Abstract
Background: Unintentional falls are a significant threat to the health and safety of nursing home/skilled nursing facility residents. Approximately 75% of residents of nursing homes fall annually, which is more than double the rate of community-dwelling older adults. One in five falls causes serious injury such as broken bones or head injury. Purpose: The purpose of this quality improvement project was to determine the effectiveness of a multi-dimensional fall prevention protocol in reducing falls in a skilled nursing/long-term care facility (the “Facility”) in Southwest Florida. Methods: Based on an in-depth review of the literature, a Multi-Dimensional Fall Prevention (MDFP) Protocol was created and included four interventions with rationales based on best evidence. The MDFP Protocol was implemented in September 2020 as a supplement to the fall prevention interventions that were currently in place on three long-term care floors of the Facility. Aggregated fall data was collected after implementation and compared to aggregated fall data during the same period in 2019. Results: Overall, the number of falls increased 1% from 2019. On the third floor the decrease was 23% and on the fourth floor the decrease was 40%. However, on the second floor, there was a 63% increase in the number of falls which may have skewed the overall number. One possible explanation for this is a change in leadership on that floor. Conclusions: The results of this quality improvement project suggest that a multi-dimensional fall prevention protocol effectively decreases the number of falls in long term care. In addition, effective and consistent leadership may also need to be considered when implementing a new protocol. Keywords: falls, skilled nursing facility, nursing home, older adults, fall prevention, fall reduction, fall protocol, long-term care, multi-dimensional, overnight briefs, overnight awakenings, nurse report, CNA report, anti-hypertensive medications, diuretics, proton pump inhibitors, thyroid medication, PDSA, quality improvement, bedside report, multi-disciplinary...; BSN to DNP