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Five minutes with Shirley Bell

Toronto, October 13, 2015

By Melissa Di Costanzo

Shirley Bell
Shirley Bell

Shirley Bell has spent 27 years working on the general internal medicine floor (14 CC). Over that time, the clinical nurse educator has witnessed many changes.

“Nursing practice has definitely changed when it comes to how to approach falls,” said the RN. “We’re looking at it from a multidisciplinary approach. It’s the entire team’s responsibility.”

Staff will also ask family members for feedback. “That was a big change over the years, and it’s important if we’re looking at providing patient-centred care,” she said.

A typical day in her life at St. Michael’s means she’s listening to report on all patients on the unit. She knows about patients’ acuity, and any special requirements. The first thing she asks charge nurses at the beginning of the day? “Have you had any falls?”

“We had a high rate of falls, and falls with injury, and these were two things that needed to be addressed,” said Bell. “We had to do something to make a change.”

16 CCN has championed and adapted the use of the intentional rounding model in falls prevention at St. Michael’s, and saw much success from this implementation. Staff from 14 CC adapted 16 CCN’s intentional rounding model.

Members from both units – including nurses and clinical assistants – will check in on patients hourly, from midnight until 7 a.m., which is when they discovered the bulk of falls occurred. Patients would attempt to go to the bathroom, or needed to be moved and were in discomfort. Intentional rounding allows staff to ask patients if they need to go to the bathroom, if they’re in pain, if they need to be repositioned and if they’d like any objects in the room to be rearranged.

If a fall does take place, staff on both units will now gather to discuss that case and share lessons learned.

Staff on 14 CC now have individualized care plans for all patients who are at risk of falling. This allows for tailored care involving methods that are targeted to the patient, such as low beds or a change in meds.

So far, these additions are making an impact.

“We’re seeing the difference right now,” said Bell.


A bad fall in hospital can lead to many problems and a longer stay. Learn how we’re doing our part to protect patients from falling.

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.