Catching Quality Before It Falls: Preventing Falls and Injuries in the Adult Emergency Department

Area of Science:

• Emergency Medicine
• Patient Safety
• Quality Improvement

Background:

• Hospital falls and injuries pose a significant patient safety concern.
• Research on falls and injuries specifically within emergency departments is limited.
• The emergency department presents unique challenges due to complex patient populations.

Purpose of the Study:

• To identify and implement evidence-based interventions for preventing patient falls and injuries in the emergency department.
• To address the gap in research concerning emergency department falls.

Main Methods:

• Conducted a literature review to identify best practices for fall prevention in emergency departments.
• Performed a retrospective chart review and root cause analysis of fall-related incidents.
• Implemented multifactorial interventions including nursing education, patient handouts, and fall-risk signage.

Main Results:

• Following implementation, zero falls were recorded in April 2017.
• The average number of falls per month from April to December 2017 was 5.2.
• Intervention adherence varied, with fall-risk assessment completion between 47-90% and handout/signage use up to 40-43%.

Conclusions:

• Multifactorial interventions are crucial for identifying and preventing falls and injuries in the emergency department.
• Sustaining changes requires multiple change strategies and strong leadership support.
• Further research is needed on emergency department-specific fall risk assessments and prevention strategies.