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Individualized Fall Prevention Program in an Acute Care Setting

An Evidence-Based Practice Improvement

Spano-Szekely, Lauraine, DNP, RN; Winkler, Anne, MA, RN, CCRN; Waters, Cathy, MSN, RN, OCN, NEA-BC; Dealmeida, Susana, MHA, RN-C; Brandt, Kathy, RPh; Williamson, Marsha, MSN, RN-BC, ANP-BC, CCRN-K; Blum, Christina, BSN, RN; Gasper, Lori, BSN, RN; Wright, Fay, PhD, RN, APRN-BC

doi: 10.1097/NCQ.0000000000000344

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.

Northern Westchester Hospital, Mount Kisco, New York (Dr Spano-Szekely and Mss Winkler, Waters, Dealmeida, Brandt, Williamson, Blum, and Gasper); and New York University Rory Meyers College of Nursing, New York (Dr Wright).

Correspondence: Lauraine Spano-Szekely, DNP, RN, Northern Westchester Hospital, 400 East Main St, Mount Kisco, NY 10549 (

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The authors declare no conflicts of interest.

Accepted for publication: May 16, 2018

Published ahead of print: September 6, 2018

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