Individualized Fall Prevention Program in an Acute Care Setting: An Evidence-Based Practice Improvement

Lauraine Spano-Szekely, Anne Winkler, Cathy Waters, Susana Dealmeida, Kathy Brandt, Marsha Williamson, Christina Blum, Lori Gasper, Fay Wright

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)127-132
Number of pages6
JournalJournal of Nursing Care Quality
Issue number2
StatePublished - Apr 1 2019


  • clinical practice guideline
  • evidence-based practice improvement
  • fall prevention
  • fall risk assessment
  • video monitoring

ASJC Scopus subject areas

  • General Nursing


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