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Individualized Fall Prevention Program in an Acute Care Setting

Fall Prevention, Sitter Reduction

April 8, 2019

The fall rate decreased to 1.14, with a 72% expense reduction based on decreased sitter usage.

Individualized Fall Prevention Program in an Acute Care Setting: An Evidence-Based Practice Improvement
Spano-Szekely L, Winkler A, Waters C, et al. J Nurs Care Qual. 2019;34(2):127-132.


A hospital’s fall prevention program was not consistently effective. The baseline fall rate was 3.21—higher than the National Database of Nursing Quality Indicators’ median of 2.91. Before the implementation of this evidence-based fall prevention protocol, the fall prevention program at as 245-bed Magnet- and Planetree-designated community hospital located in the Northeast was inconsistent and not effective.


Adding video monitoring. A clinical practice guideline with 7 key practices was used to guide the development of an individualized fall prevention program with interventions to address 4 fall risk categories and an algorithm to identify interventions. Interventions included nurse-driven mobility assessment and purposeful hourly rounding.

Video monitoring was also implemented. Using the video monitor, a safety technician was able to see if patients started to get out of bed and then use the intercom to redirect the patient, thus preventing falls. These “good catches” would not have happened without video monitoring.

With full and consistent implementation of the fall prevention program and the addition of video monitoring, this hospital saw:

  • A 54% reduction in falls from 2.51 falls per 1000 patient days to 1.15 falls per 1000 patient days
  • A 72% reduction in sitter usage, equating to $84,000 in annual savings

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