Document Type

Dissertation

Degree

Doctor of Nursing Practice

Major

Nursing

Date of Defense

7-9-2020

Graduate Advisor

Natalie Murphy

Committee

Louise Miller

Chandra Alsop

Abstract

Problem: During a three month period in 2018, a rural acute care facility experienced a fall rate of 3.4 falls per 1,000 patient days. The aim of this clinical scholarship project was to implement the Hester Davis Fall Risk Scale (HDFRS) for adult inpatients in a rural acute care facility.

Methods: Utilizing the Find, Organize, Clarify, Understand, Select- Plan, Do, Study, Act (FOCUS-PDSA) model, the HDFRS was implemented and evaluated using a pre and post design to determine its impact on falls per 1,000 patient days and falls with injury per 1,000 patient days. The method of evaluation was a retrospective database review to compare pre implementation fall data from September, October, November 2018 with post implementation fall data from September, October, November 2019.

Results: A two tailed t-test was performed to determine impact; HDFRS did not have a statistically significant impact on falls per 1,000 patient days or falls with injury per 1,000 patient days or change any factors that placed the patients at risk of fall. The cumulative compliance rate of the HDRFS was 99.15% of admissions.

Implications for practice: Fall risk identification is an important first step to a fall reduction program, but alone did not impact inpatient fall rates. This is clinically significant because proper identification and selection of patient risk factor specific interventions allows for personalized fall prevention strategy.

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