Abstract

ANA Call for Abstracts

National Data Use Conference

January 30-31, 2007

Las Vegas, Nevada

A modification of the Iowa Model for Evidence-based Practice was used for this  prospective evidence based practice (EBP) project to evaluate the outcomes of a revised fall risk screening tool.  Patient falls are a well-recognized safety priority for hospitals across the country. Supported by NDNQI data on inpatient falls, the intent of this EBP initiative was to develop a well-performing, brief, fall risk screening tool to be used for adult hospital inpatients by staff nurses at the bedside. Over the prior six (6) month period, the previously used fall risk screen had performed poorly, identifying only an average of 36% of fallers as at risk (range 18.5% - 52.3%). Therefore, 64% of patients who fell had not been triggered to receive the nursing intervention set or fall protocol.  . Review of the literature resulted in the development of a unique new screen with six (6)  weighted indicators, as well as two unweighted indicators suggested directly from staff RN's. The interdisciplinary Falls Committee, including Nursing (staff, CNSs, Directors), Risk Management, Strategic Improvement, Physical Therapy, Pharmacy, the Safety Officer, worked diligently studying the literature findings and the resultant modifications to the screen. After multiple reviews by related committees in-house, the new screen was approved for further evaluation and imbedded into the daily patient assessment flow sheet. Patient and process outcomes will be evaluated and analyzed across the hospital nursing practice after 3 months.  Data will be analyzed at the patient level and all individual fallers will be evaluated for total risk scores, selected individual indicators, and interventions documented. A stratified multi-unit sample will also be collected of patients deemed at risk who did not fall, including interventions documented. Outcomes will be evaluated from structure, process and outcome perspectives supported by NDNQI data.