Bedside care initiatives

Bedside care initiatives to improve patient care quality and safety at Duke include:

Identifying patients who are at-risk for falling is an important initiative across Duke University Health System. Each hospital and Duke HomeCare and Hospice have a process to identify patients at risk. For example, patients at Duke Regional Hospital are given purple stars on their identification bracelets and medical charts to remind nurses to make appropriate changes to prevent falls. At-risk patients and their families are also given literature detailing how to prevent falls from occurring.

Infection control strategies and education help reduce the risk of hospital-acquired infections. For example, standardizing central venous line maintenance decreases the number of catheter-associated blood stream infections that often lead to infant death.      

Prompted voiding programs encourage elderly patients to wait for assistance when going to the bathroom -- a prime time for a fall to occur. Nurses make rounds every two hours to prompt patients to use the bathroom and assist them in getting there. During a two month pilot program at Duke Raleigh Hospital, zero falls were reported.

Reducing the noise levels in and around patients’ rooms contributes to the healing process and quality of the patient’s stay. Duke Raleigh Hospital has designated quiet zones where posters and buttons remind people to be quiet, the intercom system has been disabled, and specific rooms are used for doctors and nurses to communicate. 

Suicide precaution tools help nurses offer a consistent level of safety to any patient with suicidal tendencies. For example, staff at Duke Raleigh Hospital is educated on how to best treat suicidal patients and are given checklists to remind them about precautions they should take to prevent suicides.