Delirium is a potentially modifiable fall risk factor, but few studies address the effects of delirium programs on falls. Beginning in 2011, we implemented a nursing-driven hospitalwide delirium program targeting improvements in risk identification, prevention, detection, and treatment. Over the course of the program, delirium falls decreased from 0.91 to 0.50 per patient day (P = .0002). A decrease in overall falls was also noted (P = .0007).

The Level of Service Inventory—Revised: Screening Version (LSI-R:SV) has proven to validly predict reoffending in general offender populations but has not previously been studied specifically with offenders who have a major mental illness, including those with a dual diagnosis. This research project measures the validity of the LSI-R:SV for use with 208 mentally ill offenders who were released from a secure forensic hospital in Melbourne, Australia. Results indicate that the LSI-R:SV is a good predictor of recidivism among mentally disordered offenders. However, the LSI-R:SV does not reliably predict recidivism in individuals who attracted a dual diagnosis. Further research needs to reevaluate risk factors associated with recidivism in offenders with a dual diagnosis.

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Background Hospital‐acquired pressure injuries (HAPIs) and falls are outcomes sensitive to quality of nursing care. Use of contract (traveler) nurses varies among organizations, but there is little research on the effect of contract nurses on nurse‐sensitive outcomes. Objectives To explore the relationship between use of contract nurses and two key nurse‐sensitive outcomes, HAPIs and falls. Research Design This was a cross‐sectional study of unit‐level nursing, patient, and hospital factors versus HAPIs and falls from a national nursing data consortium from 2015 to 2016. We used cluster analysis to identify similar units, and compared outcomes between clusters. Subjects 605 nursing units in 166 hospitals, 3.2 patients per nurse, and 5.3% contract nurses. Measures Prevalence and incidence of HAPIs and number of falls, adjusted by patient days. Results For both prevalence and incidence of HAPIs, there was a statistically significant difference between the five independent cluster groups (p = .012 and p = .001, respectively). The cluster with the highest percentage of nurse travelers (>7%) had the highest HAPI prevalence (0.84%) and incidence (0.055 per 1,000 patient days) despite higher nurse staffing, compared to HAPI prevalence of 0.32% and incidence of 0.017 per 1,000 patient days in the cluster with the lowest percentage of nurse travelers (<2%). We did not identify a consistent relationship between use of contract nurses and falls. Conclusions Use of contract nurses was associated with higher HAPI prevalence and incidence, independent of staffing levels. Clinical Relevance Our results suggest that institutions should either minimize the use of contract nurses, or engage in extensive training to confirm that contract nurses have understanding of the institutional practices around HAPIs.