Tiffany

A lot of my job is doing patient education, hands-on care in terms of vaccinations or perhaps coming into the room to assist with gynecologic procedures. And then in between patients, especially with those bigger cases, I’ll do a lot of telephone triage.

We were, in my opinion, experiencing an alarming rate of newborn falls. So myself and the assistant nurse manager on the unit decided that we had to do something about it.

We put together this committee that every time a fall would happen, we would go back from the beginning from the moment that the patient walked into the hospital. We would look through the chart, chart the course of the labor, and see what medication she was given. What time did the fall occur? In what setting? Was the patient feeding? Was she sitting down? Was she in her bed? And then we started to put the pieces of the puzzle together.

What that led to is us redesigning our patient beds, particularly on the postpartum unit when falls were more prone to happen. The new beds had four side rails that were completely closed off. So if a mother was to fall asleep while breastfeeding her newborn and the baby happened to fall out of the arms, the baby wasn't really going to go anywhere.

We also worked with the physicians to space out the amount of time we were giving narcotics to patients—making it every six hours instead of every four, and alternating that with pain relievers. That way they could still get quick pain relief, but not necessarily need to be on those hard-hitting medications.

We actually wrote a protocol that still exists at our hospital that I think others have modeled, which is really an honor.