Breaking the fall

: The Helping Hands program is a nurse-directed falls prevention program designed to support a hospital-wide culture of safety and reduce harm from falls.

: Patient falls and the associated morbidity and mortality represent a significant risk for patients and healthcare facilities. Age-adjusted fatalities from falls increased significantly from 1993 to 2003. By 2020, the annual cost of injuries from falls is expected to exceed $40 billion.

: Components of the Helping Hands falls prevention program worked synergistically to support the development of a culture of safety at Robert Wood Johnson University Hospital. The program consisted of nursing assessment of fall risk with the Johns Hopkins Fall Risk Assessment Tool; reviews of fall risk and intervention efficacy; creation of communication mechanisms, reporting processes, and change champion roles; engagement of patients and families in falls prevention; increased public awareness of fall risk through signage; nursing interventions; and utilization of nursing performance improvement analysts.

: Over 3 years, 65% (N = 7,900) of more than 12,000 patients assessed were at risk of falling. Most falls caused no or little harm, and at 3 years of follow-up, total falls decreased by 16.6 %, and severe falls accounted for 0.009 % (n = 2) of all falls.

: The data offer a hopeful perspective on the role of nursing engagement in developing a hospital-wide culture of safety and protecting patients from permanent harm caused by fall events.