1. Ferguson, Debbie MSN, RN, CCRN, CNRN
  2. Grandstaff, Marcy MSN, RN, CRRN

Article Content

Problem and Significance

During the years 2002-2003, our 3-hospital system documented 1136 inpatient falls. Several of these falls lead to root-cause analyses, identifying many areas for improvement in our prior fall assessment.



The purpose of this project was to develop and implement an evidence-based, interdisciplinary fall program throughout a 4-hospital network.


Description of Program

After an extensive literature search and consultation with experts in the area of fall prevention, a multidisciplinary team was formulated. The team developed a comprehensive program targeted to (1) increase fall risk awareness across all disciplines, (2) develop guidelines for care for patients at risk for falls, (3) introduce and educate new fall risk assessment processes and scale (Morse Fall scale was selected for a high degree of reliability and validity across many patient populations) with fall risk assessment starting in the ED, and (5) initiate multidisciplinary fall prevention interventions (nursing orders).



The network-wide educational program, launched in March 2004, consisted of 2 posters: one for general fall risk awareness, and the second for Morse Scale fall risk assessment. Subsequent educational packets were provided to unit-based leaders along with ongoing updates from our computer documentation teams, clinical news services flyers for general questions, and updates at hospital-based practice council meetings.



Ongoing evaluation is currently being done by the unit-based leaders for accuracy of assessment, initiation of interventions, utilization of guidelines of care, feedback from other disciplines (pharmacy, physical therapy, nutritional support). The long-term outcome goal is to decrease all inpatient falls by 5% in 2004.


Conclusion/Implication for Nursing

The Galaxy Project has significantly shifted paradigms about this aspect of patient safety in all departments. Nursing now has a program that incorporates all aspects of the nursing process.


Section Description

This year's annual NACNS conference is planned for Orlando, Fla, March 9-12, 2005. Over 300 clinical nurse specialists (CNSs) are expected to attend, and as with past conferences, attendees will also include graduate faculty from CNS programs, nurse administrators, and nurse researchers. The theme of the conference, CNS Leadership: Navigating the Healthcare Environment Toward Excellence, was selected to showcase the many ways CNSs acquire and disseminate knowledge and innovative practices in their specialty areas. Two preconference sessions are scheduled. One session, sponsored by NACNS Legislative/Regulatory Committee, targets information for CNSs interested in understanding the legislative/regulatory process as it deals with the practice of nursing, and will also help build skills CNSs need to engage in the process. The second session, sponsored by NACNS Education Committee, focuses on CNS education issues, and as with the education preconferences of past years, anticipates informative dialogue and much sharing among CNS educators around curriculum design, teaching strategies, and indicators of quality in the curriculum that link to the NACNS education standards to program review and excellence. The conference planning committee is proud and pleased to have Jeanette Ives Erickson, MS, RN, CNA, Senior Vice President for Patient Care Services and Chief Nurse Executive of Massachusetts General Hospital as the opening keynote speaker. She will begin the conference by highlighting the importance of CNS practice on patient safety. The planning committee is equally proud and pleased to have NACNS past-president Rhonda Scott, PhD, RN, Chief Nursing Officer of Grady Health System as the closing speaker. Dr Scott will challenge attendees to use the information from the conference to shape quality care delivered in a safe environment and to advance the profession of nursing through direct care to clients, influencing standards of care delivered by other nurses, and influencing the healthcare delivery system to be to support innovative, cost-effective, quality nursing care. A total of 64 abstracts for podium and poster presentations were selected in addition to graduate student posters. The abstracts address the 3 spheres of CNS practice with a strong emphasis on clinical practice improvements. As you will note from the abstracts published in this issue of the journal, specialty practice areas represented in the abstracts include children, adults, and gerontological patient groups; hospital, outpatient, and home care settings, and community health. In addition, a wide variety of specialty topics including smoking cessation programs, end-of-life care issues, and protocols outlining nursing approaches to improved diabetes, cardiovascular and ventilator management. A number of the abstracts described hospital and healthcare system level innovations that resulted from CNS practice. Collectively, these abstracts reflect the breadth, depth, and richness of CNS contributions to the well-being of individuals, families, groups, and communities. The following abstracts are from those presenters who elected to have their work published in the journal so those who are unable to attend this year's conference can share in the knowledge of the conference. As you read each abstract, consider the talent and clinical scholarship of your CNS colleagues who are advancing the practice of nursing and contributing to improved outcomes for patients and healthcare organizations. You may want to contact individual presenters to network, collaborate, consult, or share your own ideas about these topics. Watch for next year's call for abstracts and consider submitting an abstract for presentation at NACNS's next conference in Salt Lake City, Utah, March 15-18, 2006.