Date of Award

4-2019

Degree Name

Nursing (D.N.P.)

Department

College of Nursing

First Advisor

Sandra Spoelstra, PhD, RN, FGSA, FAAN

Second Advisor

Marie VanderKooi, DNP, RN

Third Advisor

Jennifer Kaiser, PhD, RN, CNE

Abstract

Introduction. Falls are the most common cause of injury to patients in acute care hospitals globally and higher incidences of falls with injury are reported in the hospitalized elderly. Falls can result in physical and emotional injury, long-term pain, functional impairment, disability, loss of income, increased hospital stay and mortality. Research demonstrates individualized, multifactorial fall prevention interventions are most beneficial in preventing falls and related injuries. This paper reports whether accurate fall risk assessment using the Hester Davis, proactive use of 5T’s (toileting, tolerating pain, tidy, turn, technology), appropriate gait belt use, individualized interventions and intentional toileting for patients with altered mental status and impaired mobility reduce falls in the neuroscience (NS) unit.

Methods. The Promoting Action on Research in Health Sciences framework guided the project in a 22 bed NS settings at a large Midwestern hospital. Staff (N= 40), received education with pre-/post-tests. A multi-faceted evidenced based fall prevention intervention was implemented.

Results. A significant improvement in fall prevention knowledge was identified. One fall occurred in the six weeks post-implementation; a clinically meaningful reduction in falls. There was no difference in the number of call light/bed alarms.

Conclusion. Accurate fall assessment, along with providing 5T’s, appropriate gait belt use and intentional toileting decreases falls. Further audits are necessary to evaluate improvements and sustained benefits.

Implications. Patient safety is the number one priority in hospitals. Multifactorial individualized fall prevention interventions reduce incidence of falls in hospitals.

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