Tailored Interventions to Reduce Patient Falls

Problem: Medical-surgical Units A and B at a midsize southeastern regional hospital accounted for 28.9% of total facility falls from June to August of 2024. Unit A had a fall rate of 1.77 with 66.7% falls related to toileting, and Unit B had a fall rate of 4.93 with 12.5% toileting falls. Purpose: This quality improvement project aimed to implement a tool, Tailored Interventions for Patient Safety (TIPS) to direct individualized patient care plans for toileting patients with elevated risk for falls according to Morse Fall Scale (MFS). Method: Using the MFS, this quality improvement project assessed patients for high fall risk upon admission or transfer to Medical Units A or B. If deemed high risk, the TIPS tool was utilized to create an individualized toileting plan, and documented in the EMR under the “care hand-off” tab. Laminated copies of the plan were posted in the room, and a verbal report was given to nurses and patient care technicians. Analysis: Data were processed by using Wilcoxon, and ANOVA test statistical analysis. At project conclusion, the fall rate for Unit A decreased to 1.08, with 0% falls related to toileting. By comparison, the overall fall rate for Unit B decreased to 3.71, and the percentage of falls related to toileting increased to 37.5%. Implications: The TIPS fall assessment tool, in combination with the MFS, led to a decrease in fall rates by developing an individualized toileting care plan for high fall risk patients; however, the results did not reach statistical significance.