Improving Fall Rates Among Older Adults in the Long-Term Care Setting: Implementation of an Educational Fall Prevention-Based Toolkit into New Employee Orientation

Falls have traditionally been problematic in long-term care facilities; therefore, it is important to ensure that appropriate methods are implemented to minimize the frequency and severity of falls within these facility types. This quality improvement study aimed to determine if the addition of an educational fall prevention toolkit to new employee orientation (NEO) would support staff’s efforts in decreasing patient falls. The key objectives will be directed toward increasing staff awareness of general and individualized fall risk factors, fall prevention, and management strategies and benefits of understanding how to use assessment tools and documenting appropriately. This project study was a 4-month initiative. Seven participants were recruited from the practice site (one registered nurse and six nursing assistants) to receive the fall prevention training. The participants served as fall advisors on their units for the length of the study and were required to conduct safety huddles with peers and disseminate information that was learned from the fall prevention training. Additionally, a small cohort of four patient’s meeting fall-risk criteria were followed through analyzing the electronic health record and facility falls data to determine trends in fall occurrences. This project study falls in line with Imogene King’s theory of goal attainment and the clinical nurse specialist (CNS) national competencies that focus on empowering patients to participate in their own well-being to improve their quality of care and the nursing professional and patient collaboration in goal setting and problem solving. Data findings showed that the cohort contributed to 45% of the total falls that occurred during the project period and most falls were noted to occur among residents with a dementia or related diagnoses, such as Parkinson’s disease. The survey results revealed that all participants agreed that the toolkit should be added to the NEO process. Although no falls occurred within thirty days of the conclusion of the project, to understand the full effects of the project outcomes, a larger sample of nursing staff would need to participate in the fall prevention training.