Documentation Quality: Preventive measures were inconsistent recorded in 21% of cases at baseline. Over six months, documentation completeness improved to 95%, with refusals of alarm pads or yellow vests increasingly accompanied by clear clinical justification. • Medication-Related Risk: Sedative and opioid-related drowsiness was documented in 28% of patients. Preventive strategies were escalated in 92% of these cases, reflecting improved integration of pharmacological risk into fall prevention planning. • Staff Awareness: Qualitative observations indicated greater attentiveness to charting accuracy, with improved alignment between nurses and ad hoc assessments. Paper reminders for reassessment were consistently applied, and staff demonstrated heightened vigilance in high-risk cases. Conclusion: Sustained auditing significantly improved the accuracy of fall risk charting and assessment. Within six months, compliance rates increased by 14 %, calculation errors declined by 75%, and documentation completeness rose to 95%. These findings underscore the effectiveness of structured feedback in fostering nurses' awareness and assessment precision. Continued emphasis on standardized scoring, timely reassessments, and integration of medication-related risks will further strengthen fall prevention strategies and patient safety outcomes in high-risk populations.
