Balancing Mobility & Fall Prevention: Implementation of the Bedside Mobility Assessment Tool, An Evidence-Based Quality Improvement Project

Falling while hospitalized is a significant threat to a patient’s health and carries significant risk to health care organizations in the United States. Regulatory pressure aimed to prevent falls with injury, a reportable healthcare-acquired condition (HAC), leads toward an environment that restricts mobility and places patients at risk for hospital-associated functional decline. Evidence: Mobility assessment can lead to improved risk identification when combined with fall risk assessment tools to accurately identify a patient's risk of falling. The Bedside Mobility Assessment Tool (BMAT) is a validated tool that prescribes mobility interventions based on safe patient handling and movement (SPHM) principles. When implemented, this tool has increased mobility while not increasing the rate of falls. Methods: This DNP scholarly project utilized the Iowa Model for Evidence-Based Practice to develop a pilot of the BMAT on an intermediate care unit in an academic hospital. Project Aim: This aim of this project is to reduce the rate of falls on the intervention unit by five (5) percent by implementing the BMAT, in addition to the Morse Fall Scale, for use by registered nurses. Results: Over the intervention period of BMAT use daily on all patients admitted to the unit, there was not a significant decrease in the fall rate, p-value = 0.903. The comparison period fall rate was 2.31 falls per 1,000 patient days (fall rate), compared to 2.61 for the intervention period. Discussion: The aim of the pilot project, to decrease in the fall rate at or below 2.21, was not met; however, it was adopted well into practice with a 95% electronic health record (EHR) completion rate. Conclusion: The BMAT offers a low-burden mobility assessment to guide SPHM interventions to prevent injury. The focus of SPHM programs should be to remove barriers to equipment availability and to implement measures in the EHR to measure mobility.