Researchers from Samuel Merritt University College of Nursing have published a study in Journal of PeriAnesthesia Nursing about a quality improvement project that examined the degree to which the implementation of a fall risk protocol in an ASC would impact staff nurses’ compliance.
The protocol, which was introduced to a Northern California ASC’s entire staff at an in-person meeting, included “screening for fall risk based on the Morse Fall Scale and measured use of fall prevention practices on a 5-point frequency Likert scale.” Pre-op and post-op nurses were then invited to attend an educational session that included a PowerPoint presentation. The nurses were split into groups, with 21 nurses participating in the presurvey and 22 nurses participating in the postsurvey. The survey included the Agency for Healthcare Research and Quality’s fall knowledge test and fall prevention practices.
The researchers—Jennifer F. Smith, DNP, RN; Mary Wyckoff, PhD, RN; Haesook Kim, PhD, RN; and Sarah Proctor, DNP, RN—found that compliance with fall prevention practices showed “statistically significant improvement after intervention,” with postsurvey nurses generating higher practice scores (95.73/105) compared to the presurvey nurses (81.24/105). Compliance with the protocol screening “revealed strong consistency” as nurses screened 97% of patients “compared to a baseline of zero screening before the protocol.” About a quarter of the adult patients involved “scored high-risk every week,” with 97.75% of those patients receiving targeted interventions. “However,” the authors noted, “there were minimal changes observed in fall knowledge scores.”
They concluded, “The results demonstrated a high rate of staff nurse compliance with screening and implementation of fall prevention practices as part of the fall risk protocol. Nurses’ knowledge about falls slightly improved but did not meet statistical significance. An increase in fall prevention practices demonstrated that the protocol closed the gap between knowledge and practice, helping the nurses identify and communicate patient fall risk status using evidence-based strategies.
“This project demonstrated that implementing a fall risk protocol in an ASC created a bridge between nursing knowledge about falls and utilizing evidence-based fall prevention practices,” the authors continued. “The project implemented a roadmap for other ASCs to follow when investigating pathways to decrease fall risk. The success of this project stems from the fact that the project drew upon best practices for fall prevention in inpatient settings and further added modifications to those practices to fit into ASC [setting.]”
Access the full study here.
