Implementing a Checklist as an Inpatient Fall Prevention Intervention: A Quality Improvement Process

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Introduction and Purpose: Older adults have a higher risk of acute setting falls, based on a multitude of factors, leading to prolonged lengths of stays and thousands of dollars in additional healthcare costs. The DNP project aimed to identify whether integrating a nurse-led Fall Prevention Checklist, alongside standard fall prevention interventions, reduces inpatient falls in older adults within a single oncology/medical-surgical inpatient setting. Methods: The project focused on decreasing falls in an inpatient setting over six weeks. Nurses were educated on the current clinical need for fall reduction, and “fall champions” were identified to help provide momentum in tool adoption. Moreover, the implementation strategy was evaluated, and nurse feedback was collected through a voluntary and anonymous post-implementation survey. Results: Nurses completed 663 Fall Prevention Checklists during shift changes. Fall rates between the implementation period and baseline rates were analyzed. The number of falls pre-implementation (6, n = 6) was significantly more significant than the number of falls post-implementation (2, n = 6), 𝜒2 (1, N = 12) = 6.00, p = .014; a decrease in the fall rate by 66.7%. Conclusion: The improvement in fall rates supports the idea that implementing a simple yet valuable tool, such as a Fall Prevention Checklist during shift change, can reduce fall rates. Only 4.5% of nurses provided feedback following the intervention, limiting nurse insight into the utility of the instrumentation. Based on the project limitations, findings should be viewed cautiously. However, the initial findings support that augment strategies, such as utilizing a Fall Prevention Checklist, can provide meaningful impacts on improving patient outcomes.

DNP project
Fall prevention