|Section||Action Steps||Tool That Supports Action||Who Should Use The Tool|
|Overview||Enlist support of senior leaders||Word Version [ - 30.6 KB] ;||Senior manager|
|Section 1||Are you ready for this change?|
|1.1||Assess the culture of safety in your hospital||Tool 1A, Hospital Survey on Patient Safety Culture; Word Version [ - 49.85 KB]||All interdisciplinary team members|
|1.2||Evaluate current organizational attention to falls||Tool 1B, Stakeholder Analysis; Word Version [ - 30.26 KB]||Implementation Team leader|
|1.3||Assess and develop leadership support for the fall prevention program||Implementation Team leader|
|1.5||Identify resources that are available and resources that are needed||Tool 1E, Resource Needs Assessment; Word Version [ - 28.99 KB]||Implementation Team leader|
|1.7||Assess your progress on completing readiness for change activities||Tool 1F, Organizational Readiness Checklist; Word Version [ - 29.55 KB]||Implementation Team leader|
|Section 2||How will you manage change?|
|2.1||Identify your Implementation Team||Tool 2A, Interdisciplinary Team; Word Version [ - 40.94 KB]||Implementation Team leader|
|2.2||Assess the current status of fall prevention activities in your hospital||Implementation Team leader, individuals designated by the Implementation Team leader|
|Determine staff knowledge about fall prevention||Tool 2E, Fall Knowledge Test; Word Version [ - 32.79 KB]||Staff nurses and nursing assistants|
|2.3||Set goals for improvement based on outcomes and processes||Tool 2F, Action Plan; Word Version [ - 34.66 KB]||Implementation Team leader with quality improvement/safety/risk manager|
|2.4||Assess your progress on completing the managing change activities||Tool 2G, Managing Change Checklist; Word Version [ - 29.25 KB]||Implementation Team leader|
|Section 3||Which fall prevention practices do you want to use?|
|3.1||Identify how fall prevention care processes connect to one another||Tool 3A, Master Clinical Pathway for Inpatient Falls; Word Version [ - 61.8 KB]||Quality improvement/safety/risk manager, staff nurses, nursing assistants|
|3.2||Implement universal fall precautions||
Tool 3E, Clinical Pathway for Safe Patient Handling; Word Version [ - 61.22 KB]
|Unit manager, staff nurses, nursing assistants, facility engineer, hospital employee who enters patient rooms|
|3.3||Identify important risk factors for falls in your patients||Staff nurses, pharmacist, nursing assistants|
|3.4||Use identified fall risk factors to implement fall prevention care planning||Tool 3J, Delirium Evaluation Bundle: Digit Span, Short Portable Mental Status Questionnaire, and Confusion Assessment Method;
Tool 3K, Algorithm for Mobilizing Patients; Word Version [ - 96.08 KB]
Tool 3L, Patient and Family Education; Word Version [ - 29.6 KB]
Tool 3M, Sample Care Plan; Word Version [ - 32.47 KB]
|Educators, staff nurses, physicians, nurse practitioners, physician assistants, nursing assistants|
|3.5||Assess and manage patients after a fall||
Tool 3O, Postfall Assessment for Root Cause Analysis; Word Version [ - 43.48 KB]
|Staff nurses and physicians|
|3.8||Assess your progress on completing the best practices activities||Tool 3P, Best Practices Checklist; Word Version [ - 29.23 KB]||Implementation Team Leader|
|Section 4||How do you implement the fall prevention program in your organization?|
|4.1||Assign staff roles and responsibilities for tasks identified in set of best practices||Implementation Team Leader, Unit manager|
|4.3||Assess current staff education practices and facilitate integration of new knowledge on fall prevention into existing or new practices||Tool 4C, Assessing Staff Education and Training; Word Version [ - 30.88 KB]||Implementation Team Leader|
|4.4||Assess your progress on implementing best practices activities||Tool 4D, Implementing Best Practices Checklist; Word Version [ - 29.22 KB]||Implementation Team Leader|
|Section 5||How do you measure fall rates and fall prevention practices?|
|5.1||Collect the right data to learn about falls, fall-related injuries, and their causes||Tool 5A, Information To Include in Incident Reports; Word Version [ - 30.61 KB]||Quality improvement/risk manager, information systems staff|
|5.2||Measure fall prevention practices||Tool 5B, Assessing Fall Prevention Care Processes; Word Version [ - 41.74 KB]||Unit manager and unit champions|
|5.3||Assess your progress on measuring progress activities||Tool 5C, Measuring Progress Checklist; Word Version [ - 29 KB]||Implementation Team Leader|
|Section 6||How do you sustain an effective fall prevention program?|
|6.3||Identify factors need to sustain your fall prevention efforts||Tool 6A, Sustainability Tool; Word Version [ - 32.85 KB]||Implementation Team Leader|
Preventing Falls in Hospitals
Table of Contents
- Preventing Falls in Hospitals
- Appendix: Bibliography of Studies Implementing Fall Prevention Practices
- 7. Tools and Resources
- 6. How do you sustain an effective fall prevention program?
- 5. How do you measure fall rates and fall prevention practices?
- 4. How do you implement the fall prevention program in your organization?
- 3. Which fall prevention practices do you want to use?
- 2. How will you manage change?
- 1. Are you ready for this change?
Internet Citation: Roadmap. Content last reviewed January 2013. Agency for Healthcare Research and Quality, Rockville, MD.