In the Name of Function: Utilizing a 24/7 Function Board to Improve Outcomes

Research Objectives: 1) To reduce witnessed falls rate to 1.0 falls per 1,000 bed days on the rehabilitation units
2) To increase the number of nursing staff who feel “extremely confident” in knowing how to help patients transfer, toilet, walk, and assist with feeding/communication by 15%
3) To increase the number of therapists that feel their patients were given the opportunity to practice acquired skills outside of the session on the nursing unit to “always” or “often” by 12%

Design: The 24/7 Function Board is an interdisciplinary communication tool hung at bedside that includes the patient's mobility, activities of daily living and communication status. Data was collected before and after implementation of this board including witnessed fall rate and surveys assessing nursing confidence in assisting patients and therapists' perception of therapeutic carryover of skills using a 5-point Likert scale. Each discipline is expected to complete and update their respective portions of the board. After three months follow-up data will be reassessed.

Setting: This study is being conducted at Northwell Health's Glen Cove Hospital 83 bed Acute Inpatient Rehabilitation Program, primarily treating patients with neurological diagnoses.

Participants: There were 106 patients treated since implementation in July, 2022. There were 29 surveys completed by therapists and 80 completed by nursing staff prior to implementation. There were 28 surveys completed by therapists and 49 surveys completed by nursing staff post-implementation.

Interventions: The 24/7 function boards are individualized and updated on admission, weekly, and when there is a change in functional status.

Main Outcome Measures: Main outcomes include witnessed falls rate and surveys completed by nursing and therapy staff.

Results: Witnessed falls rate prior to board implementation was 1.52 falls per 1,000 bed days. After implementation, the witnessed falls rate fell below the target threshold of 1.0 falls per 1,000 bed days in the month of July. In the month of August, the falls rate was just over the target threshold. Initial surveys showed 35% of nurses felt confident in knowing how to assist patients and 28% of therapists felt that patients were able to carryover skills learned in therapy. After two months of use, nursing staff confidence on how to properly assist patients improved by 16% and therapists perceived an improvement in carryover of therapeutic skills by 25%.

Conclusions: Witnessed falls rate on the nursing units will continue to be tracked over the next 6 months to assess trends. A challenge that could impact outcomes is the novelty of the tool and ability to adopt into one's everyday workflow. Ongoing education and reminders have been utilized and compliance is being tracked on a weekly basis to ensure sustainability. ​ Data from the post intervention nursing and therapy staff surveys showed that the goals related to improving outcomes were exceeded after utilizing the 24/7 function board. Although additional time is needed to determine the boards impact on falls rate, it is evident that this tool is a staff satisfier. The 24/7 function board and has the potential to be a valuable tool that will help drive patients' function, reduce witnessed falls, and improve staff confidence and interdisciplinary communication.

Author(s) Disclosures: None