Develop a nursing policy based on a specific patient safety initiative. Include the following:

  • The specific patient safety initiative
  • Purpose of the policy
  • Policy objective – include desired metrics or outcomes
  • Identify roles that will be impacted by the policy
  • Policy statement
  • Policy details – thoroughly describe
  • How often will the policy be revised?
  • Who is responsible for oversight and monitoring? What will be measured to determine effectiveness of the policy?
  • References to support the policy

Document Type/Template

  • Word Document

patient safety initiative

Nursing Policy: Fall Prevention and Patient Safety Policy


Patient Safety Initiative

Reduction of inpatient falls through implementation of a standardized fall prevention program in all inpatient units.


Purpose of the Policy

To minimize the risk of patient falls and associated injuries by establishing standardized protocols for identifying at-risk patients, implementing individualized fall prevention interventions, and educating staff, patients, and families.


Policy Objective

  • Primary Objective: Reduce inpatient falls by 30% within 12 months of implementation.

  • Secondary Outcomes:

    • Achieve 100% completion of fall risk assessments within 2 hours of admission.

    • Achieve 95% compliance with implementation of fall prevention interventions for high-risk patients.

    • Reduce the rate of fall-related injuries by 20% within the first year.


Roles Impacted by the Policy

  • Nursing Staff (RNs, LPNs, CNAs)

  • Nurse Educators

  • Patient Care Technicians

  • Physicians and Advanced Practice Providers

  • Physical and Occupational Therapists

  • Quality Improvement and Risk Management Teams

  • Unit Managers and Charge Nurses


Policy Statement

All patients admitted to the facility will be assessed for fall risk upon admission and at specified intervals. Evidence-based fall prevention strategies must be implemented for all identified at-risk patients. Staff are responsible for adhering to the fall prevention protocol to ensure a safe environment of care.


Policy Details

1. Fall Risk Assessment:

  • Conducted within 2 hours of admission, after any change in condition, transfer, and every 12-hour shift.

  • Use a validated tool such as the Morse Fall Scale or Hendrich II Fall Risk Model.

2. Identification of High-Risk Patients:

  • Patients scoring above the threshold on the fall risk tool will be classified as high risk.

  • Place yellow wristband, fall risk signage, and bed alarms accordingly.

3. Fall Prevention Interventions:

  • Keep bed in low position with brakes locked.

  • Call light within reach and encourage use.

  • Scheduled toileting rounds every 2 hours.

  • Use of non-slip socks and appropriate footwear.

  • Supervised ambulation as needed.

  • Implement hourly rounding to assess “4 Ps” (Pain, Positioning, Potty, Possessions).

4. Education and Communication:

  • Educate patients and families on fall risk and prevention strategies.

  • Interdisciplinary communication during handoff reports must include fall risk status.

5. Post-Fall Protocol:

  • Immediate medical assessment and injury evaluation.

  • Complete fall incident report within 2 hours.

  • Root cause analysis (RCA) for falls with injury.


Policy Review and Revision Frequency

  • This policy will be reviewed annually or sooner if new evidence or data trends suggest a need for change.


Oversight and Monitoring

  • Responsible Parties:

    • Quality and Risk Management Department

    • Nursing Leadership (Unit Managers and Chief Nursing Officer)

    • Fall Prevention Committee

Effectiveness Metrics:

  • Monthly fall rate per 1,000 patient days.

  • Number of falls with injury.

  • Compliance with fall risk assessments and interventions.

  • Staff adherence to documentation and rounding protocols.

Audits and Monitoring:

  • Weekly audits of fall risk documentation.

  • Random checks for intervention compliance.

  • Monthly review of fall data and trends at unit-based safety huddles.


References

  1. The Joint Commission. (2023). National Patient Safety Goals: Hospital Program. https://www.jointcommission.org

  2. Agency for Healthcare Research and Quality (AHRQ). (2022). Preventing Falls in Hospitals: A Toolkit for Improving Quality of Care. https://www.ahrq.gov

  3. Centers for Disease Control and Prevention. (2022). STEADI – Older Adult Fall Prevention. https://www.cdc.gov/steadi

  4. Morse, J.M. (2009). Preventing Patient Falls: Establishing a Fall Intervention Program. Springer Publishing.

  5. American Nurses Association (ANA). (2021). Nursing: Scope and Standards of Practice (4th ed.).

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