Date of Degree

Summer 2024

Document Type

DNP Scholarly Project

Academic Department

School of Nursing

Degree Type

Doctoral

Degree Name

Doctor of Nursing Practice

First Advisor

Dr. Melanie Brewer

Second Advisor

Dr. Corinne Cochrane

Abstract

Patient falls represent the largest category of preventable adverse events in hospitals, with 700,000 to 1,000,000 falls occurring annually in U.S. hospitals and 30-35% resulting in injuries. The cost of fall-related injuries exceeds $50 billion globally, with an average of $14,056 per fall.

The aim of this project was to introduce a standardized fall prevention approach to improve performance and reduce falls in the medical-surgical department.

A comprehensive literature review indicates multifactorial bundled approaches, clinical pathways, purposeful rounding, and patient and family engagement as effective fall prevention strategies.

This quality improvement (QI) project design was based on the Plan, Do, Study, Act (PDSA) Model for Improvement principles. The OhioHealth Change Management Model tools were instrumental in guiding the change by facilitating both the design and implementation of the project.

The project utilized a multifactorial approach with bundled interventions, including timely fall risk assessments, a structured, purposeful rounding method, gait belt availability, and patient-centered care plans and education, to enhance the existing fall prevention program.

The fall rate decreased by 35% from the baseline, and the fall-with-injury rate reduced by 63% within the two months. Compliance with fall risk assessments and purposeful rounding improved significantly, while care plan and education documentation showed moderate increases.

Bundling evidence-based fall prevention interventions demonstrated a reduction in falls and improved patient safety. Establishing a standardized fall prevention program with patient-centric interventions may enhance safety outcomes.

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