Current literature suggests that a multitude of fall prevention methods, practices and tools exist and are widely available for organizations to choose from. The main purpose of the project was to reduce or eliminate falls by implementing a customized set of Agency for Healthcare Research and Quality (AHRQ) patient fall reduction guidelines. PICOT: For adult patients age 18 and over in the Emergency Department (ED) at a level II community hospital, how can the implementation of AHRQ Patient Fall Reduction Guidelines, compared to current practice, effect patient fall outcomes, over an 8-week time period?
Methods:
Falls in the ED were calculated using a standard patient fall calculation method (number of patient falls x 1000 / number of patients seen in the ED). The KINDER 1 Fall Risk Assessment Tool was also used to identify patients at risk for falls. During project implementation, one patient experienced a fall. The number of patients who met fall risk assessment criteria was 328 out of 3,323 adult patients. Patients age 17 or younger were omitted from project data collection and participation. When a patient was identified as a fall risk, additional standard patient fall interventions were also implemented.
Results:
Prior to implementation of AHRQ guidelines, the average annual fall rate was 1.06% The fall rate percentage at the completion of this project was 0.30% over an 8-week time frame from January 6, through March 2, 2019. Fall rate comparison showed, with a 95% confidence interval, no major change in fall rate during the length of this project. However, there was a downward trend in patient fall rate that was well established.
Conclusion:
Additional research is needed that will compare quarterly fall rates over an extended period of time in order to better understand underlying causes that contribute to patient falls and improved patient safety in the ED across various health systems.