Evidence Based Research on Fall Prevention

Are Fall Preventions Effective?:

Are Fall Preventions Effective? Sara McManus, Michelle Penner , Michaela Piccolo and Katie Riedler Creighton University School of Nursing

Clinical Problem:

Clinical Problem Injury due to falls can be prevented through healthcare interventions Cost implications Length of stay 2,3 Hospital costs 3 Clinical implications Mortality 1,2,3 Quality Implications

Project Purpose:

Project Purpose Critiquing and synthesizing evidence based research related to fall prevention

PICO:

PICO Are interventions designed to reduce falls and resulting complications in hospitalized patients effective?

Summary:

Summary Article 1 This article examined the use of four different interventions and their correlation to fall rates. Level of evidence was IV

Summary:

Summary Article 2 This study used hospital data to determine correlation of call light use and call light response time with fall rate. Level of evidence was III

Summary:

Summary Article 3 This study was done to encourage awareness and prevention of inpatient falls through nurse perspectives through five dimensions of fall causes. Level of evidence VI

Summary:

Summary Article 4 This study compared the use of a novel technique to get out of bed to the traditional way to get out of bed. Level of evidence VI

Synthesis:

Synthesis Sample Findings Level of Research Location Article 1 Men over 55 years old Interventions reduce falls Moderate 2 Medical -Surgical units Veteran’s Hospital Article 2 2 Medical 1 Surgical 1 Medical-Surgical units Quicker call light response results in fewer falls Moderate Community Hospital Article 3 9 Nurses 24 solutions to prevent falls were identified Moderate One Acute Medical Unit Article 4 Single female experimenter Prone position is a safer way to get out of bed Weak University simulation room

Summary :

Summary Overall results Consistent and supported

Recommendation for Nursing Practice:

Recommendation for Nursing Practice All hospitals should have standardized guidelines for identified at-risk fall patients 1,3 Assessment for patients who may be at risk for falls 1,3 Healthcare agencies should track call light use and response time 2

Practice Implications:

Practice Implications Nurses should assess patients to determine level of risk 1 Implement fall prevention strategies 1, 2, 3

Interdisciplinary Implications:

Interdisciplinary Implications Sitters 3 Physical Therapy Occupational Therapy Physicians Pharmacists Aides 3

Future Research :

Future Research When and where do falls occur? Which populations are most at risk? How do medications and falls correlate? Which assistive devices are most effective at reducing falls? Hospital design principles 3

Implications for Practice Changes:

Implications for Practice Changes Clinical By preventing falls outcomes will be increased Increase the use of “sitters” to prevent falls Reduces morbidity and mortality Cost Decrease patient/hospital expenses Quality Healthcare agencies can track call light use information for quality improvement studies Patient satisfaction

References :

References 1 Quigley , P., Habm , B., Gibson, W., Powell-Cope, G., Sarduy , I., Tyndall, K., & White, S. (2009). Reducing serious injury from falls in two veterans’ hospital medical-surgical units. Journal of Nursing Care Quality, (24) 1, 33-41 . 2 Tzeng , Huey-Ming; Yin,Chang -Ti. (2009). Are call light use and response time correlated with inpatient falls and inpatient dissatisfaction? Journal of nursing care quality , volume 24,3 . 232-242.

References :

References 3 Tzeng , H., & Yin, C. ( 2008). Nurses’ solutions to prevent inpatient falls in hospital patient rooms. Nursing Economics, 24(3), 179-187. 4 Tzeng, H. M. & Yin, C. Y. (2008). Innovation in patient safety: a new task design in reducing patient falls. Journal of Nursing Care Quality , 23(1), 34-42