Use of an Evidence-Based Tool in Improving Communication to Decrease Falls
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2023-06-01
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Inpatient falls with major injuries resulting in 63% death was among the top ten sentinel events reported in 2015, according to The Joint Commission (TJC). Other factors to consider in fall prevention initiatives include (1) the ability of patients to return to previous living situations and (2) the economic burden of cost. In Hawaii, the out-of-pocket cost for equipment and rehabilitation after a fall is $28,000,0000 (CDC, 2020a). On a medical-surgical unit, fall prevention interventions included fall identification wristbands, non-skid socks, gait belt use, no-toileting alone, bed and chair alarm use, and video monitoring when indicated. Despite the processes and interventions in place, the unit could not meet the national benchmark, which allows only one fall without injury per month. Fall prevention initiative is a significant priority for the unit as the patient population is at an increased risk for falls and fall-related complications due to chronic and acute conditions, medication effects, age, and surgery. An evidence-based tool called Fall Tailoring Intervention for Patient Safety (Fall TIPS) was piloted to improve communication among care providers and increase knowledge and confidence in fall prevention practices. The quality improvement initiative resulted in a decreased number of falls/falls with injury on the unit during the education and trial period and has the potential for integration into practice. The mean level of confidence of staff also increased from 7.65 to 8.55 for the pre and post-test survey. However, the staff's knowledge level did not significantly increase post-test compared to the pre-test knowledge assessment survey indicating a targeted education or other means of improving fall prevention knowledge.
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