Patient falls in hospitals remain a persistent and significant health problem. Three articles in this issue make important contributions to falls prevention. Klinkenberg and Potter report on the predictive validity of the Johns Hopkins Fall Risk Assessment Tool based on 13 574 patient admissions to medicine units. Assessing high risk for falls among psychiatric inpatients is particularly challenging. Another article in this issue describes the sensitivity, specificity, and diagnostic odds ratio of the Baptist Health High Risk Falls Assessment for use with a psychiatric inpatient population. Prevention of falls requires more than a reliable assessment tool. In a project led by Gray-Miceli, 38 hospitals participated in falls prevention team training, followed by coaching and mentoring over 3 months to develop unit-based initiatives to reduce falls. The initiatives, which focused on fall risk assessment, rounding, and postfall assessment, resulted in reduced fall rates (P < .01). To decrease telemetry monitoring when no longer indicated, a team of nurses developed and tested a nurse-managed telemetry discontinuation protocol. The protocol decreased overmonitoring and ensured telemetry availability. How noisy is it at night on your unit? In another QI project, nurses implemented a multifaceted noise reduction program on 2 hospital units, which include scripted leadership rounding, staff education, a nighttime sleep promotion cart, and visual aids to remind staff to be quiet. It worked. Health care organizations have incorporated updated safety principles in their standards and the analysis of errors, but do nurses understand these principles? Armstrong et al developed and tested a scale to assess bedside nurses' skills and attitudes about updated safety concepts. This scale can be used in targeting strategies in your setting to enhance nurses’ safety practices. Is your organization using health literate best practices? Read the article by Innis et al to learn more about this. Other articles in this issue examine improving infusion pump safety, reducing medication error, the role of middle managers in QI, and more. Sit back and start reading!
Marilyn H. Oermann, PhD, RN, ANEF, FAAN