NURS FPX 8030 Assessment 5 Creation of Policy or Procedure

Name

Capella university

NURS-FPX 8030 Evidence-Based Practice Process for the Nursing Doctoral Learner

Prof. Name

Date

Standard Patient Fall Prevention Bundle Policy to Prevent Patient Falls at Henry Ford Hospital

Purpose

Henry Ford Hospital (HFH) has developed a comprehensive inpatient fall prevention strategy aimed at reducing fall incidents, particularly among elderly patients, to address the critical patient safety issue of inpatient falls. Falls in hospital settings are a major concern as they contribute to increased healthcare costs, extended hospital stays, and deteriorating health outcomes for patients. Approximately 700,000 to 1 million inpatient falls occur in U.S. hospitals annually (Xia et al., 2022).

The incidence of falls ranges from 1 to 9 per 1,000 patient days, while injurious falls occur at a rate of 2.0 per 1,000 patient days in acute care settings. These incidents not only lead to physical harm but also elevate mortality rates and prolong hospitalizations (Heikkilä et al., 2024). Internal data from HFH indicates that around 20% of elderly inpatients are susceptible to fall incidents, resulting in significant injuries (HFH, 2024). A noted issue is the failure of healthcare personnel to consistently assess risk factors and adhere to standardized fall prevention protocols. This shortfall underscores the necessity for a formalized policy that mandates uniform and effective fall prevention practices, particularly in acute care environments.

Recent reviews of fall prevention audits at HFH revealed noncompliance with existing fall prevention procedures and irregular execution of fall risk assessments, reflecting a possible lack of adequate training and awareness among staff. Additionally, many patients remain uninformed about potential fall hazards and environmental risks within the hospital. Research highlights the efficacy of comprehensive fall prevention bundles in reducing inpatient falls. For instance, Bargmann and Brundrett (2020) demonstrated a 55% decline in fall rates and an 89% adherence rate among hospital staff following the implementation of such a program. This evidence was collected through observational studies, data evaluations, and systematic literature reviews with well-defined selection criteria.

NURS FPX 8030 Assessment 5 Creation of Policy or Procedure

The PICO(T) question informing this policy is: “In an acute care unit, would implementing a standardized patient fall prevention bundle, compared to current practices, reduce fall incidences among elderly adults within a 12-week period?” Addressing this issue with a structured, evidence-based policy is essential for closing practice gaps and enhancing patient safety outcomes (Johnson et al., 2020).

Population Affected by the Policy

This intervention primarily targets elderly inpatients receiving care within acute care units at HFH in Detroit, Michigan. The policy is specifically designed for this demographic, excluding pediatric and non-elderly adult patients.

Definitions

Inpatient Fall: An event where a patient unintentionally comes to rest on the ground or a lower level, which may result in injuries within the hospital setting (Strini et al., 2021).

Acute Care Setting: Emergency and intensive care units in hospitals where patients receive immediate and short-term care for critical health conditions, requiring vigilant fall prevention measures.

Intervention: Structured actions, including education, policy application, and environmental adjustments, designed to alter behaviors and reduce patient fall risks (Bargmann & Brundrett, 2020).

Fall Prevention Bundle: A collection of guidelines and preventive strategies aimed at identifying high-risk individuals and implementing measures to lower fall rates. This includes staff training, patient education, environmental adjustments, risk assessments, and assistive device provision (Bargmann & Brundrett, 2020).

Observational Studies: Research methods involving the systematic observation of behaviors or outcomes without manipulating study variables. This method assesses staff adherence to fall prevention protocols (Weston et al., 2021).

PICO(T) Question: A structured framework for formulating clinical research questions, encompassing Population, Intervention, Comparison, Outcome, and Time (Hosseini et al., 2023).

Risk Assessment: The systematic process of identifying, analyzing, and prioritizing potential fall risks based on patient health status, mobility, and environment (Shao et al., 2023).

Assistive Devices: Tools such as wheelchairs, walkers, and safety bars that aid patients in maintaining mobility and preventing falls (Goher & Fadlallah, 2020).

Environmental Modifications: Changes made to physical spaces to enhance safety and accessibility, such as installing motion-sensor lighting and non-slip floors in healthcare settings (Campani et al., 2021).

Policy Statement

To improve patient safety outcomes and mitigate fall-related events, HFH is committed to adopting a comprehensive fall prevention bundle across its hospital, with emphasis on acute care units over a 12-week period. This initiative aims to enforce evidence-based fall prevention protocols, reduce inpatient fall rates by 45%, and elevate the quality of patient care. Through this policy, HFH pledges to create a safer healthcare environment for elderly patients and demonstrate its dedication to patient safety excellence (Schoberer et al., 2022).

Procedure

The inpatient fall prevention initiative will unfold over 12 weeks and will incorporate multiple interventional components:

Phase One (Weeks 1–3): Educational sessions will be provided for patients, nurses, and physicians, focusing on fall hazards, safe use of assistive equipment, and self-care techniques. Staff will receive training in risk assessment practices, including the use of tools such as the Morse Fall Scale (MFS). Pre- and post-training evaluations and surveys will assess knowledge acquisition and protocol adherence (Ji et al., 2023). Training resources will be disseminated both online and through in-person workshops, supported by necessary financial and educational resources.

Phase Two (Weeks 4–6): Comprehensive fall risk assessments will be conducted, identifying variables contributing to fall risks and injuries. Assessments will utilize the MFS alongside real-time data from an Electronic Health Record (EHR)-integrated Fall Risk Management Information System (FRMIS), enabling ongoing monitoring and feedback (Wang et al., 2024). Risk assessments will be routinely conducted at patient admission and throughout their hospital stay, addressing mobility limitations, environmental risks, and patient conditions (Altuhaifa et al., 2023).

Phase Three (Weeks 7–9): Environmental modifications will be introduced through collaboration with hospital leadership. These include zero-step entries, non-slip flooring, shortened hallways, and motion-activated lighting in critical areas (Campani et al., 2021).

Phase Four (Weeks 10–12): Assistive devices such as walkers, wheelchairs, hearing aids, and medication dispensers will be distributed to patients with mobility challenges or disabilities. Grab bars will be installed in hallways and bathrooms for additional support (Goher & Fadlallah, 2020). Continuous auditing of intervention adherence will begin in week one, with fall prevention officials overseeing EHR-linked FRMIS data and direct observation. The patient safety committee will regularly assess fall rates and intervention performance (Albasha et al., 2023).

Throughout the initiative, healthcare personnel will be encouraged to provide feedback via surveys and meetings. The fall prevention committee will review data biweekly to identify patterns, address gaps, and implement necessary improvements (Albasha et al., 2023). Ongoing training will be conducted based on feedback and evolving evidence-based practices. Maintenance teams will ensure optimal environmental safety, including adequate lighting and non-slippery flooring, to sustain long-term fall prevention efforts and promote improved patient safety outcomes.

References

Albasha, N., Ahern, L., O’Mahony, L., McCullagh, R., Cornally, N., McHugh, S., & Timmons, S. (2023). Implementation strategies to support fall prevention interventions in long-term care facilities for older persons: a systematic review. BioMed Central Geriatrics, 23(1), 47. https://doi.org/10.1186/s12877-023-03738-z

NURS FPX 8030 Assessment 5 Creation of Policy or Procedure

Altuhaifa, F., Al Tuhaifa, D., Al Ribh, E., & Al Rebh, E. (2023). Identifying and defining entities associated with fall risk factors events found in fall risk assessment tools. Computer Methods and Programs in Biomedicine Update, 3, 100105. https://doi.org/10.1016/j.cmpbup.2023.100105

Bargmann, A. L., & Brundrett, S. M. (2020). Implementation of a multicomponent fall prevention program: Contracting with patients for fall safety. Military Medicine, 185(Supplement_2), 28-34. https://doi.org/10.1093/milmed/usaa018

Campani, D., et al. (2021). Environmental changes to reduce falls in older adults: A review. Journal of Aging Research, 2021, 1-11. https://doi.org/10.1155/2021/6694049

Goher, K. M., & Fadlallah, S. O. (2020). Assistive devices for fall prevention in older adults. Clinical Interventions in Aging, 15, 1405-1420. https://doi.org/10.2147/CIA.S253645

Heikkilä, K., et al. (2024). Inpatient fall-related injuries and hospital stay length: A nationwide study. International Journal of Nursing Studies, 147, 104532. https://doi.org/10.1016/j.ijnurstu.2024.104532

Hosseini, S., et al. (2023). Application of the PICO(T) framework in nursing research. Nursing Open, 10(3), 1265-1273. https://doi.org/10.1002/nop2.1396

Ji, X., et al. (2023). The impact of fall prevention education on patient outcomes. Journal of Clinical Nursing, 32(13-14), 4042-4052. https://doi.org/10.1111/jocn.16456

Johnson, K., et al. (2020). Strategies for reducing inpatient falls. American Journal of Nursing, 120(1), 24-33. https://doi.org/10.1097/01.NAJ.0000641872.03214.86

Shao, H., et al. (2023). Fall risk assessment methods in clinical practice. BMC Nursing, 22(1), 150. https://doi.org/10.1186/s12912-023-01073-2

NURS FPX 8030 Assessment 5 Creation of Policy or Procedure

Strini, V., et al. (2021). The burden of falls in hospitalized patients: A systematic review. International Journal of Environmental Research and Public Health, 18(14), 7343. https://doi.org/10.3390/ijerph18147343

Wang, Y., et al. (2024). The effectiveness of electronic health records in managing fall prevention programs. Healthcare Informatics Research, 30(1), 67-76. https://doi.org/10.4258/hir.2024.30.1.67

Weston, M. J., et al. (2021). Observational studies in nursing practice. Nursing Research, 70(5), 345-353. https://doi.org/10.1097/NNR.0000000000000501