Key Strategies for Fall Reduction

Purpose:
There are numerous fall reduction strategies reported across the nation. The key to identification/implementation of successful strategies requires the engagement of frontline staff. This poster will illustrate staff engagement and fall reduction strategies utilized with associated outcomes.

Significance:
There is no magic bullet for fall prevention. The frontline staff need to own this patient safety initiative. Providing appropriate support, tools, coaching, & removing barriers are key to success. Maximizing this support reduces frustration, rate of failure, & the ability to sustain the change.

Strategy and Implementation:
Fall rates consistently above NDNQI mean. Efforts to reduce rates addressed by each nursing unit. Each unit was doing something different. Fall data was reported at the end of each quarter. Staff & management were frustrated that efforts didn't reduce falls. Multidisciplinary group formed (staff RNs, CNAs, pharmacist, risk mgt, rehab, CNS)to identify global issues (use of risk scale, timing of assessments, individualization of care plan, stratification of risk level). Point person designated to receive all fall reports allowing for timely review of each fall with involved staff and identification of issues. Fall reporting increased from quarterly to 2-3 times/wk. Reports included messages of hope and celebration to staff. Recognized that fall prevention equipment available but ineffective. Conducted fall products fair for staff to select products. Piloted 2 fall monitors. Staff selected monitors for purchase. Created computerized tools to facilitate communication of fall risk levels.

Evaluation:
Fall rates had consistently ranged from 5 to 6/1000 pt days for approximately 2 years despite reduction efforts. Since implementation of new strategies rates have significantly declined. FY 09 rates ranged from 3.61 to 3.75/1000 pt days. FY 10 rates are 2.68 to 3.07/1000 pt days.

Implications for Practice:
Active listening to staff, involving staff in issue identification and problem resolution, instilling hope, & celebrating successes; all of these strategies have resulted in fall reduction. We have sustained the change, providing a safer patient environment & have a more satisfied workforce.