Falls reduction: An Innovative Approach

Purpose:
The UT Southwestern Medical Center is committed to reducing the risk of patient falls. The falls committee decided in late 2009 to revise the falls assessment with the goal being to decrease the combined fall rates by an average of 1 fall per 1000 patient days.

Significance:
Patient falls with serious injuries is a worrisome event for all healthcare providers in all different types of settings. Falls prevention is a relevant topic for all providers and thus falls prevention is an important factor in providing safe, high quality care.

Strategy and Implementation:
The falls reduction program at UTSW underwent a total revision, including complete revision of the inpatient fall risk assessment tool, inclusion of additional evidence-based interventions, and was transitioned into the electronic medical record. The risk assessment was revised completely and broken down into the following risk categories: fall history, impaired mobility, elimination, mental status, new medications, equipment, and age over 69. Review of the evidence-based literature revealed a move toward risk specific interventions, and thus we moved the current interventions around to fit with the risk categories and then added additional evidence-based fall prevention strategies into the appropriate risk categories. Based on the original interventions, we developed a standard safety intervention list. This list has become the general safety checklist that is implemented on every patient, for example assuring the call light is within reach and personal belongings are within reach.

Evaluation:
The combined fall rates for both hospitals for the years 2006 through 2009 averaged 4 falls per 1000 patient days. After implementing the changes, the fall rate for 2010 for both hospitals was 2.8 falls per 1000 patient days.

Implications for Practice:
Attendees would learn about how to revise and develop an innovative falls reduction program that helps provide a solution to an ongoing safety issue and hopefully be able to utilize what we learned in the process of revisions to guide them in improving their own falls reduction programs.