Institute for Healthcare Improvement (in collaboration with the Robert Wood Johnson Foundation)
Cambridge, Massachusetts, USA
How to cite this document:
Boushon B, Nielsen G, Quigley P, Rutherford P, Taylor J, Shannon D. Transforming Care at the Bedside How-to Guide: Reducing Patient Injuries from Falls. Cambridge, MA: Institute for Healthcare Improvement; 2008. Available at www.IHI.org.
Launched in 2003, Transforming Care at the Bedside (TCAB) is a national effort of the Robert Wood Johnson Foundation (RWJF) and the Institute for Healthcare Improvement (IHI).
One of the most promising changes that has been developed within TCAB is reducing patient injury from falls on medical and surgical units. While built upon the best known strategies and standard of care for reducing falls among hospitalized patients, this How-to Guide adds a specific approach to the current thinking on fall prevention: the creation of customized interventions to prevent falls and subsequent injuries for the patients who are at most risk for serious injuries from a fall.
This guide can help staff learn to identify the patients at the highest risk for sustaining a serious injury from a fall and implement interventions to prevent or mitigate these injuries. Both physical injury (such as hip fracture) and emotional harm (such as subsequent fear of falling) can occur as a result of a fall. While acknowledging the emotional harm that may result from repeated falls or from falls with no apparent injury, this guide focuses on approaches to reduce physical injury associated with patient falls that occur on inpatient units.
This is How-to Guide is divided into four sections:
- Section One highlights four promising changes designed to reduce serious injuries from falls for hospitalized patients. It also includes references and links to helpful resources.
- Section Two outlines practical step-by-step activities for testing, adapting, and implementing the proposed changes described in Section One.
- Section Three includes case studies with practical, “real-world” examples of medical and surgical units where many of the changes described in this How-to Guide were implemented.
- Section Four includes resources and tools from hospitals engaged in fall prevention work.