Fall Prevention: A Best Practice Approach

Within acute care hospitals and long-term care facilities (e.g., nursing homes and assisted living centers) falls constitute the single largest category of adverse events. Anywhere from 39%-50% of patients (*) experience one or more falls. Falls are associated with significant physical and psychological complications, including: 

• Injury (i.e., injurious falls range from minor bruises and sprains to more serious events, such as hip and other fractures, spinal cord and brain injury).
• Immobility resulting in muscle weakness and functional disabilities, which can increase in the risk of further falls (i.e., muscle weakness results in balance instability).
• Psychological distress (e.g. depression, fear of falling). 

Patient falls are equally burdensome for staff (e.g., nurses, nursing aides, etc.); often leading to increased workloads (i.e., evaluating falling episodes, caring for patient’s post-fall, extra paperwork, etc.) and concerns about patient "safety", especially risk of legal liability. 

(*) The term ‘patients’ is used to refer to both acute care patients and long-term care residents.

Objectives

Upon completion of this course, participants will be able to:

1. List the components of a best practice approach to fall prevention.
2. State the steps in the fall prevention process.
3. List the advantages of benchmarking or measuring fall rates.
4. Describe the benefits of auditing fall prevention programs.

Curriculum

Chapter 1: Introduction

• Why Falls Occur
• Where and When Falls Occur 
• When Is a Fall Significant

Chapter 2: Fall Prevention Process

• Assessing Fall Risk
• Multidisciplinary Evaluation
• Care Planning
• Universal Precautions vs. Targeted Interventions 
• Monitoring
• Post-Fall Assessment
• Essential Components of a Fall Prevention Program

Chapter 3: Steps to Success

• Culture of Safety

Chapter 4: Measuring Success

• Fall Rates and Benchmarking
• External vs. Internal Benchmarking

Chapter 5: Root Causes of Falls

• Care Process or Staff Factors
• Organizational Factors

Chapter 6: Audits

• Process Steps

Chapter 7: Redesigning Fall Prevention Practices

Appendix

• Post Fall Assessment Policy
• Family Role in Patient Safety
• Calculating Fall Rates: 101
• Role of Falls Nurse Coordinator or Champion