Use of a Fall Prevention Coordinator to Decrease Inpatient Falls

Purpose:
Patient falls are identified as a high safety risk by The Joint Commission and a never event by the Centers for Medicare and Medicaid Services (CMS). The goal of the Fall Prevention Coordinator (FPC) is to provide oversight of the fall prevention program and to prevent hospital inpatient falls.

Significance:
An inpatient hospital fall can be a significantly life altering event for an elderly patient. It also puts the hospital at risk for litigation and financial risk for treatment of injuries incurred as a result of a fall. CMS will no longer reimburse any treatment costs caused by an inpatient fall.

Strategy and Implementation:
Danbury Hospital recognized the need for a FPC to provide oversight of the fall prevention program designed to prevent inpatient falls. This coordinator focuses on making unit rounds, identifying patients at high risk for falls, and evaluating effectiveness of prevention measures implemented for these patients. Through these rounds, the coordinator works directly with the clinical staff to provide real time education, offering bedside support for identifying individualized fall prevention plans of care. The coordinator also has facilitated other prevention improvements including hourly rounding with intention, environmental evaluation, switch to a multi-functional battery operated exit alarm, post-fall huddles and investigations, use of diversional activities, and medication review. This focus on fall prevention has also allowed the decrease in sitter hour usage for fall prevention.

Evaluation:
Decrease in fall incidence supports the success of the use of the FPC. Fall incidence in 2008 was 2.7, 2009 was 2.6 and 2010 was 2.4 prior to initiating the FPC. Fall incidence decreased to 1.87 since the implementation. Sitter use from 2010 to 2011 decreased almost by half.

Implications for Practice:
The use of the FPC to support dedicated fall prevention measures is effective in preventing falls and improving patient safety. The PFC helps to keep the staff focused on fall prevention.