Clinical Effectiveness and Cost of a Hospital-Based Fall Prevention Intervention: The Importance of Time Nurses Spend on the Front Line of Implementation : JONA: The Journal of Nursing Administration

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Clinical Effectiveness and Cost of a Hospital-Based Fall Prevention Intervention

The Importance of Time Nurses Spend on the Front Line of Implementation

Nuckols, Teryl K. MD, MSHS; Needleman, Jack PhD; Grogan, Tristan R. MS; Liang, Li-Jung PhD; Worobel-Luk, Pamela MSN; Anderson, Laura MPH; Czypinski, Linda MD; Coles, Courtney MPH; Walsh, Catherine M. MSN

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JONA: The Journal of Nursing Administration 47(11):p 571-580, November 2017. | DOI: 10.1097/NNA.0000000000000545

Abstract

OBJECTIVE 

The aim of this study is to evaluate the clinical effectiveness and incremental net cost of a fall prevention intervention that involved hourly rounding by RNs at 2 hospitals.

BACKGROUND 

Minimizing in-hospital falls is a priority, but little is known about the value of fall prevention interventions.

METHODS 

We used an uncontrolled before-after design to evaluate changes in fall rates and time use by RNs. Using decision-analytical models, we estimated incremental net costs per hospital per year.

RESULTS 

Falls declined at 1 hospital (incidence rate ratio [IRR], 0.47; 95% confidence interval [CI], 0.26-0.87; P = .016), but not the other (IRR, 0.83; 95% CI, 0.59-1.17; P = .28). Cost analyses projected a 67.9% to 72.2% probability of net savings at both hospitals due to unexpected declines in the time that RNs spent in fall-related activities.

CONCLUSIONS 

Incorporating fall prevention into hourly rounds might improve value. Time that RNs invest in implementing quality improvement interventions can equate to sizable opportunity costs or savings.

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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