Problem and significance to nursing: FY20 D3 had 6 falls with injury. Many patients have a limited understanding of why they are deemed a fall risk.
PICO question: In a hospital setting, will patient and family engagement in a fall prevention program affect the incidence of falls compared to no active patient/family engagement in the fall prevention program?
Brief statement of the evidence: Tailoring fall prevention education to patient-specific risk factors leads to a decrease in falls and an increase in a patient’s awareness of their fall risk factors. 9 articles; 2 level-1 articles, 1 level-2 article, 2 level-3 articles, and 4 level-5 articles all ranging from good to high quality.
Theory: This intervention allows the nurse and the patient to develop a fall prevention plan tailored to the patient’s specific risk factors. This allows the patient to be at the center of their fall prevention plan, allows them to set their own goals, and directly addresses the patient’s fall related concerns. This has led to decreased falls and an increased patient awareness of their fall risk factors.
Implementation strategies: D3 staff was surveyed to determine current fall prevention education methods and to determine potential barriers to implementing a new mode of education. An educational tool was developed for staff to use to educate patients. Staff was educated on proper use of the tool during monthly staff meetings. A post-survey was conducted to determine how often staff used the tool and if they felt patients responded to the fall prevention education.
Outcome analysis: After implementation of a tailored fall prevention education tool, D3 had a decrease in the number of falls from 6 in 2020 to 1 fall in 2021.
Conclusions and recommendations: Use of a fall prevention education cling tailored to a patient’s specific fall risk factors and interventions led to a decrease in falls on D3. Patient and family engagement in a fall prevention program decreased the incidence of falls compared to no active patient/ family engagement in the fall prevention program.
Implications: This tool can be adopted for unit-specific needs and used on other units to educate patients on their fall prevention plan and decrease the number of falls hospital-wide.
Evidence-based references
1. Ang, W., Heryani, N., Lau, S., & Lau, Y. (2018). Evaluation of a Fall Prevention Educational Video on Fall Risk Awareness, Knowledge and Help Seeking Behavior Among Surgical Patients. Singapore Nursing Journal, 45(1), 2733.
2. Bargmann, A. L., & Brundrett, S. M. (2020). Implementation of a Multicomponent Fall Prevention Program: Contracting With Patients for Fall Safety. Military Medicine, 185(Supplement_2), 28-34. doi:10.1093/milmed/usz411
3. Haines, T. P., Hill, A., McPhail, S., Oliver, D., Brauer, S., Hoffmann, T., & Beer, C. (2011). Patient Education to Prevent Falls Among Older Hospital Inpatients. Arch Intern Med, 171(6), 516-524.
4. Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A., & Morris, M. E. (2020). Hospital falls prevention with patient education: A scoping review. BMC Geriatrics, 20(1). doi:10.1186/s12877-020-01515-w
5. Kuhlenschmidt, M., Reeber, C., Wallace, C., Chen, Y., Barnholtz-Sloan, J., & Mazanec, S. (2016). Tailoring Education to Perceived Fall Risk in Hospitalized Patients With Cancer: A Randomized, Controlled Trial. Clinical Journal of Oncology Nursing, 20(1), 84-89. doi: 10.1188/16.cjon.84-89
6. Lim, M. L., Ang, S. G., Teo, K. Y., Wee, Y. H., Yee, S. P., Lim, S. H., & Ang, S. Y. (2018). Patientsʼ Experience After a Fall and Their Perceptions of Fall Prevention. Journal of Nursing Care Quality, 33(1), 46-52. doi: 10.1097/ncq.0000000000000261
7. Opsahl, A. G., Ebright, P., Cangany, M., Lowder, M., Scott, D., & Shaner, T. (2017). Outcomes of Adding Patient and Family Engagement Education to Fall Prevention Bundled Interventions. Journal of Nursing Care Quality, 32(3), 252258. doi:10.1097/ncq. 0000000000000232
8. Radecki, B., Keen, A., Miller, J., Mcclure, J. K., & Kara, A. (2020). Innovating Fall Safety. Journal of Nursing Care Quality, 35(3), 220-226. doi: 10.1097/ncq.0000000000000447
9. Rochon, R., & Salazar, L. (2019). Partnering with the Patient to Reduce Falls in a Medical-Surgical Unit. Int J SPHM,9(4), 135-142.