Date of Award
College of Nursing
Introduction. Falls are the leading cause of injury and injury death in adults over the age of 65. A retrospective examination at Level 1 trauma center in the Midwest found that 19.4% (118/605) of older adults admitted with a ground level fall were readmitted with a subsequent fall and injury. The aim of this quality improvement initiative is to determine if the implementation of an evidenced based patient toolkit and a discharge algorithm for providers will reduce outpatient falls. The objective was to reduce hospital readmission due to repeat fall.
Methods: The design of this project was mixed methods, observational, with a pre- /post-comparison to evaluate improvement. The setting was on an inpatient medical surgical trauma unit in an acute care hospital in the Midwest. Participants were providers, nurses, and patients. A toolkit was to be provided to patients fitting inclusion criteria at discharge to be utilized at home. Trauma service line providers were to utilize an algorithm at discharge.
Results: Two nurse surveys were administered. Implementation of the project was impacted by other initiatives and the COVID-19 pandemic shifting the organizations priorities and limiting student access to the site. Completion survey rate 3.6% (2 of 55). RN mean years of employment 3.5 (Standard Deviation [SD] 1.2). !00% reported they were able to review toolkit. There was 0% change in discharge practice after education.. Half of the nurses that completed the survey reported they provided patients with a ground level fall education a discharge. 100% of nurses reported they rarely/never discuss patient fall risk with providers during rounds.
Conclusions: Use of an evidenced based patient toolkit and a discharge algorithm for providers could potentially decrease readmission due to repeat ground level fall and injury. Further implementation efforts will be needed to evaluate effectiveness.
Karl, Sara, "Utilization of Patient Toolkit and Discharge Algorithm for Providers to Reduce Readmission due to Repeat Ground Level Fall" (2020). Doctoral Projects. 122.