Prediction of Falls in Acute Care Using The Morse Fall Risk Scale. Jewell Vanessa D,Capistran Katherine,Flecky Kathleen,Qi Yongyue,Fellman Sarah Occupational therapy in health care The high number of patient falls occurring within acute care hospitals throughout the United States has led to increased patient impairment and contributed to rising healthcare costs. The is a commonly used assessment tool for prediction of a patient's potential for experiencing a fall while in a healthcare facility. This retrospective study reviewed the use of the in a 300+ bed acute care hospital setting to determine adequacy for patient fall predictions over a four-month period. Use of multivariate regressions and Chi-Square test statistics revealed the Morse Fall Risk Scale was a predictor of patients' fall risk in this setting with other significant predictors of fall risk potential including male gender and diagnosis (neurologic, cardiac, general medical/surgical conditions). Patients experiencing a fall had a statistically significant longer hospital stay. Occupational therapy practitioners play an important role on the interdisciplinary team by providing a comprehensive fall assessment, developing fall prevention programs, and providing discharge recommendations. 10.1080/07380577.2020.1815928

Fall Prevention Practices and Implementation Strategies: Examining Consistency Across Hospital Units. Journal of patient safety OBJECTIVE:Our study examines how consistently fall prevention practices and implementation strategies are used by U.S. hospitals. METHODS:We conducted a cross-sectional, descriptive study of 60 general adult hospital units.We administered a survey measuring 5 domains of fall prevention practices: visibility and identification, bed modification, patient monitoring, patient safety, and education. We measured 4 domains of implementation strategies including quality management (e.g., providing data and support for quality improvement), planning (e.g., designating leadership), education (e.g., providing consultation and training), and restructuring (e.g., revising staff roles and modifying equipment). RESULTS:Of 60 units, 43% were medical units and 57% were medical-surgical units. The hospital units varied in fall prevention practices, with practices such as keeping a patient's bed in a locked position (73% strongly agree) being used more consistently than other practices, such as scheduled toileting (15% strongly agree). Our study observed variation in fall prevention implementation strategies. For example, publicly posting fall rates (60% strongly agree) was more consistently used than having a multidisciplinary huddle after a fall event (12% strongly agree). CONCLUSIONS:There is substantial variation in the implementation of fall prevention practices and implementation strategies across inpatient units. Our study found that resource-intensive practices (e.g., scheduled toileting) are less consistently used than less resource-intensive practices and that interdisciplinary approaches to fall prevention are limited. Future studies should examine how units tailor fall prevention practices based on patient risk factors and how units decide, based on their available resources, which implementation strategies should be used. 10.1097/PTS.0000000000000758

Individualized Fall Prevention Program in an Acute Care Setting: An Evidence-Based Practice Improvement. Spano-Szekely Lauraine,Winkler Anne,Waters Cathy,Dealmeida Susana,Brandt Kathy,Williamson Marsha,Blum Christina,Gasper Lori,Wright Fay Journal of nursing care quality BACKGROUND:A 245-bed community hospital established patient fall prevention as its patient safety priority. PROBLEM:The hospital's fall prevention program was not consistently effective. The baseline fall rate was 3.21, higher than the National Database of Nursing Quality Indicators' median of 2.91. APPROACH:An interprofessional fall prevention team evaluated the hospital's fall program using the evidence-based practice improvement model. A clinical practice guideline with 7 key practices guided the development of an individualized fall prevention program with interventions to address 4 fall risk categories and an algorithm to identify interventions. Interventions included nurse-driven mobility assessment, purposeful hourly rounding, and video monitoring for confused and impulsive fall-risk patients. OUTCOMES:The fall rate decreased to 1.14, with a 72% expense reduction based on decreased sitter usage. CONCLUSIONS:An interprofessional team successfully reduced falls with an evidence-based fall prevention program. 10.1097/NCQ.0000000000000344

Redesigning a Fall Prevention Program in Acute Care: Building on Evidence. Fridman Viktoriya Clinics in geriatric medicine Through education, frontline nurse involvement, and redesigning fall prevention approach, hourly rounding was promoted as a proactive falls prevention strategy with the goal of decreasing falls and promoting patient safety, health, and comfort. Nurses in health care organizations increase patient safety and reduce patient falls in the hospital setting through hourly rounding with a purpose. Current practices must be redesigned to ensure that acute care fall prevention initiatives are consistent and transformational. 10.1016/j.cger.2019.01.006

Evidence-Based Practice Guideline: Fall Prevention for Older Adults. Kruschke Cheryl,Butcher Howard K Journal of gerontological nursing Falls are a major cause of injury and death annually for millions of individuals 65 and older. Older adults are at risk for falls for a variety of reasons regardless of where they live. Falls are defined as any sudden drop from one surface to a lower surface. The purpose of this fall prevention evidence-based practice guideline is to describe strategies that can identify individuals at risk for falls. A 10-step protocol including screening for falls, comprehensive fall assessment, gait and balance screening when necessary, and an individualized fall intervention program addressing specific fall risks is presented. Reassessing fall risk and fall prevention programs will ensure a proactive approach to reducing falls in the aging population. [Journal of Gerontological Nursing, 43(11), 15-21.]. 10.3928/00989134-20171016-01