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digital.ahrq.gov/ahrq-funded-projects/evaluation-ahrqs-time-pressure-ulcer-program/annual-summary/2010
January 01, 2010 - Lessons learned from the PrU program will also serve to inform the development of an On-Time Fall Prevention … of tools to guide clinical decisionmaking for fall prevention. … prevention tools. … prevention implementation effort using an approach similar to the On-Time PrU prevention, including … The draft fall prevention tools were reviewed with members of the Advisory Panel in September and October
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psnet.ahrq.gov/node/40181/psn-pdf
September 25, 2011 - The cost of serious fall-related injuries at three
midwestern hospitals. … The cost of serious fall-related injuries at three Midwestern
hospitals. … https://psnet.ahrq.gov/issue/cost-serious-fall-related-injuries-three-midwestern-hospitals
In this study … prevention
strategies. … psnet.ahrq.gov/issue/medicare-nonpayment-hospital-falls-and-unintended-consequences
https://psnet.ahrq.gov/issue/fall-prevention-acute-care-hospitals-randomized-trial
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psnet.ahrq.gov/node/44556/psn-pdf
December 23, 2016 - Preventing falls and fall-related injuries in health care
facilities. … https://psnet.ahrq.gov/issue/preventing-falls-and-fall-related-injuries-health-care-facilities
Falls … prevention team, using patient-specific approaches to minimize fall
risk, and conducting a post-fall … https://psnet.ahrq.gov/issue/preventing-falls-and-fall-related-injuries-health-care-facilities
https: … /primer/never-events
https://psnet.ahrq.gov/issue/sentinel-event-alert
https://psnet.ahrq.gov/issue/fall-prevention-acute-care-hospitals-randomized-trial
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psnet.ahrq.gov/node/846157/psn-pdf
March 15, 2023 - Patient perception of fall risk and fall risk screening
scores. … Patient perception of fall risk and fall risk screening scores. … https://psnet.ahrq.gov/issue/patient-perception-fall-risk-and-fall-risk-screening-scores
Falls in inpatient … https://psnet.ahrq.gov/issue/patient-perception-fall-risk-and-fall-risk-screening-scores
https://psnet.ahrq.gov … /primer/falls
https://psnet.ahrq.gov/issue/fall-prevention-acute-care-hospitals-randomized-trial
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digital.ahrq.gov/sites/default/files/docs/publication/action-cp-cds-tool-specifications.pdf
June 16, 2021 - prevention care plans for their assigned patients. … Prevention plan is designed for adult populations)
− Patients in the facility or facilities specified … and the prevention plan was not initiated [“Not Done”] … and has a fall or fall-related injury prevention plan of care initiated … Prevention
Stool Characteristics – GI
Stools Parameter
Seizure Parameter
One or more of the following
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www.ahrq.gov/patient-safety/settings/long-term-care/resource/ontime/fallspx/factraining.html
November 01, 2017 - to the On-Time Falls Prevention Facilitator Training. … Identify resident risk factors that may have caused a fall. … Provide summarized fall data to improve prevention practices, make timely interventions, and identify … Prevention Plan. … The goal is to focus on prevention improvement.
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digital.ahrq.gov/2020-year-review/research-summary/supporting-clinicians-improve-decision-making-and-patients-care-emerging-research
January 01, 2020 - prevention. … This tool will support primary care practices in their fall risk assessment and prevention care plans … Called the Advancing Fall Assessment and Prevention Patient-Centered Outcomes Research Findings into … The tool will identify shareable community-based fall assessment and prevention CDS resources, available … at the point of care, that support interoperable fall prevention CDS logic according to HL7 Clinical
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psnet.ahrq.gov/node/41628/psn-pdf
January 03, 2017 - it-possible-identify-risks-injurious-falls-hospitalized-patients
Despite limited evidence that hospital fall … prevention programs can decrease them, patient falls have been
deemed a preventable complication that … unable to pinpoint variables that identified patients likely to sustain an injury from a
hospital fall … interventions-preventing-falls-acute-and-chronic-care-hospitals-systematic-review-and-meta
https://psnet.ahrq.gov/issue/fall-prevention-acute-care-hospitals-randomized-trial … wisdom-and-justice-not-paying-preventable-complications
https://psnet.ahrq.gov/perspective/implementing-fall-prevention-program
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psnet.ahrq.gov/issue/remote-patient-monitoring-improves-patient-falls-and-reduces-harm
April 16, 2018 - Findings indicate that remote patient monitoring (when combined with standard fall precautions) can reduce … the incidence of falls and fall-related injuries, as well as decrease fall-related expenditures. … August 9, 2023
Assessment of a wearable fall prevention system at a Veterans Health Administration … December 7, 2022
Fall prevention with the Smart Socks System reduces hospital fall rates … March 16, 2022
Inpatient fall prevention: use of in-room Webcams.
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psnet.ahrq.gov/node/840172/psn-pdf
November 16, 2022 - The Stoplight Mobility Alert System for safety and
prevention of falls in children with physical and … The SMAS was developed as an adjunct
to the existing institutional fall prevention bundle and to address … Based on a fall risk assessment and the patient’s locomotion score (walk, wheelchair, crawl), they are … does not require assistance
After admission, all patients are placed on a red mobility alert until a fall … https://psnet.ahrq.gov/innovation/stoplight-mobility-alert-system-safety-and-prevention-falls-children-physical-and
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www.ahrq.gov/patient-safety/settings/long-term-care/resource/ontime/fallspx/highrisk.html
October 01, 2017 - AHRQ’s Safety Program for Nursing Homes: On-Time Falls Prevention
Electronic Reports
On-Time …
Mental: Unsafe Behaviors
Mental: Cognitive Impairment
Gait and Balance Instability
Fall … : 8-30 Days
Fall: 31-180 Days
Psychoactive Medications
Other High-Risk Medications
Resident … Status Change
Behavior:
New Unsafe
New Gait/
Balance
or
Device Order
New Fall
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psnet.ahrq.gov/issue/national-center-patient-safety-falls-toolkit-2004
May 24, 2017 - The toolkit provides information on (1) designing a falls prevention and management program; (2) effective … interventions for high-risk fall patients; (3) implementing hip protectors for high-risk fall patients … ; and (4) educating patients, families, and staff on falls and fall-injury prevention. … April 6, 2011
Incidence, patterns, and prevention of wrong-site surgery. … February 8, 2006
WebM&M Cases
Another Fall
April
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psnet.ahrq.gov/issue/sitters-patient-safety-strategy-reduce-hospital-falls-systematic-review
March 08, 2023 - assessing the effectiveness of bedside “sitters” for agitated patients who appear to be at high fall … In general, the researchers found very-low-certainty evidence that sitters reduce fall risk in acute … All included studies had a least one methodological limitation (such as not defining what consisted a fall … to engage older adults in fall prevention in a nursing home. … January 27, 2021
Fall prevention implementation strategies in use at 60 United States
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psnet.ahrq.gov/node/47402/psn-pdf
March 13, 2019 - medicalsurgical-units-four-hospitals-united-
states
This prospective observational study found that patients who experienced a fall … This study lends weight to fall prevention as a patient safety priority. … medicalsurgical-units-four-hospitals-united-states
https://psnet.ahrq.gov/primer/falls
https://psnet.ahrq.gov/issue/fall-prevention-acute-care-hospitals-randomized-trial
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digital.ahrq.gov/ahrq-funded-projects/evaluation-ahrqs-time-pressure-ulcer-program/annual-summary/2011
January 01, 2011 - Lessons from the PrU program will also inform the development of an On-Time Fall Prevention Module, which … A yearlong process of workgroup meetings has already informed the standardization of fall documentation … and the development of tools to guide clinical decisionmaking for fall prevention. … prevention tools. … (Achieved)
Design the tools and establish the foundation for a fall prevention implementation effort
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psnet.ahrq.gov/issue/preventing-falls-hospitals-toolkit-improving-quality-care
December 24, 2008 - offers information and resources to guide hospitals through process change to implement and sustain fall … prevention efforts. … December 27, 2014
Inpatient fall prevention programs as a patient safety strategy: a
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psnet.ahrq.gov/node/855440/psn-pdf
November 15, 2023 - NPSD Data Spotlight: Patterns of Fall Interventions. … https://psnet.ahrq.gov/issue/npsd-data-spotlight-patterns-fall-interventions
Falls are a frequently … Databases (NPSD) highlights the most common interventions in place among patients who experienced a
fall … https://psnet.ahrq.gov/issue/npsd-data-spotlight-patterns-fall-interventions
https://psnet.ahrq.gov/issue … network-patient-safety-databases
https://psnet.ahrq.gov/issue/network-patient-safety-databases
https://psnet.ahrq.gov/issue/fall-prevention-smart-socks-system-reduces-hospital-fall-rates
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/fallsprev/fallspximpl-ig.pdf
June 02, 2025 - s Safety Program for Nursing Homes: On-Time Falls Prevention 1
On-Time Falls
Prevention:
Implementation … AHRQ’s Safety Program for Nursing Homes: On-Time Falls Prevention 2
On-Time Falls
Prevention:
Implementation … AHRQ’s Safety Program for Nursing Homes: On-Time Falls Prevention 4
On-Time Falls
Prevention:
Implementation … AHRQ’s Safety Program for Nursing Homes: On-Time Falls Prevention 10
On-Time Falls
Prevention: … AHRQ’s Safety Program for Nursing Homes: On-Time Falls Prevention 11
On-Time Falls
Prevention:
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psnet.ahrq.gov/issue/reducing-falls-safety-spotter-program
November 16, 2022 - Patients at high risk for falls can be targeted for personalized prevention interventions, but such … September 23, 2020
A randomized trial of a multifactorial strategy to prevent serious fall … Innovations
Preventing Falls Through Patient and Family Engagement to Create Customized Prevention … March 2, 2016
Fall prevention in hospitals: an integrative review. … March 2, 2012
Falls prevention at Mayo Clinic Rochester: a path to quality care.
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digital.ahrq.gov/ahrq-funded-projects/shareable-interoperable-clinical-decision-support-older-adults-advancing-fall/citation/management
January 01, 2023 - Management of fall risk among older adults in diverse primary care settings. … Management of fall risk among older adults in diverse primary care settings. … Project Name
Shareable, Interoperable Clinical Decision Support for Older Adults: Advancing Fall … Assessment and Prevention Patient-Centered Outcomes Research Findings into Diverse Primary Care Practices