Background: Fall rates continue to be a significant problem in health care facilities despite all the research and tool kits created to prevent falls. Hospitals that have successfully reduced fall rates find it challenging to sustain a reduction in the fall rates. During hospitalizations, 3%-20% of patients fall, with 30%-50% resulting in injury (Joint Commission, [JC], 2015).

Internal Evidence: Despite Medical City Alliance (MCA) having an evidence-based fall program, the fall rate has not decreased. Falls are one of the quality measures identified at the division level that needs improvement.

PICOT: In adult patients in a progressive care unit (P), how does a structured fall prevention program (I), compared to no structured fall prevention program (C), affect the rate of falls over three months.

Body of Evidence: Falls are the leading cause of fatal and nonfatal injuries in the older population (CDC, 2017; NQF, 2011). Falls create an economic burden on the healthcare system. Nonfatal injuries cost hospitals $50 billion yearly, and nonfatal injuries cost $754 million annually (Florence et al., 2018).

Implementation: The fall prevention education was updated to adhere to the Division fall policy via a PowerPoint presentation uploaded into HealthStream.

Outcomes/Evaluation: The fall rate post fall prevention education for 2020 in the Progressive Care Unit (PCU) was 3.52 per 1000 bed days.

Impact/Sustainability: Fall prevention education was updated to reflect the current policy. Barriers were identified and in the process of being corrected. Jenny Earls, Assistant Chief Nursing Officer (ACNO), has made plans to repeat education this year and utilize it for new-hire orientation. Connie Linwood, the Medical-Surgical Unit Manager, is responsible for the continuous spread of fall prevention and resources to the fall committee. The fall dashboard will continue to be updated by Nina Alford, Manager of Physical/Occupational (PT/OT) Therapy.

Date of publication

Spring 5-3-2021

Document Type

DNP Scholarly Project



Persistent identifier


Committee members

Cheryl D. Parker, PhD, RN-BC, CNE


Doctor of Nursing Practice