A Multi-pronged Approach for Reducing Falls in an Acute Care Setting

Purpose:
To establish a culture of safety by engaging bedside nurses in the prevention of falls through patient-specific assessment and plan of care strategies and interactive competency-based staff training

Significance:
In 2009,the Fall Prevention PI committee identified an increase in falls & falls with serious injuries.Research indicates falls may be reduced by identifying risk factors;developing a plan of care for prevention, performing comprehensive investigation of falls, and instituting post fall evaluations.

Strategy and Implementation:
A root cause analysis was performed and indicated a need to improve the engagement of nursing associates by incorporating consistent fall prevention strategies in their daily practice.A multi-pronged strategy was implemented to reduce falls in the acute care setting. The strategy included: 1) development of an evidence-based fall prevention policy to guide the assessment, intervention, and evaluation of falls; 2) incorporation of unit-based fall prevention champions (RNs and Patient Care Technicians) on the Fall Prevention Performance Improvement Committee; 3) integration of an evidence-supported risk screening tool and intervention strategies to reduce falls; 4) development and implementation of a post fall debriefing tool; 5) formulation of a multifaceted interactive training program (Mobility Matters) to improve mobility, reduce falls and pressure ulcers; and 6) institution of bedside competency validation.

Evaluation:
Analysis of fall-specific data collected from the hospital-based occurrence reporting system and NDNQI comparative database on falls and falls with injury.

Implications for Practice:
Nurses, who are at the forefront of care and given the appropriate knowledge base, tools, and skills, can significantly improve patient safety and nurse sensitive outcomes through a multi-pronged approach to fall reduction.