Evaluating the Effectiveness of a Fall Risk Screening Tool Implemented in an Electronic Medical Record System

Staffing Utilization and Fall Prevention With an Electronic Surveillance Video System: A Randomized Controlled Study

BACKGROUND

There is limited research addressing how to optimize both staffing and patient outcomes with the use of technology to reduce falls during hospitalization.

PURPOSE

We compared the effects of 2 staffing patterns in conjunction with the use of an electronic surveillance system on patient falls on an inpatient medical unit.

METHODS

Study participants were randomized to receive electronic surveillance system monitoring with a dedicated rounder or electronic surveillance system without a dedicated rounder. Falls during the study period were analyzed.

RESULTS

Of 1032 patients, there were 8 falls during the 3-month study. Six falls occurred in the intervention group, with no rounder, and 2 occurred in the group with a dedicated rounder. The data showed no statistical significance but had clinical implications.

CONCLUSION

In response to our findings, the dedicated rounder will function as a mobility technician, providing support to our nursing staff and a resource for fall risk patients.

Evaluating the Humpty Dumpty Fall Scale: An International, Multisite Study

BACKGROUND

The Humpty Dumpty Falls Prevention Program was developed to address an unmet need to identify pediatric patients at risk of a fall event.

PURPOSE

The aim of this study was to evaluate the performance of the Humpty Dumpty Fall Scale-Inpatient (HDFS) across a diverse, international pediatric population. In addition, the characteristics of patients who experienced a fall were analyzed.

METHODS

A retrospective, cross-sectional design was used to assess fall risk across 16 hospitals and 2238 pediatric patients. Multiple and simple logistic regressions were performed to evaluate association of individual scale items and total score with falls during hospitalization. Reliability, sensitivity, and specificity of the HDFS were also assessed.

RESULTS

Several of the HDFS items were significantly associated with the risk of falls in the pediatric population, but specificity of the tool is a concern to consider for future tool enhancement.

CONCLUSIONS

Characteristics for further refinement of the HDFS were identified.

Fall Risk Program for Oncology Inpatients: Addition of the "Traffic Light" Fall Risk Assessment Tool

BACKGROUND

The incidence of falls on inpatient oncology units indicated the need for quality improvement. This project aimed to reduce falls by implementing a fall reduction plan including the "Traffic Light" Fall Risk Assessment Tool (TL-FRAT).

LOCAL PROBLEM

We retrospectively reviewed the oncology unit fall data from January 2013 to September 2014 and found that the average fall incidence was high.

METHODS

The project used a program evaluation design, and the process was guided by Kotter's 8-step change model.

INTERVENTIONS

We implemented the TL-FRAT to classify oncology inpatients at a high risk of falling in advance.

RESULTS

The average fall incidence and falls with injury during the project were reduced.

CONCLUSIONS

Adding the TL-FRAT to the fall protocol on the units effectively reduced the incidence of falls related to impaired mobility. The TL-FRAT can improve nurses' sensitivity to falls related to impaired mobility and, subsequently, guide corresponding fall prevention strategies.