Nursing Commons^™

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 …

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 …

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 …

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 …