Core Initiatives and Innovative Models for Fall Prevention

Purpose:
Data indicated that departments within our organization were above the benchmark for falls in 2011. To address this we looked to identify successful core solutions to increase staff buy-in for quality improvement leading to decreased falls. This is our innovative model for fall prevention.

Significance:
Falls significantly impact both the patient and the organization's health by leading to functional decline and increased healthcare needs. Studies report the average hospital stay for patients who fall is 12.3 days longer and injuries from falls lead to a 61% increase in patient care costs.

Strategy and Implementation:
An innovative model was used to successfully create and sustain a culture of safety to reduce patient falls. This model included structured hourly rounding, educational fall handouts, post fall huddles, staff fall reduction contracts, increased use of bed/chair alarms and the Call Don't Fall Safety Volunteer Program. Hourly rounding served as a reminder to staff to check on patients at least every hour and document their status. Upon admission, increased education and handouts were given to patient's educating them about the use of bed/chair alarms and reminding them to call. Post fall huddles were implemented where staff immediately debrief about the details of any fall. A staff fall reduction contract was created and has increased the level of staff accountability for patient safety. Mindful of nursing resources a volunteer based program is being piloted to reduce falls. We are working with Volunteer Services in the hospital to utilize trained volunteers for fall prevention.

Evaluation:
Routine reporting and comparison using NDNQI, Magnet and Joint Commission standards are vital in creating quality goals. With the adoption of the above model we have dropped our total fall rate from 38 in 11/11 to 17 in 04/12 allowing an increase in departments meeting our benchmark standards.

Implications for Practice:
This model has created a sustained culture of safety. There is increased staff buy-in to create and maintain a safe environment for our patients. Patients and family are more actively involved in fall reduction and our team approach has been successful in this quality improvement initiative.