Fall Prevention in a Medical Intermediate Care Unit (MIMU) Through Use of a Collaborative Fall Bundle

PURPOSE This DNP project focused on reducing the fall rate in a medical intermediate care unit by half, from 1.81 falls per 1000 patient days to 0.91 falls per 1000 patient days. BACKGROUND The number of patient falls poses a significant concern in a medical intermediate care unit. The fall rate goal is zero. METHODOLOGY The Collaborative Fall Bundle includes implementing the Fall TIPS Toolkit, an 11 x 17 bedside poster informing patients and staff of their fall risk factors and interventions to counteract; an alarm buddy system pairing two nurses to answer each other's call lights and assist with ambulation-required tasks; and a zoning approach requiring nurses to complete charting at an assigned zone, enabling timely responses to bed alarms. The project was guided by the Plan-Do-Study- Act model. Anonymous electronic surveys evaluated staff opinions of each element. The primary project measure was the fall rate. RESULTS The fall rate decreased from 1.81 to 0.89 falls per 1000 patient days. Surveys revealed non- compliance with certain elements of the bundle such as zoning staff within the unit and the alarm buddy system, while the Fall TIPS toolkit was widely favored. IMPLICATIONS The project duration limited the sample size. While the project yielded positive results, a year-long project may better assess the impact of the Fall TIPS toolkit alone in reducing falls. This project effectively reduced falls by 50%, and with the staff’s satisfaction with the Fall TIPS toolkit, improvements appear sustainable.