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theses

Purpose of Project:
Fall prevention is a long-standing challenge in many areas of healthcare. While millions have been spent to develop techniques to reduce falls for patients on medical units. This is not the case in psychiatric units. There is a severe lack in implementable research-based techniques currently used to reduce falls in psychiatric units, especially at the bedside and in the bathroom. This project implemented research-based tools that are widely used in medical units to test their effectiveness in falls reduction in psychiatric units.

Methodology:
Exit alarms and call bells were provided to patients that were considered high risk according to the psychiatric specific Wilson Sims Fall Scale. The project examined if these tools are helpful to reduce falls. It documented the effects on perceived nursing workload and on improved communication of patient needs to staff. The project was conducted in four phases: Education, Deployment, Survey, and Data analysis. The number of and location of falls during the four months before and after implementation of the intervention were compared, as well as nominal data from the reasons for eligible patients not receiving the intervention. Nominal data from the survey was also analyzed. The study examined open ended log and survey data to identify any patterns in responses.

Results:
Results of falls date showed an overall reduction of falls, but statistical significance could not be established. Falls data showed a reduction of falls in the bedroom and bathroom. Nursing Survey revealed that nurses felt that call bells and exit alarms are helpful to communicate their patients’ needs, helped to prevent patients from falling, and that both exit alarms and call bells more effective in preventing falls than either one intervention individually. Nurse were evenly split on if they felt that using call bells and exit alarms had reduced work load.

Implications for Practice:
Call bells and exit alarms in patients who are high fall risk may be effective tools, Are accepted by nurses, and there is evidence to further study them.The unit had decided to continue their use, but further expanded testing is necessary to substantiate significant results of the falls reduction. After further testing, considerations will be made to spread their use throughout the hospital system. This has the potential to save money on costly falls and reductions in reimbursement, which should also be studied in the future. Further study is needed to provide significant results that support improvements in patient care and safety with fewer falls and potential cost savings for the hospital system.

ETD_10853

DNP

Includes bibliographical references

doi:10.7282/t3-h7ft-q769

ETD doctoral

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