Fall Risk Prevention among Hospitalized Adult Patients 4 0 A CRITICAL APPRAISAL

Fall Risk Prevention among Hospitalized Adult Patients 4

0

A CRITICAL APPRAISAL FOR FALL RISK PREVENTION AMONG HOSPITALIZED ADULT PATIENTS

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Table of Contents

Introduction 3

Part 1: Risk Assessment Tool and Quality Improvement Strategy 4

Risk Assessment Tool: WSFRAT 4

Quality Improvement Strategy: PDSA 6

Factors Influencing High-Quality Care Delivery 7

Organizational Culture 7

Staffing and Workload 7

Interprofessional Collaboration 8

Education and Training 8

Part II: Critical Appraisal of Research Evidence 9

Introduction to the Study 9

Staging the Critical Appraisal 9

Study Aims and Design 9

Data Collection and Analysis 10

Sample and Setting 10

Ethical Considerations 11

Results and Implications 11

Conclusion 14

Reference List 15

A Critical Appraisal for Fall Risk Prevention among Hospitalized Adult Patients

Introduction

The incidences of falls remain high in healthcare facilities and involve mostly elderly patient or those with multiple health complications. Falls can lead to a small number of injuries, long-term disablement, or even death which have a direct impact on the patient’s life, and the health care resources. The Newly qualified nurses (NQNs) in adult nursing are aware about the risks of falls for the patients and there is a dire need of prevention strategies. The concepts and ways of delivering healthcare systems are constantly changing, emphasizing evidence-based practice and developing QI initiatives. Hence it is recommended that accurate and valid tools for identifying fall risk be utilized and systematic quality improvement initiatives be undertaken to enhance patient safety and deliver safe, patient-centered care. Another growing scale that has been developed that can be used to screen those patients who are most likely to fall is the Wilson Sims Fall Risk Assessment Tool (WSFRAT). However, the Plan-Do-Study-Act cycle presents a more structured way of implementing and changing fall prevention interventions. The nursing students realize that it is not easy to apply the concepts that they have learnt in real life health care concerning fall prevention. Critical aspects such as organizational culture, staffing, cooperation, and knowledge influence the quality of care. Establishing the best working practices and strategies to prevent falls is paramount to NQNs.

Part 1: Risk Assessment Tool and Quality Improvement Strategy

Risk Assessment Tool: WSFRAT

The WSFRAT has become one of the practical tools in an unceasing struggle against patient falls in the hospital environment. The tool is easy to navigate and easy to complete. According to Woodson (2021), the WSFRAT use of mobility status, previous episodes of fall, age, cognitive impairment, and medications to make the evaluation offers a broad picture of a patient’s risk of falling. Another valuable aspect of the WSFRAT is that it can classify patients into three groups based on their fall risk levels: low, moderate, and high. The stratification helps the healthcare teams describe early intervention activities. For instance, in my unit, patients who have been construed as high-risk based on their WSFRAT scores are subjected to more prolonged and more regular observation issued with extra assistive gadgets. Specifically, the targeted intervention has enhanced the quality of the fall prevention activities by focusing on the seemingly more at-risk clients.

Though the present study has revealed the use of WSFRAT as a helpful instrument, it is crucial to understand that this tool also has its limitations. Certain domains involve observational data set by subjective measures, causing disparities in the nurse’s critique (Kim et al., 2022). NQNs who have yet to develop sound clinical judgment skills sometimes do not know how to rate some risk factors. In such cases, discussing with other people with more experience has been helpful, thereby creating a learning organization and likely receiving better risk appraisals. An in-depth analysis of the peer-reviewed study findings suggests that the WSFRAT has adequate validity and reliability to support its use. In an acute care setting, Kim et al. (2022) validated the tool and discovered evidence of sufficient fall risk measures based on good predictive validity. The research led to the identification of a sensitivity of 0. Recall of identified articles was good at 0.81 and specificity of 0. 75, which shows that the WSFRAT is an efficient tool for identifying patients at a higher risk of falling without flagging many unreal cases. As evidenced by the studies, these results resonate with the NQN clinical practicum, where the tool’s effectiveness in assessing the risk of falls in diverse patient groups has been witnessed.

Advanced tools like the WSFRAT are helpful but should not replace clinical judgments. Morris et al. (2021) reported that these tools may not be more accurate than a nurse’s judgment. The findings are consistent with my paradigm that the problem transcends simple solutions. As Hogans (2023 proposes, using WSFRAT coupled with clinical assessment when attending to elderly patients with a moderate risk for a fall as per WSFRAT r provides critical insights. However, noticing that the patients are confused and can barely walk steadily, adding more measures than the tool advised to prevent falls that could lead to severe consequences is essential. Therefore, the issue of fall prevention requires some level of interprofessional collaboration. Woodson (2021), in an interprofessional fall prevention program, established profound decreases in fall incidences in older adult psychiatric units. The findings resonate with my practice, as sharing the WSFRAT scores during interprofessional rounds and discussions has resulted in an enhanced, broader, and integrated approach to preventing falls, including suggestions from physicians, physical therapists, and pharmacists. Most NQNs remain impressed with fall risk assessment and prevention. The WSFRAT is a helpful framework and yields better results when used with clinical reasoning, teamwork, and patient focus. Every case is a chance to improve the tool’s utilization and understanding of its output within the framework of a patient-centered approach.

Further, the WSFRAT has created a great awareness of fall prevention among our nursing team through discussions on the occurrence of falls. Regularly reviewing challenging cases is critical, as well as discussing how the tool’s scores align with patient outcomes and what additional factors may need consideration. Such discussions enhance understanding of fall risk assessment and the measurement of continuous improvement and patient safety. While the WSFRAT is a powerful tool in our fall prevention arsenal, its effectiveness is maximized with clinical reasoning, interprofessional collaboration, and ongoing education (Blaizes, 2020; Mandela et al., 2021).  As NQNs continue to develop professional skills, it is vital to continue leveraging the strengths of the WSFRAT while remaining mindful of its limitations, always striving to provide the safest, highest-quality care to all patients at risk of falls.

Quality Improvement Strategy: PDSA

The PDSA cycle is a widely used quality improvement methodology in healthcare settings). For fall prevention initiatives, PDSA provides a structured approach to implementing, evaluating, and refining interventions (Basso et al., 2023; Wagner, 2023). The PDSA’s four stages include:

1. Plan: Identify the problem and develop a targeted intervention

2. Do: Implement the intervention on a small scale

3. Study: Analyze data and outcomes

4. Act: Refine the intervention based on findings

PDSA cycles implemented to test new fall prevention initiatives in nursing practice should include hourly rounds or environmental fall checks. The fact that PDSA is cyclical enables the immediate addressing of various concerns, such as the fall, which is helpful (Spano-Szekely et al., 2024). One of the significant advantages of PDSA as a model is the focus on data and rational decision-making. For instance, Woodson (2021) employed the PDSA cycles to integrate and enhance interprofessional fall prevention, which improved and decreased falls in the older adult psychiatric unit. However, a drawback may be that because of the high frequency of completion of PDSA cycles, it may be difficult to find significant changes in the rate of falls, as this can be a rare event (Lopez et al., 2023). NQNs should focus on mastering data analysis and understanding. Therefore, the systematic way the PDSA yields in assessing interventions is promising.

Factors Influencing High-Quality Care Delivery

The following potential factors pinpoint my capacity as an NQN to offer standard, quality, and safe patient care to patients, especially those prone to falls.

Organizational Culture

The safety culture within a healthcare organization is closely related to the approaches toward preventing falls. A safety culture that can be described as positive is an environment in which individuals feel free to report any mistake or near miss, and teamwork thrives. Matters related to safety are kept improving all the time (Thatphet et al., 2021). In my experience as an NQN, I have realized that units with advanced safety culture are more willing to adopt new fall prevention techniques and participate in quality improvement measures. However, changing organizational culture is complex and needs leadership attention and support.

Staffing and Workload

Having adequate staff prevents falls since nurses can conduct proper assessments. Finally, and more crucially, nurses can also apply preventive measures (De Oliveira Silva et al., 2023). High patient-to-nurse ratios can lead to rushed assessments and missed opportunities for intervention. As an NQN, I have experienced the challenges of managing competing priorities during busy shifts, which can impact the quality of fall prevention care. Inadequate staffing also contributes to nurses’ stress and burnout, compromising patient safety.

Interprofessional Collaboration

The intervention in preventing falls involves a multisectoral team practice encompassing the nursing, medical, pharmacological, and physiotherapy sectors. Collaboration between professionals is vital in assessing, identifying, and developing proper preventive measures (Woodson, 2021). As an NQN, I am still building my knowledge of communicating with my co-workers and integrating myself into the team. I have observed that hospitals with effective collaboration, such as interprofessional rounds, can deal with multiple fall risks associated with patients with other related diseases.

Education and Training

Continuing education and professional development are pertinent to clinicians implementing recommended fall prevention interventions. I need to continue further education as an NQN to improve my knowledge and practical training in identifying the risk factors and measures to prevent falls among older adults (Bell, 2020; Ofosuhene, 2021). However, it is always a challenge to set proper time aside and give the staff the necessary training to properly implement new tools or newly developed protocols.

Part II: Critical Appraisal of Research Evidence

Introduction to the Study

Woodson’s (2021) study focuses on an interprofessional fall prevention intervention to decrease falls in an older adult inpatient psychiatric unit. The study is based on the existing and pressing practical problem of fall prevention among geriatric patients in hospitals, including psychiatric facilities, for people with certain inherent risks. The findings of this study can be applied in other healthcare units and other settings.

Staging the Critical Appraisal

Woodson (2021) used a quality improvement framework, which resonates with Basso et al.’s (2023) call for programmatic research in healthcare. The focus on a psychiatric unit ensures that the identified gap by Noh et al. (2021) concerning assessing fall risks beyond typical tools is addressed. The study used the PDSA cycle, a reliable approach, especially to testing interventions, which aligns with the systematic approach proposed by Spano-Szekely et al. (2024). Woodson’s intervention also included a group of specialists, contributing to the understanding of the significance of interprofessional practice addressed by Dabkowski et al. (2022). Such an approach appears particularly relevant in increasing the levels of patient safety and the quality of care.

Study Aims and Design

Woodson’s work proposed the development of an interprofessional fall risk team to promote fall prevention for an older adult inpatient psychiatric unit. The conceptual framework used in this study was a quality improvement project that utilizes PDSA cycles (Woodson, 2021). The approach is compatible with newly implemented clinical interventions. The approach is similar to other successful fall prevention studies, such as Lopez et al. (2023), who also used PDSA cycles to implement a quality improvement program in an academic medical center. In the same context, Spano-Szekely et al. (2024) supported the usefulness of PDSA cycles in the example of the fall prevention program. A vital feature of the PDSA process is its cyclical nature, through which constant changes are made in light of new knowledge, which is crucial in healthcare. Nonetheless, it should be noted that employing a more stringent framework for experimental design, as is the case in some studies, for example (Morris et al., 2021), may restrict the generalization of results.

Data Collection and Analysis

NQNs will find the data collection and analysis approach discussed by Woodson quite interesting but constraining to some extent. Falls were attained before and after the intervention and evaluated by comparing these points’ figures using descriptive statistics. Such data presentation gives helpful trend information regarding the state of affairs after the intervention. Still, it does not enable one to conclude the impact of the intervention firmly. When comparing this to other studies, it is notable that Noh et al. (2021) used a more reliable matched case-control approach to identify fall predictors – thus providing more robust evidence. Likewise, De Freitas Luzia et al. (2020) relied on the Nursing Outcomes Classification to assess outcomes of fall prevention more extensively. Such comparisons helped me think about how the methods for developing improvements in the quality of a project can be driven by strict analytical character. Moreover, NQNs should focus more on learning more complex and practical approaches to enhancing the scientific foundation of our fall prevention interventions.

Sample and Setting

Analyzing Woodson’s work shows how specific the study was — it occurred in just one older adult psychiatric unit. On the one hand, such specificity was beneficial in terms of informed interventions, yet on the other hand, it raised the question of the generalizability of the results (Woodson, 2021). Due to the failure to develop an exact sample size, the audiences are left pondering about the statistical soundness of the outcomes. Other works, such as the Raborn (2024) study carried out in an outpatient adult blood cancer center, present more explicit sample information despite the specificity of the setting. The comparison provides a good lesson in focusing on the accuracy and specifics of the reports in future research work, specifically in quality improvement projects.

Ethical Considerations

Analyzing Woodson’s study raises a critical concern that the ethical approval was not clearly stated, thus making it somewhat difficult for me to determine whether the study complies with the basic standards of ethical practice in healthcare research learned in nursing classes and training. When comparing this to other studies, it is notable that Basso et al. (2023) described their ethical concerns in their systematic review framework. The contrast brought the need for more clarity in ethical research issues. Since NQNs are responsible for operating ethically in practice and research, they should strive to identify transparent, ethical practices in future reviewed studies.

Results and Implications

NQNs reading the results and implications of Woodson’s study find it inspiring and stimulating. The observed decrease in falls from 13- (accounting for 40% of all falls) to 3- (accounting for 16% of all falls) in the older adult unit post-intervention underscores the promise of this intervention (Woodson, 2021). The considerable reduction indicates that the interprofessional fall prevention program enhanced patient safety. Yet, embracing critical appraisal of any research findings raises critical statistical analysis issues, which lowers the range of conclusions that can be made from such an outcome. Drawing from the observations of the case scenario in the hospital, NQNs come to appreciate that fall prevention is not always an easy task, mainly when dealing with older adults suffering from one or more comorbidities. Interprofessional collaboration pinpointed in the study aligns with what happens in practice settings. Most NQNs realize that efficient cooperation between nurses, doctors, physiotherapists, and other medical workers plays a crucial role in patients’ quality of life.

However, NQNs also realize that much care should be taken to generalize these findings to other contexts. Every healthcare environment is different and enlists different patients, and effective interventions in a particular setting are bound to differ slightly from those in another setting. Reviewing Woodson’s (2021) work with similar studies from other scholars also helps NQNs in this process. For instance, Lopez et al. (2023) implemented a quality improvement program to prevent falls in an academic medical center. In the study, the researchers noted a 50% decrease in falls within a 16-month, reinforcing Woodson’s (2021) study. In addition, Lopez et al. offered more formal descriptive analysis, such as p-values and confidence intervals, adding credibility to their conclusions.

Another comparable study is the one by Thatphet et al. (2021). The study under discussion also dealt with fall prevention, but the subject was the emergency departments. Though their environment was quite distinct from that of Woodson’s psychiatric unit, they also stressed the integration of many disciplinary relationships. In the study, Thatphet et al. (2021) supported the call for intervention strategies specific to each care organization’s risks and requirements. The point affirms my earlier warning about generalizing Woodson’s conclusions for practice in other healthcare facilities. The study by Strini et al. (2021) offers a different view on the subject. Following a systematic literature review of the fall risk assessment scales, the authors acknowledged the utility of many fall risk assessment scales; however, they also noted some problems in predicting falls accurately. The need to balance structured assessment tools with clinical reasoning or judgment and interprofessional collaboration seems to be supported by the Woodson (2021) Adly et al. (2020) and Subedi and Subedi Timsina (2022) studies. Among all these studies, De Oliveira Silva et al. (2023) compare the reliability and accuracy of different fall risk assessment tools. According to them, although several standardized tools are helpful, they should be implemented with the individualized risk factor assessment.

The above findings fit well with the interprofessional model discussed in Woodson’s work, where all members of a fall prevention team provide their specialty to achieve an integrated approach. Another important layer to this conversation is the study by Dabkowski et al. (2022), in which the participants were adult inpatients willing to report their perceptions of their fall risk. In that process, the researchers also identified that patient awareness of their fall risk factors is relatively low, a factor necessary for educating patients in prevention initiatives. Such an aspect is not featured in Woodson’s study but can be recommended as a potential feature of interprofessional fall prevention.

Woodson highlights interprofessional collaboration for fall prevention, which is motivating for NQNs. However, the study lacks sufficient assessment techniques. Montgomery et al.’s (2021) framework on quality improvement frameworks helps build on our current approach. Similarly, Heikkilä (2024) adds the aspect of considering the consequences of falls, while Ihemere (2022) also echoed the need to prioritize mobility assessments. Such perspectives significantly improve our protective measures against fall risk in inpatient care settings. The work of Singh (2023) in primary care scenarios has also inspired me to participate in this area. Leading an organization’s quality improvement is inspiring, and leading such efforts in one’s practice is even more fulfilling.

Moreover, it is crucial to accept that Woodson’s study had its drawbacks and echoes the importance of adopting evidence-based practices, as was pointed out by Esguerra (2020). While advancing NQN clinical practice competency and developing an understanding of research, new nursing practitioners shall stay receptive to critical thinking and questioning. Fall prevention’s complexity poses new challenges requiring better ways to address and guarantee quality care and safety to the affected patient population.

Conclusion

NQNs recognize the importance of practical fall risk assessment and prevention strategies in delivering safe, high-quality care to adult patients with complex needs. The WSFRAT and PDSA quality improvement methodology, offer valuable frameworks for addressing this challenge. However, successfully implementing both approaches depends on organizational culture, staffing levels, interprofessional collaboration, and ongoing education. A review of the research evidence article by Woodson reveals that further and purposeful strategies are promising in preventing falls among older adults, raises the consciousness of interprofessional fall prevention programs, and reveals the requirement for the rigorous assessment of interventions. In the future, NQNs should strive to incorporate lifelong learning and quality improvement activities to strengthen fall prevention knowledge and care delivery to meet the patient’s complex care needs.

Reference List

Adly, N.N., Abd-El-Gawad, W.M. and Abou-Hashem, R.M. (2020) Relationship between

malnutrition and different fall risk assessment tools in a geriatric inpatient unit. Aging Clinical and Experimental Research, 32(7), pp. 1279-1287.

https://doi.org/10.1007/s40520-019-01309-0

Blaizes, C.D.F. (2020) Improving Fall Prevention with Patient Education in the Acute Care

Setting. Grand Canyon University. Doctoral Dissertation. https://search.proquest.com/openview/aa019bb659b74dab0d4e13ad18d8e058/1?pq-origsite=gscholar&cbl=51922&diss=y

Bell, T.R. (2020) Process Improvement to Increase Use of a Falls Prevention Patient Education

Video on an Inpatient Cardiac Unit. http://hdl.handle.net/10342/8489

Bouda, P.J. (2022) Preventing Falls Using Evidence-Based Interventions in a Long-Term Care

Facility. University of Missouri-Saint Louis. Doctoral Dissertation. https://search.proquest.com/openview/418fe7d474844816639b3105cc55dd34/1?pq-origsite=gscholar&cbl=18750&diss=y

Basso, I., Gonella, S., Bassi, E., Caristia, S., Campagna, S. and Dal Molin, A. (2023) Quality

improvement interventions to prevent the use of hospital services among nursing home residents: protocol for a systematic review and meta-analysis. BMJ Open, 13(9), p.e074684. https://doi.org/10.1136/bmjopen-2023-074684

Dabkowski, E., Cooper, S., Duncan, J.R., and Missen, K. (2022) May. Adult inpatients’

perceptions of their fall risk: a scoping review. In Healthcare (Vol. 10, No. 6, p. 995). MDPI. https://doi.org/10.3390/healthcare10060995

De Freitas Luzia, M., Vidor, I.D., da Silva, A.C.F.E. and de Fátima Lucena, A. (2020) Fall

prevention in hospitalized patients: evaluation through the nursing outcomes classification/NOC. Applied Nursing Research, 54, p.151273. https://doi.org/10.1016/j.apnr.2020.151273

De Oliveira Silva, S., Barbosa, J.B., Lemos, T., Oliveira, L.A.S. and de Sá Ferreira, A. (2023)

Agreement and predictive performance of fall risk assessment methods and factors associated with falls in hospitalized older adults: A longitudinal study. Geriatric Nursing, 49, pp.109-114.

https://doi.org/10.1016/j.gerinurse.2022.11.016

Esguerra, E. (2020) A patient-centered approach to fall prevention.

https://sigma.nursingrepository.org/items/5373bea7-ed29-425c-9838-ee0ed3bfce48

Grant RN, D. 2023. Purposeful Rounding for Fall Reduction.

https://repository.usfca.edu/capstone/1588

Hogans, V. (2023) A Quality Improvement Project On Evaluating The Effectiveness Of

Implementing a Fall Intervention Checklist during End-Of-Shift Report on a Post-Operative Unit. DNP Capstone Project. http://hdl.handle.net/10755/23017

Heikkilä, A. (2024) Inpatient Falls in Adult Acute Care–Risk Assessment, Risk Factors, And

Consequences. University of Helsinki Open Repository. Ph.D. Thesis. http://hdl.handle.net/10138/575874

Ihemere, N. (2022) Implementation of a Standardized Mobility Assessment: A Quality

Improvement Project to Improve Early Mobilization in Hospitalized Adult Patients. Ohio State University. DNP Project. http://hdl.handle.net/1811/101381

Kim, Y.J., Choi, K.O., Cho, S.H. and Kim, S.J. (2022) Validity of the Morse fall scale and the

Johns Hopkins fall risk assessment tool for fall risk assessment in an acute care setting. Journal of Clinical Nursing, 31(23-24), pp.3584-3594. https://doi.org/10.1111/jocn.16185

Lopez, M., Ma, C., Aavik, L. and Cortes, T.A. (2023) Implementing a quality improvement

program to reduce falls and increase patient medication satisfaction in an academic medical center. Geriatric Nursing, 49, pp.207-211. https://doi.org/10.1016/j.gerinurse.2022.09.002

Montgomery, C.D., Pereira, D.E., Hatcher, J.B., Kilbury, D., Ballance, S., Bradham, T., Duggan,

M.C. and Welch, S.A. (2021) Improving the assessment and documentation of patient mobility using a quality improvement framework. Geriatric Nursing, 42(2), pp.325-330. https://doi.org/10.1016/j.gerinurse.2021.01.002

Morris, M.E., Haines, T., Hill, A.M., Cameron, I.D., Jones, C., Jazayeri, D., Mitra, B., Kiegaldie,

D., Shorr, R.I. and McPhail, S.M. (2021) Divesting from a scored hospital fall risk assessment tool (FRAT): A cluster randomized non‐inferiority trial. Journal of the American Geriatrics Society, 69(9), pp.2598-2604.

https://doi.org/10.1111/jgs.17125

Mandela, M. and Denise Zabriskie, D.N.P. (2021) A Comprehensive Fall Risk Screening

Protocol for Older Adults in Primary Care Setting: A Quality Improvement Project. Touro University. DNP Thesis. https://www.doctorsofnursingpractice.org/wp-content/uploads/project_form/abstract_191021101255.pdf

Masangkay, R. (2021) Purposeful Nurse Hourly Rounding: Plan to Decrease Patient Falls During a Pandemic. School of Nursing and Health Professions. DNP Project. https://repository.usfca.edu/dnp/276

Noh, H.M., Song, H.J., Park, Y.S., Han, J. and Roh, Y.K. (2021) Fall predictors beyond fall risk

assessment tool items for acute hospitalized older adults: a matched case-control study. Scientific Reports, 11(1), p.1503. https://doi.org/10.1038/s41598-021-81034-9

Ofosuhene, A. (2021) Staff Development Project for Fall Prevention in Long-Term

Care. Walden University. Doctoral dissertation, https://search.proquest.com/openview/d2bb546a3a506c6f2771517fac5855d6/1?pq-origsite=gscholar&cbl=18750&diss=y

Raborn, C. (2024) Improving Fall Risk Screening in Oncology Patients: Implementing an

Oncology-Specific Fall Risk Screening Tool in an Outpatient Adult Blood Cancer Center.

University Carolina Digital Repositories. Dissertation.

https://doi.org/10.17615/032x-1208

Strini, V., Schiavolin, R. and Prendin, A. (2021) Fall risk assessment scales: A systematic

literature review. Nursing Reports, 11(2), pp.430-443. https://doi.org/10.3390/nursrep11020041

Subedi, R. and Subedi Timsina, S. (2022) Prevention of Fall in Elderly Living in Long-Term Care Settings. Lab University. Thesis. https://www.theseus.fi/handle/10024/755643

Singh, M. (2023) Implementing a Fall Screen and Prevention Program in the Primary Care

Setting: A Quality Improvement Project. Sacred Heart University. DNP Projects. https://digitalcommons.sacredheart.edu/dnp_projects/54

Spano-Szekely, L.A.U.R.A.I.N.E., Winkler, A., Gasper, L. and Wright, F. (2024) Falls

Project. In: R. Levin and B. Lauder eds. Evidence-Based Practice Improvement: Merging Evidence-Based Practice and Quality Improvement, p.339. https://books.google.com/books?hl=en&lr=&id=CALhEAAAQBAJ&oi=fnd&pg=PA339&dq=Plan,+Do,+Study+and+Act+(PDSA),+as+a+quality+improvement+strategy+for+preventing++fall+risks+hospitalized+adult+patientsts&ots=lgXmxAh6cn&sig=H_jnABYHyl2O5Oa8ecv4Mo1sd7g

Thatphet, P., Kayarian, F.B., Ouchi, K., Hogan, T., Schumacher, J.G., Kennedy, M. and Liu,

S.W. (2021). Lessons learned from emergency department fall assessment and prevention programs. Cureus, 13(7). https://doi.org/10.7759cureus.16526

Woodson, T., 2021. Implementation of an Interprofessional Fall Prevention Program to Reduce

Falls on an Older Adult Inpatient Psychiatric Unit. University of the Incarnate Word. DNP Project. https://athenaeum.uiw.edu/uiw_dnp/98/

Wagner, L. (2023) Implementation of a Fall Prevention Program to Decrease

Falls In A Skilled Nursing Unit. The University of North Carolina at Greensboro. Doctoral Dissertation.

https://libres.uncg.edu/ir/uncg/f/L_Wagner_Paper_2023.pdf