J Clin Outcomes Manage
A hospital fall assessment and intervention project
Capan K, Lynch B
Abstract Objective: To describe the design and implementation of an inpatient fall prevention protocol. Methods: A multipdisciplinary falls task force developed a fall assessment and intervention tool that evaluates for 7 risk factors, with points assigned according to whether the risk factor is present. Patients with a score > 30 (or patients admitted because of a fall) are considered at high risk for falling. All at-risk patients receive a wrist band and door magnet, a fall prevention guide, are offered hip protectors, and are assessed for orthostatic hypotension. Other interventions (eg, low bed, bed alarm, prompted toileting, medication review) are assigned based on risk factors present. All patients admitted to the hospital are assessed for fall risk regardless of age or condition and reassessed every 12 hours during their stay. The tool was pilot tested on a medical/neurology unit with a high fall incidence rate for 5 months and then rolled out hospital-wide. Results: Since introducing the fall prevention protocol, total fall rate has dropped from 0.45 per 100 patient-days in 2003 to 0.32 per 100 patient-days in 2005, surpassing the benchmark target of 0.35 per 100 patient-days. Severity of fall-related injuries has also declined. Conclusion: A fall risk assessment and prevention tool can change staff behavior and increase patient safety
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