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1.5 CE Test Hours

Original Research

Exploring Clinicians’ Perceptions About Sustaining an Evidence-Based Fall Prevention Program

Contrada, Emily

AJN The American Journal of Nursing: May 2018 - Volume 118 - Issue 5 - p 34,46
doi: 10.1097/01.NAJ.0000532807.43595.37
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Exploring Clinicians’ Perceptions About Sustaining an Evidence-Based Fall Prevention Program

GENERAL PURPOSE:

To present the results of a study done to address the knowledge gap between implementing and sustaining evidence-based fall prevention programs for hospitalized patients.

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LEARNING OBJECTIVES/OUTCOMES:

After completing this educational activity, you should be able to

  • outline the purpose and methods of this study.
  • list fall prevention strategies used by the facility in this study.
  • identify perspectives of the interprofessional health care team members who participated in this study.
  1. Bouldin and colleagues reported a fall rate on adult medical–surgical and surgical nursing units of how many falls per 1,000 patient-days?
    1. 1.93
    2. 2.89
    3. 3.56
  2. Consistent recommendations for fall prevention from the authors’ literature review included tailoring interventions so that they meet specific patient needs and also consider
    1. contextual factors.
    2. careful data analysis.
    3. a theoretical framework.
  3. According to Spyridonidis and Calnan, among other researchers, one recognized problem with fall prevention programs, especially on units with competing initiatives, is
    1. difficulty gaining interprofessional support for new initiatives.
    2. a tendency to drift back to earlier practice patterns.
    3. difficulty maintaining fall rates below national benchmarks.
  4. In the authors’ study, all research team members discussed the methodological components until they reached consensus, in order to
    1. ensure the integrity of the data analysis.
    2. ensure the integrity of the data.
    3. limit the potential for bias.
  5. All of the participating nursing staff, nurse managers, and nursing practice leaders identified which of the following as their primary method of objectively assessing a patient's fall risk?
    1. the fall risk assessment scale (FRAS)
    2. the immediate environment
    3. the patient's chronic comorbidities
  6. Almost all of the nonnurse participants were focused on
    1. the patients’ fall histories.
    2. medications that can worsen fall risk.
    3. their own role-specific assessment method.
  7. An example of a passive communication pattern is
    1. reporting a patient's fall risk during handoffs.
    2. documenting a patient's FRAS score.
    3. informing family members about a patient's fall risk.
  8. One strategy for increasing awareness of a patient's fall risk involves placing which of the following symbols on the room door?
    1. a red apple
    2. a crescent moon
    3. an autumn leaf
  9. An example of an active communication strategy is
    1. leaving a lift device in a patient's room.
    2. reporting fall data in daily interprofessional huddles.
    3. writing the FRAS score on the whiteboard in the patient's room.
  10. Some nonnurse participants in the authors’ study reported routinely checking electronic health records for evidence of
    1. hypotension.
    2. hypokalemia.
    3. confusion.
  11. A nurse manager participant reported providing a daily reminder to staff to
    1. reassess fall risk.
    2. set bed alarms.
    3. monitor call lights.
  12. Which of the following did participants identify as directly affecting the ability of nursing staff to prevent some patients’ falls?
    1. the absence of family members
    2. variations in staff commitment
    3. nurse-to-patient staffing levels
  13. Which of the following factors was reported as making staff reliant on a patient's ability to call for help when needed?
    1. protective isolation for neutropenia
    2. patients’ presence in hallways and common areas
    3. staff presence at quality improvement collaboration meetings
  14. Participants in the nurse manager group reflected that having access to and examining unit-level fall data provides staff with
    1. better guidelines for risk reassessment after a fall.
    2. greater awareness of the need for hourly rounds.
    3. opportunities to discuss the details of patient falls.
  15. A nonnurse participant reported doing which of the following instead of using the hospital's fall data?
    1. improving surveillance
    2. reviewing incident reports
    3. monitoring orthostatic blood pressures
  16. Some members of the Falls Committee focus group were surprised to learn of which of the following practices on other units?
    1. asking families about patients’ fall history
    2. reporting FRAS scores during handoffs
    3. keeping a list of patients at high fall risk next to the unit clerk
  17. All but one participant identified which of the following team members as having primary responsibility for assessing a patient's fall risk?
    1. nursing assistants
    2. physicians
    3. nurses
  18. The authors’ literature review identified several strategies that are essential in implementing fall prevention programs. These include engaging which of the following at all organizational levels?
    1. researchers
    2. change champions
    3. assessment specialists
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