STOP-FALLING: A Simple Checklist Tool for Fall Prevention in a Nursing Facility

Falls are highly prevalent and lead to major health morbidity and mortality in older adults. We developed a "STOP-FALLING" checklist as a multifactorial intervention tool kit for a single long-term care facility. The objective of this study was to determine feasibility and adherence of the checklist, and to determine whether STOP-FALLING reduces total number of falls, frequent fallers, and fall-related injuries. This is a quality improvement demonstration project comparing the effect on falls 3 months before and 3 months after introducing a STOP-FALLING checklist. All older adult patients who lived in the long-term care unit of a single facility were included. PTs, geriatricians, and registered nurses participated in the STOP-FALLING initiative. Staff were surveyed on satisfaction by 8-item questionnaires, which were obtained 3 months after checklist implementation. Data on the rate of falls, the number of recurrent fallers, the number of minor injuries, and the number of major injuries 3 months prior and 3 months after the intervention were collected by facility fall log. A total of 32 patients were screened using the STOP-FALLING checklist. Staff survey revealed a high satisfaction rate with ≤15 minutes to complete the checklist. Data at 3 months after initiation of the checklist revealed a reduction in the fall rates (2.80-1.65 falls per person-year), number of frequent fallers (5.00-2.30/mo after), number of falls without injuries (3.00-1.67/mo), number of minor injuries (4.00-2.67/mo), and number of major injuries (0.33-0/mo). We observed excellent staff satisfaction using the STOP-FALLING checklist. Our pilot project suggests that the intervention may decrease fall rates and other fall-related injuries.