Individualized Fall Prevention Program in an Acute Care Setting: An Evidence-Based Practice Improvement

J Nurs Care Qual. 2019 Apr/Jun;34(2):127-132. doi: 10.1097/NCQ.0000000000000344.

Abstract

Background: A 245-bed community hospital established patient fall prevention as its patient safety priority.

Problem: The hospital's fall prevention program was not consistently effective. The baseline fall rate was 3.21, higher than the National Database of Nursing Quality Indicators' median of 2.91.

Approach: An interprofessional fall prevention team evaluated the hospital's fall program using the evidence-based practice improvement model. A clinical practice guideline with 7 key practices guided the development of an individualized fall prevention program with interventions to address 4 fall risk categories and an algorithm to identify interventions. Interventions included nurse-driven mobility assessment, purposeful hourly rounding, and video monitoring for confused and impulsive fall-risk patients.

Outcomes: The fall rate decreased to 1.14, with a 72% expense reduction based on decreased sitter usage.

Conclusions: An interprofessional team successfully reduced falls with an evidence-based fall prevention program.

MeSH terms

  • Accidental Falls / prevention & control*
  • Accidental Falls / statistics & numerical data
  • Evidence-Based Practice / methods*
  • Guideline Adherence / standards*
  • Hospitals*
  • Humans
  • Inpatients
  • Mobility Limitation
  • Organizational Innovation
  • Patient Safety*
  • Risk Assessment / methods
  • Safety Management