Date of Conferral

2023

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Margaret Harvey

Abstract

AbstractThe purpose of this quality improvement (QI) evaluation project was to decrease patient falls on a neurological stroke unit. This unit had the most falls throughout the hospital system. The unit averaged 50-60 falls per year with an average of 4.75 falls per month. Guided by Neumann’s system model, the project targeted those patients at the highest risk for falling related to deficits post-stroke and post-neurological disease process. Staff were informed about Last fall, Express needs, Awareness of safety, and Frequency of bowel and bladder (LEAF) to determine if this tool could decrease falls in the neurological stroke population patients. The LEAF tool was introduced to staff via instructional modules and PowerPoint presentations over an hour interval, along with visual aids on fall prevention at staff meetings and unit-based council meetings. The total number of staff that received instruction on the LEAF tool was N=54. The study was conducted with a chart review sample size of N = 1558. Data were gathered using EPIC electronic health record database. For the study, inclusion criteria from chart reviews included Morse fall risk scale scores greater than 65, and National Institute of Health Stroke Scale (NIHSS) scores greater than 42. Falls decreased by 50% during the 8-week study. The LEAF tool proved beneficial to the family members by providing them with an increased sense of safety and security; nursing staff awareness increased surrounding those at the highest risk of falling; and the patient benefited by being able to have a safe discharge, a decreased length of stay and no further complications during hospitalization. Staff engagement and monitoring of those at risk for falling is vital for the sustainment of fall reduction, a positive social change.

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