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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
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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 (lszekely@northwell.edu).

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.jncqjournal.com).

The authors declare no conflicts of interest.

Accepted for publication: May 16, 2018

Published ahead of print: September 6, 2018

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