+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Temporal Trends in Fall Rates with the Implementation of a Multifaceted Fall Prevention Program: Persistence Pays Off

Temporal Trends in Fall Rates with the Implementation of a Multifaceted Fall Prevention Program: Persistence Pays Off

Joint Commission Journal on Quality and Patient Safety 44(2): 75-83

Most fall prevention programs are only modestly effective, and their sustainability is unknown. An academic medical center implemented a series of fall prevention interventions from 2001 to 2014. The medical center's series of fall prevention interventions were as follows: reorganized the Falls Committee (2001), started flagging high-risk patients (2001), improved fall reporting (2002), increased scrutiny of falls (2005), instituted hourly nursing rounds (2006), reorganized leadership systems (2007), standardized fall prevention equipment (2008), adapted to a move to a new hospital building (2008), routinely investigated root causes (2009), mitigated fall risk during hourly nursing rounds (2009), educated patients about falls (2011), and taught nurses to think critically about risk (2012). To evaluate temporal trends in falls and injury falls, piecewise negative binomial regression with study unit-level random effects was used to analyze structured validated data sets available since 2003. From July 2003 through December 2014, the crude fall rate declined from 3.07 to 2.22 per 1,000 patient days, and injury falls declined from 0.77 to 0.65 per 1,000 patient days. Nonsignificant increases in falls occurred after nurses started rounding hourly and after the move to the new hospital. On the basis of regression models, significant declines occurred after nurses began to mitigate fall risk during hourly rounds (p = 0.009). Instituting incremental changes for more than a decade was associated with a meaningful (about 28%) and sustained decline in falls, although the rate of decline varied over time. Hospitals interested in reducing falls but concerned about competing clinical and financial priorities may find an incremental approach to be effective.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 065562870

Download citation: RISBibTeXText

PMID: 29389463

DOI: 10.1016/j.jcjq.2017.08.009

Related references

Assessing the Effectiveness of Engaging Patients and Their Families in the Three-Step Fall Prevention Process Across Modalities of an Evidence-Based Fall Prevention Toolkit: An Implementation Science Study. Journal of Medical Internet Research 21(1): E10008, 2019

Patient and family education for fall prevention: involving patients and families in a fall prevention program on a neuroscience unit. Journal of Nursing Care Quality 24(3): 243-249, 2009

Fall Prevention Mobile Clinic: A Novel Fall Prevention Program for Community-Dwelling Older Adults. Canadian Journal on Aging 37(4): 482-495, 2018

Implementation of a patient fall prevention program. Journal of Neuroscience Nursing 23(5): 315-319, 1991

Development and Implementation of a Pharmacy Fall Prevention Program. Hospital Pharmacy 44(12): 1095-1102, 2009

Fall-prevention strategies and patient characteristics that impact fall rates after total knee arthroplasty. Anesthesia and Analgesia 119(5): 1113-1118, 2014

Using a standardized fall prevention tool decreases fall rates. Nursing 46(3): 64-67, 2016

Fall occurrence in a geriatric psychiatry setting before and after a fall prevention program. Journal of Gerontological Nursing 27(10): 49-53, 2001

Mediating Role of Fall-related Efficacy in a Fall Prevention Program. American Journal of Health Behavior 43(2): 393-405, 2019

Trends in Geospatial Drivers of Fall-Related Hospitalizations and Asset Mapping of Fall Prevention Interventions for Vulnerable Older Adults. Journal of Aging and Health 2019: 898264318822381, 2019

Fall prevention exercise program for fall risk factor reduction of the community-dwelling elderly in Korea. Yonsei Medical Journal 44(5): 883-891, 2003

The effect of an individualized fall prevention program on fall risk and falls in older people: a randomized, controlled trial. Journal of the American Geriatrics Society 53(8): 1296-1304, 2005

Nurses' caring attitude: fall prevention program implementation as an example of its importance. Nursing Forum 46(3): 137-145, 2011

The Ironbark program: Implementation and impact of a community-based fall prevention pilot program for older Aboriginal and Torres Strait Islander people. Health Promotion Journal of Australia 29(2): 189-198, 2018

The effects of fall prevention program on knowledge, self-efficacy, and preventive activity related to fall, and depression of low-income elderly women. Taehan Kanho Hakhoe Chi 35(1): 104-112, 2005