Reduction Of Falls On A Neuroscience Unit Through Implementation Of Signage Indicating A Patient's Fall Risk Assessment

Purpose:
Falls are a significant source of patient injury while at an acute care facility. The purpose of this intervention was to reduce the chance of negative patient outcomes through a falls reduction program utilizing visual cues reminding patients, families, and staff of the patient's current fall risk.

Significance:
Patients on a neuroscience unit are often admitted with diagnoses inherently increasing their risk for falls. A program developed to prevent hospital acquired conditions is cost-effective and has the potential to prevent furthered functional decline, depression, lengthened hospital stays and death.

Strategy and Implementation:
A key to implementing a successful fall prevention program requires collaboration with nursing staff, patients, families, and the interdisciplinary team. It was deemed necessary that every person coming in contact with the patient should know the patient's limitations and risk factors. A sign was designed to be strategically placed classifying the patient in the following individualized risk categories: low, moderate, high and bed rest. The signs are used as reminders and education aids for staff, patient and family members. Unit staff was educated on assessment of the patient, classifications associated with the assessment, interventions per classification and in the use of the signs. The nursing staff was instructed to review the fall risk category during bedside shift report with the patient, family and oncoming nurse. The interdisciplinary teams consisting of patient escorts, physical and occupational therapist were educated regarding the new tiered fall classification system.

Evaluation:
Outcomes were measured against the number of falls occurring each month from existing nursing quality indicators. After the start of the multi-component falls program using the risk classification signs, a significant decrease in falls was obtained. Other nursing units have adopted the tiered plan.

Implications for Practice:
A multimodal tiered approach based on the individualized risk factors for a patient proved to be an effective tool for reducing falls in an acute care setting. The system engages all members of the healthcare team, patient and family to raise the overall awareness of patient risks and limitations.