Implementation of an Education Program to Decrease Inpatient Falls

BACKGROUND: Inpatient falls are affecting 1 million patients across the United States every year with 25% of fall resulting in injury. Approximately 25% of falls are preventable with accurate assessment and appropriate fall precaution interventions. According to the literature, obtaining an accurate fall risk assessment is the first step in inpatient fall prevention.

LOCAL PROBLEM: Patient falls increased on 2 cardiac stepdown units in a level III trauma center in Knoxville, Tennessee. From 2020- 2022, the combined units experienced a 48% increase in patient falls. Nursing leadership identified staff knowledge deficits and inaccurate scoring of fall assessments as primary contributors to the increase in patient falls. This evidence-based project was developed to increase nurses’ awareness of the Morse Fall Scale and increase adherence to the utilization and accurate completion of the fall risk tool.

METHODS: The John Hopkins Evidence Based Practice Model was used to guide this project. Nurses completed a survey before and after receiving the education to assess nurses’ confidence at scoring fall risk. A random chart audit of 20 charts was performed prior to the educational intervention and 1 month post-intervention to assess for documentation of patient’s average fall scores, nurses’ adherence to completing the Morse Fall Score each shift, and patient falls.

INTERVENTIONS: Two education sessions were conducted to increase nurse confidence and adherence to accurately assessing patients’ fall risk. Visual reminders were posted in highly visible areas in the units.

RESULTS: The quarterly fall rate decreased from 9.3 to 8 post-implementation. The average nurse confidence increased from 7.8 to 9.1 following the education. Nurse compliance with use of the Morse Fall Score improved from 75% to 90%.

CONCLUSIONS: Implementing an education program was successful at improving compliance to fall risk assessments, obtaining accurate fall scores, decreasing patient falls, and improving nurses’ confidence and attitude towards current fall risk practices.