Challenges in Defining and Categorizing Falls on Diverse Unit Types

Staggs, Vincent S.; Davidson, Jan; Dunton, Nancy; Crosser, Brandon

doi:10.1097/ncq.0000000000000085

Cited by 40 publications

(21 citation statements)

References 13 publications

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“…These results have implications for fall‐risk‐reduction quality improvement and research. First, coordinating team processes predicted total, injurious, and unassisted fall rates, which are the primary fall‐related outcomes reported in the literature . This finding is consistent with a laboratory simulation, which demonstrated that MTS performance was explained by the extent of inter‐team coordination conducted by the leadership (eg, coordinating) team .…”

Section: Discussionsupporting

confidence: 79%

Evaluating the use of multiteam systems to manage the complexity of inpatient falls in rural hospitals

Jones

Skinner

Venema

et al. 2019

Health Services Research

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Objective To evaluate the implementation and outcomes of evidence‐based fall‐risk‐reduction processes when those processes are implemented using a multiteam system (MTS) structure. Data Sources/Study Setting Fall‐risk‐reduction process and outcome measures from 16 small rural hospitals participating in a research demonstration and dissemination study from August 2012 to July 2014. Previously, these hospitals lacked a fall‐event reporting system to drive improvement. Study Design A one‐group pretest‐posttest embedded in a participatory research framework. We required hospitals to implement MTSs, which we supported by conducting education, developing an online toolkit, and establishing a fall‐event reporting system. Data Collection Hospitals used gap analyses to assess the presence of fall‐risk‐reduction processes at study beginning and their frequency and effectiveness at study end; they reported fall‐event data throughout the study. Principal Findings The extent to which hospitals implemented 21 processes to coordinate the fall‐risk‐reduction program and trained staff specifically about the program predicted unassisted and injurious fall rates during the end‐of‐study period (January 2014‐July 2014). Bedside fall‐risk‐reduction processes were not significant predictors of these outcomes. Conclusions Multiteam systems that effectively coordinate fall‐risk‐reduction processes may improve the capacity of hospitals to manage the complex patient, environmental, and system factors that result in falls.

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Section: Discussionsupporting

confidence: 79%

Evaluating the use of multiteam systems to manage the complexity of inpatient falls in rural hospitals

Jones

Skinner

Venema

et al. 2019

Health Services Research

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“…세계보 건기구(World Health Organization, WHO)는 낙상을 "손상 여부와 관계없이 의도하지 않게 지면이나 바닥 또는 더 낮은 곳으로 몸이 위치하게 되는 것"이라고 정의하였다 [6]. 또 다른 정의는 "낙상이란 손상여부와 상관없이 바닥 에 의도하지 않게 갑작스럽게 떨어지는 것"이다 [7]. (Figure 2).…”

Section: 낙상 정의 및 분류unclassified

Clinical Practice Guideline for Assessment and Prevention of Falls in Adult People

Chun¹,

Kim²,

Kwak³

et al. 2018

Qual Improv Health Care

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Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

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“…Process improvement and education opportunities can then be identified and put into practice, reducing future risks to patients. Hospitals that are members of the National Database of Nursing Quality Indicators (NDNQI) program report unit‐level data, including fall rates, to NDNQI for data analysis (Staggs, Davidson, Dunton, & Crosser, ). Detailed performance reports are then released for benchmarking and tracking unit and hospital performance over time for the numbers of total falls and injurious falls per 1,000 patient‐days (Staggs et al., ).…”

Section: Literature Reviewmentioning

confidence: 99%

Safety Standards: Implementing Fall Prevention Interventions and Sustaining Lower Fall Rates by Promoting the Culture of Safety on an Inpatient Rehabilitation Unit

Leone

Adams

2016

Rehabilitation Nursing

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Purpose: The purpose of this article is to review a quality improvement project aimed to examine how nurse leaders in an inpatient rehabilitation (IPR) unit can reduce the number of patient falls by implementing multiple fall prevention interventions and sustain their results by promoting a strong culture of safety on the unit. Design and Methods: A retrospective review of IPR fall rates was performed. Quarterly fall rates were then compared with implementation dates of fall prevention interventions (safety huddles, signage, and hourly rounding). Culture of safety scores were also examined to assess the effect of an enhanced culture of safety on the sustainability of lowered fall rates. Findings: The largest decrease in fall rate was noted after initial revitalization efforts of the IPR unit's culture of safety concurrently with hourly rounding. Conclusions: Fall rates rise and fall despite multiple fall prevention interventions and encouraging a positive shift in the culture of safety. Clinical Relevance: Physical injuries following a fall can reduce mobility and increase morbidity. Costs associated with falls negatively impact costs and reimbursement. Employing evidence-based fall prevention strategies are then of critical importance to nurse leaders as falls remain an ongoing serious adverse event.

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Challenges in Defining and Categorizing Falls on Diverse Unit Types

Cited by 40 publications

References 13 publications

Evaluating the use of multiteam systems to manage the complexity of inpatient falls in rural hospitals

Evaluating the use of multiteam systems to manage the complexity of inpatient falls in rural hospitals

Clinical Practice Guideline for Assessment and Prevention of Falls in Adult People

Safety Standards: Implementing Fall Prevention Interventions and Sustaining Lower Fall Rates by Promoting the Culture of Safety on an Inpatient Rehabilitation Unit

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