Advanced Nursing and Your Role in Fall Prevention

Nurse tending to elderly patient in hospital bed
Nurse tending to elderly patient in hospital bed

According to the U.S. Department of Health & Human Services, between 700,000 and 1 million people in the United States fall in the hospital each year. As an aspiring chief nursing officer or clinical nursing educator, learning how to ensure hospital safety operations comply with established standards and regulations should be at the top of your educational to-do list.

Falls are a major concern, as falls can result in fractures, lacerations, internal bleeding and other injuries that can lead to increased healthcare utilization. And, research shows that one-third of falls can be prevented. Nurses play a pivotal role in hospital safety. As a hospital administrator or nurse educator, you are responsible for providing nurses with appropriate information about patient fall risks and established safety standards to prevent falls.


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Chief nursing officers and administrative responsibilities in fall prevention

  • Ensure hospital leadership supports staff in fall reduction initiatives
  • Assess current staff education practices and facilitate integration of new knowledge on fall prevention into existing or new practices
  • Set expectations for all staff – not just nurses – that quality is a shared responsibility
  • Encourage individual ownership and accountability for patient safety and quality
  • Break down silos and approach falls from a team mentality
  • Create a safe culture for reporting errors without blame
  • Hold staff accountable for their individual fall prevention responsibilities
  • Provide ongoing, engaging and meaningful feedback to staff
  • Make sure you have adequate nursing staff when resources are scarce

Nurse educator responsibilities in fall prevention

  • Strengthen curricula to emphasize the concepts and skills needed to participate in fall prevention activities
  • Empower nurses to lead in patient care
  • Help nurses translate fall prevention theory into practice at the bedside
  • Incorporate program/interventions into daily existing workflow
  • Prepare nurses to be more adept at translating their observations of problems at the bedside into an effective improvement effort, and help aspiring nurses understand how to use data to change practice
  • Implement a universal fall precaution practice (see below)
  • Conduct safety rounds
  • Keep the data reports current, including national and state benchmarks

Universal fall precautions for nurses

  • Familiarize the patient with the environment
  • Have the patient demonstrate call light use
  • Maintain call light within reach
  • Keep the patient's personal possessions within patient safe reach
  • Have sturdy handrails in patient bathrooms, rooms and hallways
  • Place the hospital bed in low position when a patient is resting in bed; raise bed to a comfortable height when the patient is transferring out of bed
  • Keep hospital bed brakes locked
  • Keep wheelchair wheel locks in "locked" position when stationary
  • Keep nonslip, comfortable, well-fitting footwear on the patient
  • Use night-lights or supplemental lighting
  • Keep floor surfaces clean and dry, and clean up all spills promptly
  • Keep patient care areas uncluttered
  • Follow safe patient handling practices

Spring Arbor University offers an online master’s-level nursing program for nurses who want to advance into positions of nursing education and nursing administration. Within each of these programs, you will learn to establish and manage hospital safety operations, like fall prevention, in a clinical environment.

What is the Best Fall Prevention Education for Nurses?

The Centers for Medicare and Medicaid Services (CMS) have classified falls resulting in injuries or death as events that should never occur in the health care setting, or “never events.” While this is not a new decision and facilities have been aware of it for years, there is always room for improvement. Quality improvement is a focus for nurses pursuing their Master of Science in Nursing. It is a nurse’s duty to protect their patients from preventable harm. There is plenty of research on the subject of fall prevention in hospitals, and one method in particular has proven to be especially effective.

Intentional Rounding: What is it?

Hourly rounding is a best friend to both nurse and patient. It’s a patient satisfaction and fall prevention program that goes by several other names, including intentional rounding and structured nursing rounds. All terms generally refer to the practice of checking in on patients on a regular, predictable basis to ensure that their needs are met. Nurses, or another staff member, visit each patient to check if there’s anything they need, such as pain medication, meals or a trip to the bathroom. It is an acceptable practice to delegate every other rounding hour to nursing assistants. Nursing assistants also benefit from this practice as it helps anticipate and cluster care.

The value of hourly rounding for fall prevention is well documented. A study published in the Journal of Clinical Nursing reported that a neuroscience ward that implemented hourly rounding had 50 percent fewer patient falls. The benefits of active fall prevention through frequent rounds are worth taking the time to explain to your patients. Some units may consider creating a fall prevention handout to help remind patients that they will be checked on often and to look out for their own safety.

Many falls take place because patients’ needs are not being met, especially toileting needs. Most people highly value their independence and think little of getting out of their chair or bed to use the bathroom or retrieve out of reach belongings. If they are weak, unsteady on their feet or their mental status isn’t normal, simple actions such as these place them at risk for falls.

Benefits of Frequent Rounds

With hourly rounding, patients’ needs are being anticipated before they arise, meaning that they are able to receive assistance walking to the bathroom before the need becomes urgent and they can’t wait. Fall prevention in the elderly is especially important. Patients who are confused or suffering from dementia benefit greatly from frequent, intentional rounds. It can be difficult for these patients to identify and express their needs. Regular assessment of their needs helps prevent falls by minimizing their discomfort. If their pain is under control, their possessions are in reach and their toileting needs have been met, they are less likely to attempt getting up without assistance.

Boost Your Nursing Practice With Higher Education

Health care and nursing are constantly evolving to adapt to the needs of the population, such as elderly fall prevention in an aging population. Evidence-based care and interventions such as intentional rounding are a cornerstone of safe, effective care. Spring Arbor University values an academic-minded approach to nursing care. Our online MSN programs are designed to cultivate compassion, curiosity and an analytic mind in nurses.

Nurses with a desire to grow and expand their practice can enjoy the flexibility of SAU’s online MSN programs. They are designed for working nurses, and most coursework is online. Courses may be taken one at a time for maximum flexibility, allowing you to pursue your dream of higher education without sacrificing your nursing experience or time with family and friends. Your personal student success coach helps guide you along the entire way, from enrollment to graduation with your Master's degree.


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