Orthostatic Vital Signs Algorithm: Decreasing Falls in Patients Undergoing Blood and Marrow Transplantation or Treatment With Cellular Immunotherapy

Clin J Oncol Nurs. 2020 Oct 1;24(5):489-494. doi: 10.1188/20.CJON.489-494.

Abstract

Background: Falls experienced by patients undergoing blood and marrow transplantation or treatment with cellular immunotherapy (BMT-CI) may result in injury or death. An algorithm was developed using the patient fall circumstances identified in a chart analysis from 2016.

Objectives: This study aimed to determine if the Moffitt BMT-CI Orthostatic Vital Signs Algorithm could decrease inpatient falls.

Methods: A pre-/post-test program evaluation was conducted for one year pre- and postimplementation of the algorithm on newly admitted inpatients. Adherence rate of nurses using the algorithm was monitored.

Findings: Overall falls decreased from 5.38% to 3.44%, with zero falls or injuries related to orthostasis for newly admitted patients. Adherence of nurses using the algorithm increased from 60% to 93%. The fall rate has been sustained less than baseline with 100% adherence, and the algorithm has been adopted as standard of practice.

Keywords: blood and marrow transplantation; cellular immunotherapy; fall prevention; falls.

MeSH terms

  • Algorithms
  • Bone Marrow*
  • Humans
  • Immunotherapy / adverse effects
  • Vital Signs*