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  1. Spano-Szekely, Lauraine DNP, RN
  2. Winkler, Anne MA, RN, CCRN
  3. Waters, Cathy MSN, RN, OCN, NEA-BC
  4. Dealmeida, Susana MHA, RN-C
  5. Brandt, Kathy RPh
  6. Williamson, Marsha MSN, RN-BC, ANP-BC, CCRN-K
  7. Blum, Christina BSN, RN
  8. Gasper, Lori BSN, RN
  9. Wright, Fay PhD, RN, APRN-BC


Background: A 245-bed community hospital established patient fall prevention as its patient safety priority.


Problem: The hospital's fall prevention program was not consistently effective. The baseline fall rate was 3.21, higher than the National Database of Nursing Quality Indicators' median of 2.91.


Approach: An interprofessional fall prevention team evaluated the hospital's fall program using the evidence-based practice improvement model. A clinical practice guideline with 7 key practices guided the development of an individualized fall prevention program with interventions to address 4 fall risk categories and an algorithm to identify interventions. Interventions included nurse-driven mobility assessment, purposeful hourly rounding, and video monitoring for confused and impulsive fall-risk patients.


Outcomes: The fall rate decreased to 1.14, with a 72% expense reduction based on decreased sitter usage.


Conclusions: An interprofessional team successfully reduced falls with an evidence-based fall prevention program.