Fall Prevention: Pays Off!

Purpose:
The purpose of this project is to describe the implementation of a series of initiatives aimed at reducing falls and the development of a falls prevention toolkit. Central to our strategy was engaging patients and families in our falls prevention program and using an interdisciplinary approach.

Relevance/Significance:
According to the Agency for Healthcare Research and Quality, nearly one million people fall in hospitals in the U.S. each year, and almost one-third of falls are preventable. A fall may result in injuries and lead to increased utilization of healthcare resources, thus falls have a quality, safety, and financial impact. Nurses and leadership in our organization were concerned about our fall rates and wanted to implement best practices across clinical settings in an effort to reduce falls.

Strategy and Implementation:
This initiative started with restructuring our Fall Prevention Committee by asking a patient to participate as a member and including interdisciplinary representation. Members of the committee include nurses from across practice settings and staff from physical therapy, transportation, environmental services, pharmacy, security, and lift team. The group focused on: evaluation of falls and falls with injuries, identification of fall types, and financial impact. After consultation with a fall prevention expert and reviewing the literature, a number of strategies were implemented including: education regarding fall types and best practices for prevention, environmental rounds with safety modifications, Partnership for Safety Contract, outpatient fall prevention policy, transportation stability scale, mobility recommendations tool, and bi-weekly CNO led Friday Fall Review, which includes direct care nurses, to discuss causes of recent falls, potential preventative measures, and trends.

Evaluation:
Implementation of the falls reduction strategies over a four year period resulted in a 36% overall reduction in falls. The improvement was greater in the outpatient setting than the inpatient setting, with 55% and 21% reduction in falls, respectively.

Implications for Practice:
Reducing falls requires a multi-faceted approach. Key components to our success included using an interdisciplinary team, consistent application of prevention strategies, thoughtful attention to individual risk factors and engaging patients and families in this important safety initiative.