Nurse Scientists’ Success: Implementation of Bed-side Fall Injury Attenuation Solutions

Nurses  Across All Levels and Organization will learn:

1. 3 strategies to utilize barriers to practice as solutions for invention and population-based approach to fall injury prevention.
2. 4 organizational priorities to separate fall injury prevention as separate and distinct from fall prevention.
3. 3 patient safety priorities to use of bedside floor mats

Practical takeaways that address:  Nurses know that patients who fall in their care are at risk for injury and injury severity is dependent on the circumstances and characteristics of  falls, intrinsic and extrinsic injury risk factors by patient and population, and implementation on injury reduction interventions.   Yet, within healthcare organizations, fall prevention strategies, still predominately universal fall precautions,  have not prioritized protection from injury when patients fall. Interventions to protect patients from injuries when they fall are separate and distinct from fall prevention strategies, not operationalized as fall injury prevention programs and plans of care.  Evidence exists that injury prevention requires more that low bed position, but impact attenuation to protect patients’ body on impact based on how a patient falls,  height, and padded vs concrete flooring.  When combined, fall  injury severity experienced by patients  is reduced,  preserving function and saving lives.   

Lessons Learned.  For over a decade,  protection from injurious falls has been a national patient safety objective by US Center for Medicare and Medicaide Services,  and now  linked to organization performance and hospital reimbursement.   Injury prevention strategies  exists to  reliability implement  in hospital fall prevention programs to protect our patients from injuries.   The primary impact absorbing intervention solution is floor mats.  However, they are met resistance even though effective evidence exists.  To eliminate resistance,  nurse scientists, devoted to reducing fall-related injuries,  working with engineers,  designed and tested the only impact absorbing floor that was been approved by US Food and Drug Administration for use at patients’ bedside.

Impact. As a result organizational barriers to implementation,  injurious falls are still occurring, and remain the leading sentinel event report to The Joint Commission in 2024.  Fall-related injuries result in preventable harm, extended hospitalization, rehabilitation, and even loss of function and / or life, which requires for nurse leaders to have skills, tools and solutions for sustainable, enculturated fall injury prevention solutions. Two nurse scientists’ career dedication to fall and fall injury prevention committed to use barriers to implementation to create solutions to implementation, relying on prior research as foundation for innovative design, set apart from all other solutions by being first to seek FDA approval, setting the standards for future products.

Outcomes.  Participants will learn nurse scientists’ experience designing and testing an innovative fall injury prevention intervention;  preparing, achieving and sustaining FDA approval,  and organization’s acceptance and adoption;   

Implications.  With the advancement by these nurse scientists,  the first FDA criteria has been established and approved for use of floor mats at patients’ bedside.  Nurses are in the position to ensure the safest patient safety interventions to reduce harm are implemented at the point of care, and will continue to be champions for best practices that should become common practices when barriers to practice are replaced with solutions.

Application to other settings.  All content in this presentation applies to all settings for care from hospital at home to  long-term care.

References.

Bowers, B., Lloyd, J., Lee, W., Powell-Cope, G., & Baptiste, A. (2008). Biomechanical evaluation of injury severity   associated with patient falls from bed. Rehabilitation   Nursing, 33(6), 253–259.

Bulat T, Applegarth S, Wilkinson S, Fitzgerald S, Ahmed S, Quigley P. Effect of multiple impacts on protective properties of hip protectors.  Original research. Clinical Interventions in Aging. 2008;3(3); 1-5.

Fixsen, D., Scott, V., Blase, K., Naoom, S., & Wagar, L. (2011). When evidence is not enough: The challenge of implementing fall prevention strategies. Journal of Safety Research, 42, 419–422.

Ganz, D.A., Huang, C., Saliba, D., Shier, V., Berlowitz, D., Lukas, C.V., .. . Neumann, P. (2013). Preventing falls in hospitals: A toolkit for improving quality of care. Rockville, MD:

Agency for Healthcare Research and Quality. AHRQ Publication  No. 13-0015-EF.

Oliver, D., Healey, F., & Haines, T. (2010). Preventing falls and fall-related injuries in hospitals. Clinics in Geriatric Medicine, 26, 645–692.

Quigley, P. (2015).   Evidence levels:  Applied to select fall and fall injury prevention practices.  Feature Article.  Rehabilitation Nursing,  41(1) 5-15.