Develop a story about a patient: you decide the age, sex, past medical history. Once you have a background, you can start developing your prevention program now based on one of your patients/residents (granted if you pick a hospital there could be any age but remember you want to base this on an elderly person. Begin the paper with the place you choose and how it will approach the safety of the organization, then introduce the patient you have and how that person will be safer and how they will be screened in the system. You can then fill in the rest with the program you developed and how it will affect your patient and the rest of the patients in your facility

Please use the attached articles, must be APA style, 4-5 pages excluding title and reference page. PLEASE FOLLOW RUBRIC 

Project Rubric

Falls Prevention program

Levels of

Criteria Points

The name of the program? (maybe include an acronym) 0 to 10

What type of facility? (eg. hospital, nursing home, etc.) 0 to 10

Describe a �ctitious patient that will experience the speci�c intrinsic and
extrinsic risk factors as a geriatric syndrome of falls. (PMH: Make up what you
need to for the report)

0 to 20

Name at least three (3) instruments or evaluations speci�c to the patient. 0 to 10

Give �ctitious results that you believe that you will see with your �ctitious
patient. (with results of instruments or tests)

0 to 10

What will you need to initiate the program? Anything from forms to personnel,
training, specialty items, etc

0 to 10

Risks: intrinsic/extrinsic the factors relevant to this particular situation 0 to 10

How will you institute the program you have developed 0 to 10

APA 7th edition compliant 0 to 10



Rubric Detail

View Associated

January-February 2021 • Vol. 30/No. 128

Susan B. Fowler, PhD, RN, CNRN, FAHA, is Nurse Scientist, Center for Nursing Research,
Orlando Health, Orlando, FL.

Ellen S. Reising, MSN, APRN-CNS, ACCNS-AG, RN-BC, is Clinical Nurse Specialist,
Advanced Practice Nursing & Research, Dr. P. Phillips Hospital – General Surgery Unit,
Orlando, FL.

A Replication Study of Fall TIPS
(Tailoring Interventions for Patient

Safety): A Patient-Centered Fall
Prevention Toolkit

Susan B. Fowler
Ellen S. Reising

he Agency for Healthcare
Research and Quality (AHRQ,
n.d.) defined a fall as a sud-

den, unintended, uncontrolled
down ward displacement of a pa –
tient’s body to the ground or other
object. This includes situations in
which a patient falls while being
assisted by another person but
excludes falls resulting from a pur-
poseful action or violent blow. The
National Quality Forum (2015)
identified five levels of injury from
• None – patient had no injuries

(no signs or symptoms)
• Minor – required application of

a dressing or ice; cleaning of a
wound; limb elevation; topical
medication; pain, bruise, or

• Moderate – needed suturing,
application of surgical tape
strips/skin glue; splinting; mus-
cle/joint strain

• Major – required surgery, cast-
ing, traction; consultation for
neurological (basilar skull frac-
ture, small subdural hematoma)

or internal injury (rib fracture,
small liver laceration); patients
with coagulopathy who receive
blood products

• Death – resulting from injuries
sustained from fall, but not from
physiologic events causing the
Fall risk is assessed on all patients

admitted to most facilities. The
Morse Fall Scale is used widely in
many healthcare settings and
included in some risk models for
inpatient falls (Choi et al., 2018). At
the study institution, this scale is
used for risk assessment on admis-
sion, during the dayshift assessment,
when a change in the patient’s con-
dition occurs, upon transfer to
another unit, and after a fall.

Standard or universal fall preven-
tion identified by the AHRQ (2018)
includes specific interventions,

such as familiarizing the patient
with the environment and having
the patient demonstrate call light
use. The call light is maintained
within the patient’s reach, as are
personal possessions. Sturdy hand –
rails should be present in the bath-
rooms, patient room, and hallway.
The bed is in low position and bed
brakes are locked; the bed can be
raised to a comfortable height when
transferring the patient. Wheelchair
wheel locks also should be used
when the wheelchair is stationary.A
night light or supplemental lighting
is needed. The patient care area
should be uncluttered, with surfaces
kept clean and dry. Staff should fol-
low safe patient handling pr

MILITARY MEDICINE, 185, S2:28, 2020

Implementation of a Multicomponent Fall Prevention Program:
Contracting With Patients for Fall Safety

CPT Arrah L. Bargmann, BSN, RN* ; Maj Stacey M. Brundrett, MSN, RN, AGCNS-BC*

Falls during hospitalizations can increase the length and cost of a hospital stay. Review of patient safety reports on a
26-bed medical-surgical telemetry unit revealed that the number of falls went from 6 in 2015 to 12 in 2016. The reports
identified a knowledge gap in the patient population and nursing staff related to high fall risk interventions. A literature
review suggests that patient-staff safety agreements, in combination with proper implementation of Clinical Practice
Guidelines, can successfully increase education and adherence to fall prevention measures and reduce the number of
inpatient falls.

The objective of this evidence-based practice project was to determine if the implementation of a patient fall safety
agreement in combination with an existing evidence-based fall prevention bundle reduces the number of falls. Based
on the literature review, the unit developed a multicomponent fall prevention program that emphasizes staff and patient
education. The program consists of (1) assessment of the patient’s fall risk using the Johns Hopkins Fall Assessment Tool,
(2) daily patient education on factors contributing to the patient’s fall risk during the shift assessment, (3) an educational
handout on fall risk factors maintained at the bedside, (4) ensuring compliance with implementation of previously existing
fall prevention measures, and (5) a patient fall safety agreement.

During the first 4 months, the fall rate decreased by 55% and staff compliance with interventions for high fall risk
patients increased to 89%. To achieve added compliance, the unit implemented an incentive program, which resulted in
the increased adherence to the fall risk interventions. The unit experienced 87 and 88 consecutive fall-free days, which
was the longest consecutive days since May 2015. This project has reached sustainment and the unit continues to see a
low fall rate, well below the national average for medical-surgical units.

One of the largest obstacles to this project was staff and leadership turnover. However, the project found that patient fall
safety agreements facilitate a dialogue among staff and patients as well as encourage patients to take ownership of their
own care. They improve the safety of patients and create a collaborative environment for nurses to conduct safe, quality
patient care.

Falls during hospitalizations are a safety concern, resulting in
added healthcare costs, increased length of stay, and increased
disability rates to name a few. According to the Agency

*Brooke Army Medical Center, 3551 Roger Brooke Dr, JBSA-Fort Sam
Houston, TX 7


Evaluating the effects of an exercise
program (Staying UpRight) for older adults
in long-term care on rates of falls: study
protocol for a randomised controlled trial
Lynne Taylor1,2* , John Parsons1, Denise Taylor2, Elizabeth Binns2, Sue Lord2, Richard Edlin1, Lynn Rochester3,4,
Silvia Del Din3, Jochen Klenk5,6,7, Christopher Buckley3, Alana Cavadino1, Simon A. Moyes1 and Ngaire Kerse1


Background: Falls are two to four times more frequent amongst older adults living in long-term care (LTC) than
community-dwelling older adults and have deleterious consequences. It is hypothesised that a progressive exercise
program targeting balance and strength will reduce fall rates when compared to a seated exercise program and do
so cost effectively.

Methods/design: This is a single blind, parallel-group, randomised controlled trial with blinded assessment of
outcome and intention-to-treat analysis. LTC residents (age ≥ 65 years) will be recruited from LTC facilities in New
Zealand. Participants (n = 528 total, with a 1:1 allocation ratio) will be randomly assigned to either a novel exercise
program (Staying UpRight), comprising strength and balance exercises designed specifically for LTC and acceptable
to people with dementia (intervention group), or a seated exercise program (control group). The intervention and
control group classes will be delivered for 1 h twice weekly over 1 year. The primary outcome is rate of falls (per
1000 person years) within the intervention period.
Secondary outcomes will be risk of falling (the proportion of fallers per group), fall rate relative to activity exposure,
hospitalisation for fall-related injury, change in gait variability, volume and patterns of ambulatory activity and
change in physical performance assessed at baseline and after 6 and 12 months. Cost-effectiveness will be
examined using intervention and health service costs.
The trial commenced recruitment on 30 November 2018.

Discussion: This study evaluates the efficacy and cost-effectiveness of a progressive strength and balance exercise
program for aged care residents to reduce falls. The outcomes will aid development of evidenced-based exercise
programmes for this vulnerable population.

Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12618001827224. Registered on 9
November 2018. Universal trial number U1111-1217-7148.

Keywords: Falls, Exercise therapy, Randomised trials, Aged care, Long-term care, Nursing home

© The Author(s). 2020 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0
International License (, which permits unrestricted use, distribution, and
reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to
the Creative Commons license,