Example_of_Evidenced_Based_Project

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					                                            RN Education on the Morse Fall Scale
                                                             Jacqueline Williams, RN; BSN, MM/HRM, MSN(c)



               Problem Statement                                    Practice Innovation                                                                          Evaluation Method                                Conclusions
Inpatient falls continue to be a major problem and account for     Setting: Community hospital                                                                                                        Evidence based education on the
                                                                                                                                                                  Design: A quantitative,
 up to 70% of accidents in the inpatient setting.                   in southern California with 700                                                                                                     Morse Fall Scale increased RN
                                                                                                                                                                  evidence based 15 item pre
                                                                    acute care beds.                                                                                                                    knowledge and scoring accuracy.
Falls result in increased lengths of stay, increased costs,                                                                                                      and posttest questionnaire
 poor quality of life, early admission to long term care            Target Participants: A                                                                       design.
 facilities, and serious emotional and physical injuries.           convenience sample of 44 staff                                                                Retrospective chart audits
                                                                    RNs on 3 acute care floors.                                                                   were also utilized pre and post
In 2005, inadequate patient assessment was identified as the       Final sample of 27 RNs.                                                                       intervention to measure                     Implications for
 root cause in >70% of patient falls in the inpatient setting.
Changes in regulations regarding reimbursement for hospital
                                                                    Intervention: 10 minute                                                                      changes in scoring accuracy.                Clinical Practice
                                                                    evidence based educational                                                                    Analysis: Descriptive
 acquired conditions such as fall related injuries means                                                                                                                                                Regular education on fall risk
                                                                    inservice on the MFS to                                                                       statistics were used to measure
 increased costs for organizations.                                                                                                                                                                     assessment tools used by staff RNs is
                                                                    increase RN knowledge and                                                                     for changes in knowledge and
PICO Question: Does providing evidence based (EB)                  accuracy in scoring of the MFS.                                                               scoring accuracy.                     needed to reinforce knowledge and
 education on the Morse Fall Scale (MFS) to RNs in acute                                                                                                                                                increase scoring accuracy.
 care settings increase knowledge and accuracy in scoring of                                                                                                                                            Accurate fall risk assessment leads to
 the Morse Fall Scale?                                                                                                                                                                                  earlier identification of at risk patients.
                                                                                                                                             Results                                                    When accurate fall risk assessment is
                                                                                                                                                                                                        linked with the appropriate interventions,
                                                                                                                                                                                                        many falls can be prevented in at risk
                                                                                                                                             Knowledge
                         Evidence                                                                                                             (n = 27)                                                  populations.
                                                                                                                                                                                                        Recommendations:
Accurate fall risk assessment is the first step in fall                                          100                                            88
                                                                                                                                                          92.5
                                                                                                                                                                 85.1                                   Provide MFS education during nursing
                                                                            % of correct scores




 prevention.                                                                                                74

                                                                                                                              62.9

                                                                                                                                                                                     Secondary Dx
                                                                                                                                                                                                        and/or unit orientations, annually, and
                                                                                                   50
                                                                                                                 44.4




78% of all falls are anticipated physiological falls and are
                                                                                                                                                                                     Mental Status      when practice problems are identified.
                                                                                                                                                                                     Impaired Gait

 therefore preventable.                                                                             0                                                                                                   Conduct monthly chart audits and
                                                                                                        Pretest                                Posttest                                                 tracers to monitor practice.
The MFS is a reliable & valid tool which can identify 80% of
 patients likely to fall when used correctly.
National Patient Safety Goal 9 requires the implementation                                                                 Scoring Accuracy
 of a fall reduction program to include staff education on                                                                Chart Reviews (N = 49)
 patient fall risks, risk reduction strategies, and interventions                                   40
 to reduce patient fall risks.
                                                                       discrepancies




                                                                                                                               30 6
                                                                                                                                 .                                                  Secondary D x
                                                                                                    30
                                                                                                                                                                                    Mental Status
                                                                                                                                                                                                                  QuickTime™ an d a
                                                                            % of




                                                                                                    20                                                                                                               decompres sor
Knowles Adult Learning Theory asserts that adult learners                                                             12 2
                                                                                                                         .              .
                                                                                                                                      12 2
                                                                                                                                                                                    Impaired Gait
                                                                                                                                                                                                           ar e need ed to s ee this p icture .
                                                                                                    10           8.1                                             8.1
                                                                                                                                                                                    H istory of Falls
 are autonomous and self-directed. Therefore, educational                                                                                             4                 4



                                                                                                        0
                                                                                                                                                            0




 programs need to be relevant, goal-oriented, practical, and                                                           Pre                            Post
 draw on the participant’s life experiences and knowledge.
                                                                     Acknowledgement and thanks to Rhonda Amber, RN; MSN, CNS

				
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posted:9/23/2011
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