Fall Prevention as a Goal - A Specialized Hospital Experience Where Culture Intervenes

Purpose:
Limited studies has focused on the cultural and spiritual needs of patients at risk of fall.Nurses implemented Patients Fall Prevention Program utilizing EBP recommendations and considering the unique cultural aspects of the population aimed to reducing the incidence and severity of patients' falls

Relevance/Significance:
Falls of patients negatively impacts quality of life, longer hospital stay and additional treatment necessary after falls contribute to a 61% increase in patient care costs. Several studies have shown that there is no single intervention, such as bed alarms or bracelets to identify patients at high risk of falls, has proving to be effective. Fall prevention in health care settings is considered a patient safety challenge, especially when cultural and spiritual obligations are present.

Strategy and Implementation:
In May 2012,we launched a multidisciplinary performance improvement (PI) project.The overall aim was to implement a comprehensive fall prevention program with a focus on the unique setting within Saudi Arabia In this paper we will discuss the implementation steps of the PI project include: •Establishing a multidisciplinary Internal Fall Prevention Policy •Listing the roles and responsibilities of health care team in the fall prevention program •Building post fall algorithm •Implementing the Morse Fall Assessment and Humpty dumpty Scales •creating patient and family educational booklet •Highlighting how nurses showed better ability to root cause fall events •Describing several strategies used to reduce in-hospital falls in Muslim patients, considering washing and prayer practices, and self-care activities •Explaining how do nurses' understanding patients' spiritual domain, awareness of environment safety, and active listening reduce unnecessary exposure to falls or slips

Evaluation:
The hospital has consistently outperformed patient falls indicator below the 10th percentile and falls with injury below the 25th percentile compared to Magnet benchmark. Healthcare providers' compliance with established guidelines has improved as showen in the quarterly inernal audits. 4000 copies of the educational booklet were distributed to patients and families.

Implications for Practice:
Availability of Evidence Based fall assessment scales Intervention algorithm governs multidisciplinary practice Improved reporting of falls events by healthcare providers Improved awareness of Muslims' culture Improved patient/ family involvement and awareness of fall prevention