Medicine and Health Sciences Commons^™

Effectiveness Of Fall Prevention Program On Nurses’ Knowledge And Fall Prevention Practices, Alisha Bhardwaj, Deepa Chugh

Manipal Journal of Nursing and Health Sciences

economic harm. Nurses who care for patients should be aware of the risk factors of patient falls, ways to prevent falls and provide nursing intervention. Hence, a fall prevention program was organized in order to educate the nurses regarding fall prevention. Objective: The objectives of the study were to identify the nurses’ knowledge and fall prevention practices in the hospital before and after implementation of educational sessions, to evaluate the effectiveness of fall prevention programs on nurses’ knowledge and fall prevention practices and to find out the association between post-intervention nurses’ knowledge with selected demographic variables. Method: Pre-experimental research design …

The Unheard Cry Of An Emergency Nurse, Monica Rita Hendricks, Dr.Sunil Kumar Shetty

Manipal Journal of Nursing and Health Sciences

Abstract

Working as an emergency nurse, brings along with it a string of complications that the nurse initially did not sign up for when she opted for a job in the emergency department. The dreams of a fresh staff are soon crushed by the turmoil of their her job.

The aim of this reality check article is to spread awareness among the nurses in India and make them feel supported in their ordeal. The paper also focuses on what could be done to help the nurses traverse through their stressful everyday nursing lives.

Key words: Emergency department, nurse, stress

A Quality Improvement Initiative To Decrease Fall Risk In Community Dwelling Elderly, Michele Shearer

Doctor of Nursing Practice (DNP) Manuscripts

Falls are a health concern for the elderly and are the leading cause of fatal and non-fatal fall injuries in this population (Burns & Lee, 2016). Meijers, et al. (2012) found that one in three community dwelling elderly will experience at least one fall per year with an even higher rate in adults greater than 80 years old. Numbers of falls are expected to increase as this population ages. This increase in falls and their consequences will produce an enormous economic burden on the United States health care system (Burns & Lee, 2016). The purpose of this program was to …

Dnp Final Report: Reducing The Rate Of Falls With A Stuctured Fall Program, Elanda L. Douglas

DNP Final Reports

Background: Fall rates continue to be a significant problem in health care facilities despite all the research and tool kits created to prevent falls. Hospitals that have successfully reduced fall rates find it challenging to sustain a reduction in the fall rates. During hospitalizations, 3%-20% of patients fall, with 30%-50% resulting in injury (Joint Commission, [JC], 2015).

Internal Evidence: Despite Medical City Alliance (MCA) having an evidence-based fall program, the fall rate has not decreased. Falls are one of the quality measures identified at the division level that needs improvement.

PICOT: In adult patients in a progressive care unit (P), …

Fall Prevention: Remote Video Monitoring, Shawna Moser

MSN Capstone Projects

Patient safety is a top priority for all healthcare organizations, but as a healthcare facility, is everything, within the means of the facility, being done to ensure patient safety? Challenges exist for all healthcare organizations when faced with patient safety, but there it is a necessity for these healthcare organizations to overcome these challenges and protect their patient population. A common challenge within the acute care setting is the prevention of falls. “Falls during hospitalization harbor both clinical and financial outcomes” (Gringauz et al., 2017, p. 1). Research on fall interventions has shown that a multifocal approach is most effective …

Further Fall Prevention, Kristen L. Janes

MSN Capstone Projects

Falls continue to occur in the acute care setting despite our best efforts. Decreased falls, increased patient safety, decreased cost, and decreased length of stays in the acute care setting are imperative. This is a benchmark study on the concept of an education pamphlet being presented to patients and family members educating on all fall precautions and interventions that are to be expected to be in use during their stay. Study also reflects fall interventions that are in use and have shown to decrease falls.

Strategies To Reduce Fall Rates In A Long-Term Care Facility, Kimberly H. Brewer

Walden Dissertations and Doctoral Studies

AbstractFalls among residents of long-term care facilities (LTCFs) pose significant threats to their health and quality of life, as falls often lead to life-threatening injuries such as traumatic brain injury and hip fractures. The etiology of the falls is multifactorial and complex; thus, interventions to reduce the falls typically combine two or more evidence-based interventions. The objective of this doctorate project was to develop an evidenced-based clinical practice guideline (CPG) outlining a multifaceted, evidenced-based bundled set of interventions for a fall prevention program to reduce falls for elderly patients living in the LTCFs. Lewin’s 3-step model of change was used …

Increasing Fall Awareness Through Nursing Staff Education, Evelyn Ahiante Dennis

Walden Dissertations and Doctoral Studies

Patient falls are a significant healthcare concern, with the highest risk being among older adults aged 65 and older. A lack of nursing knowledge can contribute to patient falls. This DNP project was conducted in the medical-surgical trauma unit of a 137-bed local rehabilitation center in Northern Georgia. The intention of the project was to understand if a nursing staff education program would increase knowledge regarding falls prevention. Kurt Lewin’s change theory provided the framework for the project. The project participants were nine medical surgical nurses. Using the analysis, design, development, implementation (ADDIE) model, a falls prevention education program was …

Staff Education On Fall Prevention For Inpatient, Geriatric, Psychiatric Patients, Shannon C. Hampton

Walden Dissertations and Doctoral Studies

Falls among hospitalized, geriatric patients are a leading cause of injury. Geriatric patients with psychiatric illnesses are at an even greater risk of falls. The project site was experiencing an increase in the number of patient falls and identified a need for staff education on fall risk assessment and implementation of interventions specific to the hospitalized, geriatric, psychiatric patient. Thus, the practice-focused question for this project was whether an educational program on evidence-based assessment and fall prevention strategies would improve nurses’ knowledge and skills to assess risk for falls and implement appropriate interventions for inpatient, geriatric, psychiatric patients. Knowles’s adult …

Nurse-Patient Ratios And Falls In The Acute Care Setting: A Staffing Educational Program, Trinia Shawell Williams

Walden Dissertations and Doctoral Studies

AbstractThe correlation between patient falls and nurse-patient ratios in acute care has been a prevalent topic for decades. The lack of nurse-patient ratio guidelines to direct nurse staffing has restricted nursing leaders’ efforts to address this issue. The purpose of this staff education project was to educate nursing leaders on nurse-patient ratios and their association to patient falls. The practice-focused question centered on whether education would increase nursing leaders’ knowledge about appropriate staffing ratios and practices to reduce falls at a long-term acute care facility. Rogers’s diffusion of innovations theory was the change model used to guide this project. There …

Nursing Interventions For Reducing Falls Among Older Adults On Polypharmaceutical Agents, Kevin O. Onuekwusi

Walden Dissertations and Doctoral Studies

In the United States, the cost of treating a resident of a long-term care facility (LTC) after a fall with injury is between $10,000 and $26,000. Current nursing interventions for fall prevention among older adults aged 65 years and over at the local LTC do not address the risk of polypharmacy and are focused on environmental and intrinsic factors. The purpose of this systematic literature review was to find the nursing interventions that have been used to reduce falls in older adults aged 65 years and over in nursing homes and LTCs who are on polypharmaceutical therapy. Primary research articles …

The Relationship Between Anosgnosia For Hemiplegia After Stroke And Fall Events In The Acute Inpatient Stroke Rehabilitation Population, Elizabeth Mosley Byrd

All ETDs from UAB

Background/Significance: Inpatient falls on acute stroke rehabilitation units remains a significant issue that negatively affects healthcare costs and causes physical and psychological injury. Prevelance of falls in the stroke rehabilitation population may be due to the presence of anosognosia for hemiplegia (AHP), which is as an unawareness of physical disability. Though the link between AHP and falls has been suggested in the literature, a formal investigation has not been conducted to address the relationship between the variables. Purpose: To explore the association between the presence of anosognosia for hemiplegia after stroke and patient fall events while admitted to an acute …

Implementing Virtual Sitters To Reduce Falls And Sitter Costs, Asia Quovadis Williams Plahar

Doctor of Nursing Practice (DNP) Projects

The setting for this DNP project was a 326-bed, suburban hospital in Northern California that was facing challenges with preventing falls with injury and rising sitter costs. Between May 2018 and June 2019, there were four sentinel events related to falls with significant injuries. This hospital was financially impacted by the growing cost of the expanding sitter program caused by the rising elderly patient population, with demographics requiring one-to-one, in-person sitters to observe them visually. There is ample research demonstrating the utility of video monitoring systems to improve patient safety by reducing falls, enhancing staff safety by reducing workplace injuries …

Decreasing The Fall Rate On A Medical Surgical Unit With An Enhanced Fall Algorithm In The Electronic Medical Record, Natali Sokolovski

Master's Projects and Capstones

This paper summarizes the quality improvement falls prevention project on a Medical-Surgical unit with an Enhanced Fall Algorithm incorporated in the Electronic Medical Record conducted by two Clinical Nurse Leader students of the University of San Francisco.

This project addresses the patient falls events in a San Francisco-Bay Area Hospital on a Medical-Surgical unit. The aim is to decrease the rate of falls on a Medical-Surgical microsystem unit by 50% with an Enhanced Fall Algorithm incorporated into the Electronic Medical Record by June 2021. The patient population consists of general medical surgical patients where many of the patients have an …

Impact Of Hourly Rounding On Fall Rates: A Benchmark Paper, Monica D. Smith

MSN Capstone Projects

Falls and fall-related injuries create a significant financial burden on patients and healthcare organizations, particularly in adult inpatient hospital units such as rehabilitation and medical-surgical units. Costs associated with additional hospital days, diagnostic testing, and potentially fall-related surgeries can average about $14,000 per fall (The Joint Commission, 2015). Moreover, falls can be devastating in older adults, impacting their overall quality of life. According to Abou et al., 20% of yearly individual costs associated with falls are among patients with Parkinson's disease (2020). This is a proposal to implement a pre-and post-implementation change project. This paper addresses the use of evidence-based …

Implementation Of A Fall Risk Assessment Tool In Primary Practice May Decrease Fall Frequency In The Aging Population, Regina M. White

Doctoral Dissertations and Projects

The purpose of this evidence-based project was to illustrate the benefits of utilizing a fall risk assessment tool during office visits for the aging population of a Midwestern U.S. primary care practice. Utilization of this tool helped minimize fall frequency, thus improved quality of health. The reduction in falls helped minimize unnecessary healthcare expenses. This manuscript identified a rationale for the project, specific tool utilization, outcome measures before and after implementation, limitations, and future application for practice. Provider compliance with tool utilization and frequency were measured. Multiple potential causes of falls and recommendations to minimize falls were identified with the …

Reducing Patient Falls Through Purposeful Hourly Rounding, Amanda Savage

Student Scholarly Projects

Practice Problem: Falls significantly affect patients, resulting in temporary or permanent harm, even death. In a large acute care facility, patient falls increased from 444 in 2016 to 556 falls in 2019.

PICOT: In an adult inpatient hospital setting, does purposeful hourly rounding (PHR), compared to no rounding, reduce patient falls over a period of 30 days during the same time period from the previous year?

Evidence: Of the 360 articles reviewed, 12 articles, varying from evidence levels two (1), level three (4), and level five (7), supported PHR as effective in reducing harm from falls in adult …

Preventing Falls In Long-Term Care Using Patient-Centered Fall Interventions, Angela Blakley

Student Scholarly Projects

Practice Problem: The practice problem identified within the Community Living Center included continuous falls, despite using current fall prevention strategies and provider-driven interventions. Baseline data reflected a fall rate of 4.2 in the long-term care areas despite improving the fall prevention program.

PICOT: The PICOT question that guided this project was: In older adult residents (P), what is the effect of a standing operating procedure (SOP) using patient-centered interventions (I) compared to physician-driven fall interventions (C) on decreasing falls and falls with injuries (O) within one month (T)?

Evidence: In twelve high-quality articles that fit the eligibility criteria and …

Use Of Delirium Protocols In Decreasing Falls Among Adults In Acute Care: An Integrative Review, Shelly Steverson Thornton

Doctoral Dissertations and Projects

Delirium in elderly hospitalized adults continues to be a common and costly issue in health care today. Various delirium protocols and strategies are available to reduce negative outcomes of delirium such as falls, increased length of stay, pressure ulcers, hospital readmissions, the need for transferal to long-term care, and mortality rates. However, many hospitals have still not implemented routine delirium protocols. Because falls in older hospitalized adults are often linked to delirium, this integrative review was undertaken to examine delirium protocols and approaches that specifically decrease falls among older adults in acute care settings. Several multicomponent, multidisciplinary delirium protocols were …

A Patient-Centered Approach To Fall Prevention, Elmer Esguerra

Student Scholarly Projects

Practice Problem: In 2019, a rural hospital in South Texas reported 102 incidents of patient falls. Although below the corporate fall rate benchmark of 2.2/1000 patient days, the hospital recognized that it was clinically significant and aimed at improving its fall prevention outcomes.

PICOT: The PICOT question that guided this project was: Among adult patients in the acute care setting would the implementation of patient-centered interventions be more effective compared to the usual fall prevention interventions in reducing incidence of falls one month after implementation?

Evidence: Seven pertinent studies, which included a randomized controlled trial and a systematic review, recommended …

Impact Of The Hester Davis Fall Risk Scale On Inpatient Falls, Amelia Payne

Dissertations

Problem: During a three month period in 2018, a rural acute care facility experienced a fall rate of 3.4 falls per 1,000 patient days. The aim of this clinical scholarship project was to implement the Hester Davis Fall Risk Scale (HDFRS) for adult inpatients in a rural acute care facility.

Methods: Utilizing the Find, Organize, Clarify, Understand, Select- Plan, Do, Study, Act (FOCUS-PDSA) model, the HDFRS was implemented and evaluated using a pre and post design to determine its impact on falls per 1,000 patient days and falls with injury per 1,000 patient days. The method of evaluation was a …

Purposeful Hourly Rounding And Reduction Of Patient Falls, Iesha S. Bell

Doctor of Nursing Practice Projects

Falls are a pervasive and persistent problem in all healthcare settings, with adverse clinical, social, and economic outcomes for patients, staff, and institutions involved. The systematic process of purposeful rounding is an intentional act conducted with a clear purpose for the patient's benefit. Prevention of inpatient falls remains a challenge for nurses. Despite fall prevention efforts by nurses, the rate of patient falls in the acute care setting is a major safety concern. A Doctor of Nursing Practice project was crafted and implemented to educate nursing staff on purposeful hourly rounding and apply the 4 P's (pain, positioning, possessions, and …

Reducing The Rate Of Falls In Hospice Patients: A Fall Prevention Pilot Program, Allison Floyd

Doctor of Nursing Practice Final Manuscripts

Background and Evidence Problem: As the population ages, there is an increase in the incidents of falls. Falls are the predominant cause of both nonfatal and fatal injuries among adults aged 65 years and older (Bergen et al., 2016). Extensive research has been conducted in fall prevention in hospitals, skilled nursing, and rehabilitation units. End-of-life care in a hospice setting presents a greater challenge in risk identification and prevention of falls. A local hospice had 457 falls between July 2018 to mid-March 2019 with a lack of consistent, detailed, fall education and documentation.

Evidence-Based Practice Intervention: Utilizing the American Geriatrics …

Fall Prevention Assessment In The Intermediate Care Patient Population, Dawn Rose

Doctor of Nursing Practice Final Manuscripts

Fall Prevention Assessment in the Intermediate Care Patient Population

Falls cause greater than 600,000 deaths per year and are the most common injury in people over 65 years of age. Fall prevention in the acute care setting has been identified as key goal in the most recent JCAHO review process. Falls on an intermediary care unit lead to an increased rate of morbidity, delayed discharge, and excess cost expenditure.

Even with appropriate evidence-based tools in place, Hospital A’s intermediate care unit, recorded an increased rate of falls; the highest rate in its health care system. An investigation identified factors contributing …

Hospital To Home: Fall Prevention Interventions For The Discharging Patient, Joy Bridewell

Nursing Masters Papers

Falls is a major public health problem globally, with an estimated 646,000 fatal falls per year. This makes falls the second leading cause of unintentional injury death. Falls are very costly with non-fatal fall injuries costing about $50 billion per year and fatal falls with an estimated $754 million. Many risk factors contribute to a person’s risk of falling. Risk factors include age, gender, muscle strength, underlying medical or disabling conditions, and unsafe environments. Patients who have been hospitalized are also among those at risk. Most hospitalized patients are assessed frequently to determine their risk of falling so that care …

Hourly Rounding: The Effects On Fall Rates In Adult Population In Acute Care Setting, Sheyla J. Pellicier Mercucci

MSN Capstone Projects

Falls are one of fourteen categories of hospital-acquired conditions (HACs) listed by the Centers for Medicare and Medicaid Services (2020). Falls are costly and stressful for everyone involved; patients, families, nursing staff and physicians. According to the United States Department of Health and Human Services (2019), about seven hundred thousand to one million hospital admitted patients fall every year. The estimated cost of a fall is about fourteen thousand fifty-six dollars if an injury occurs and can extend patient’s hospital length of stay (LOS) to up to 6.3 more days (Joint Commission Center for Transforming Healthcare, 2019).

When a patient …

Systematic Literature Review On Fall Prevention In An Acute Care Hospital Setting, Sonia A. Hudson

Walden Dissertations and Doctoral Studies

Falls, with and without injury, in acute care hospitals are quite common but can be prevented if appropriate interventions are in place to address this issue. It is imperative that nurses assess fall risks of all patients admitted to the hospital and advocate for appropriate interventions to prevent falls in those who are found to be at risk. The purpose of this project was to recommend changes to the current fall prevention protocol in the project facility, an acute care hospital, based on best practices identified in a systematic review of the literature. At the time of the project, the …

Registered Nurse Engagement And Patient Falls In The Acute Care Setting, Jenna Zaliauskas

Walden Dissertations and Doctoral Studies

Falls are a critical problem for inpatient medical-surgical adult patients. Past research has indicated a link between nurse disengagement and unsafe care. The purpose of this study was to improve the understanding of the relationship between nurse engagement and patient falls with injury on medical surgical units in health care facilities in the United States using the National Database of Nursing Quality Indicators. Retrospective data were reviewed from 13 U.S. hospitals in the Midwest covering Q1 (2018) and Q2 (2018) on medical-surgical units related to nurse engagement and patient falls. A correlational and MANOVA design was used to determine the …

Systematic Literature Review On Fall Prevention In An Acute Care Hospital Setting, Sonia A. Hudson

Walden Dissertations and Doctoral Studies

Falls, with and without injury, in acute care hospitals are quite common but can be prevented if appropriate interventions are in place to address this issue. It is imperative that nurses assess fall risks of all patients admitted to the hospital and advocate for appropriate interventions to prevent falls in those who are found to be at risk. The purpose of this project was to recommend changes to the current fall prevention protocol in the project facility, an acute care hospital, based on best practices identified in a systematic review of the literature. At the time of the project, the …

Effectiveness Of A Standardized Fall Assessment Tool In Reducing Falls Among Elder Home Health Clients, Terica M. Woods

Walden Dissertations and Doctoral Studies

Because of the physiological changes that occur with the normal aging process, falls tend to have more serious consequences in individuals age 65 and older. The purpose of this systematic review of literature was to analyze studies that addressed the impact of a multifactorial fall risk assessment tool on decreasing falls in the elderly home health patient population following hospitalization. The conceptual model for this project was Roper, Logan, and Tierney’s activity of daily living model. A narrative analysis was used to analyze 16 selected articles from the CINAHL, ProQuest and MEDLINE databases. Results indicated that implementing fall assessment tools …