Bedside Nurses Leading the Way Utilizing Evidence-Based Practice to Attain Better Clinical Outcomes For Fall Prevention

Purpose:
The purpose of this initiative is to utilize bedside nurses in leading quality initiatives to reduce patient falls by 50%. Implementation of a staff, patient, and family teaching program is used to promote awareness of patients safety and fall reduction.

Significance:
Falls in hospitals are widespread and a serious threat to patient safety. Using current NDNQI benchmarks as the standard of measure for a Cardiac Progressive Care Unit indicated the unit was performing outside of the national benchmark causing an increase in cost and liability.

Strategy and Implementation:
A week long educational program was implemented for staff to improve understanding of the "fall bundle" related to prevention of falls. Patients who are idenfitied as high risk based on the Morse Fall Score have a fall bundle initiated. The "fall bundle" consisted of the following interventions: new to the bundle included a sign on the ceiling above the patients bed which states "please call don't fall", as well as a contract with the patient and family that they sign. This contract states they understand their fall risk and the interventions that will be implemented. Additional interventions that are a part of the "fall bundle" include a yellow armband, yellow blanket, yellow non-skid footies, a yellow magnet outside the patients room, and bed/chair alarms on all high risk patients. An important piece of this intervention is staff buy-in with maintaining vigilience to the process and continual awareness. Yellow fall prevention shirts, bracelets and buttons were given to all staff.

Evaluation:
An audit tool was developed to mointor staff compliance using the new "fall bundle" and the teaching contracts.Data will be collected for six months looking at implementation of the "fall bundle", total number of falls and falls with serious injury using NDNQI data.

Implications for Practice:
Fall prevention is high on the priority list of hospital quality initiatives. Implementation of a bundle for high fall risk patients and education of staff, patients/families in utilizing individual fall prevention measures will reduce falls and assure the appropriate interventions are in place.