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psnet.ahrq.gov/node/837430/psn-pdf
June 15, 2022 - stop-using-these-adult-bed-rails-warns-consumer-product-safety-commission
Bedrails are used in hospitals and at home to minimize falls … do-split-side-rails-present-increased-risk-patient-safety
https://psnet.ahrq.gov/issue/effect-bedrails-falls-and-injury-systematic-review-clinical-studies
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psnet.ahrq.gov/node/60727/psn-pdf
July 29, 2020 - ten health care systems to evaluate the effectiveness
of a multifactorial intervention to prevent falls … randomized-trial-multifactorial-strategy-prevent-serious-fall-injuries
https://psnet.ahrq.gov/primer/falls
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psnet.ahrq.gov/issue/evidence-guiding-practice-reported-versus-observed-adherence-contact-precautions-pilot-study
June 28, 2017 - June 28, 2017
Is it possible to identify risks for injurious falls in hospitalized patients … November 30, 2022
In-hospital sequelae of injurious falls in 24 medical/surgical units … March 13, 2019
Effects of an intervention to increase bed alarm use to prevent falls … October 19, 2022
Cost of inpatient falls and cost-benefit analysis of implementation
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psnet.ahrq.gov/node/846157/psn-pdf
March 15, 2023 - https://psnet.ahrq.gov/issue/patient-perception-fall-risk-and-fall-risk-screening-scores
Falls in inpatient … psnet.ahrq.gov/issue/patient-perception-fall-risk-and-fall-risk-screening-scores
https://psnet.ahrq.gov/primer/falls
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psnet.ahrq.gov/node/50905/psn-pdf
February 19, 2020 - Tailoring Interventions for Patient Safety) program has been shown to be effective in
preventing inpatient falls … access to the Fall TIPS program are more engaged and feel more
confident in their ability to prevent falls
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psnet.ahrq.gov/node/47597/psn-pdf
August 07, 2019 - The authors explore areas of impact, including patient satisfaction, falls, and hospital-acquired pressure … intentional-rounding-integrative-literature-review
https://psnet.ahrq.gov/primer/nursing-and-patient-safety
https://psnet.ahrq.gov/primer/falls
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digital.ahrq.gov/sites/default/files/docs/citation/u18hs026154-crane-final-report-2023.pdf
January 01, 2023 - about falls in the prior year as well as falls requiring a visit
to the Emergency Department, the Narcan … The falls instrument was 2 items including
number of recent falls and fall severity as defined by requiring … We evaluated whether the falls instrument was identifying PWH who were having recent falls including … number
of falls and whether the falls instrument should be applied strictly based on age criteria or … Comorbidities and symptoms associated with falls from 2020-
2021.
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psnet.ahrq.gov/node/44388/psn-pdf
October 14, 2015 - The study
looked at four nursing-sensitive adverse outcomes: pressure ulcers, falls with injuries, catheter-associated … Rural hospitals had significantly fewer
of these hospital-acquired conditions, except for patient falls … medicares-policy-not-pay-treating-hospital-acquired-conditions-impact
https://psnet.ahrq.gov/issue/preventing-falls-injury
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hcup-us.ahrq.gov/reports/statbriefs/sb156.pdf
March 14, 2013 - United
States.1 More Americans aged 1–44 years die from injuries such
as motor vehicle crashes, falls … ED visits for injury are described based on the
external cause of injury (e.g., falls, transport related … The most
common cause was falls (35.7 percent), followed by being struck by an object (18.3 percent) … Although falls were the most common type of injury that resulted in an ED
visit for all age groups, … The
NEDS includes 11 data elements that identify the cause of the injury: cutting, drowning, falling
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psnet.ahrq.gov/node/838011/psn-pdf
January 01, 2023 - sensors that detect when a patient is trying to stand up – reduced fall rates among patients at risk
of falls … /issue/fall-prevention-smart-socks-system-reduces-hospital-fall-rates
https://psnet.ahrq.gov/primer/falls
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psnet.ahrq.gov/node/844759/psn-pdf
September 18, 2019 - advanced electronic health
records experienced fewer adverse events, mostly notably medication errors, falls … https://psnet.ahrq.gov/primer/medication-errors-and-adverse-drug-events
https://psnet.ahrq.gov/primer/falls
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psnet.ahrq.gov/node/837728/psn-pdf
July 27, 2022 - events, hospital-acquired infections, postoperative adverse events, hospital-acquired pressure ulcers,
falls … national-priorities-and-goals-aligning-our-efforts-transform-americas-healthcare
https://psnet.ahrq.gov/primer/health-care-associated-infections
https://psnet.ahrq.gov/primer/falls
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www.uspreventiveservicestaskforce.org/home/getfilebytoken/6fMLEz4CfAVoj9YBYVbm73
April 17, 2018 - are major risk
factors for incident osteoporotic fractures.1,6 Ten percent to 15%
of falls result in … older
adults at average and increased risk for falls without vitamin D in-
sufficiency or deficiency … The USPSTF found adequate evidence that
vitamin D supplementation does not prevent falls. … risk for falls;
multifactorial interventions may also be effective in some persons as well. … Interventions to
Prevent Falls in Older Adults: A Systematic Review
for the U.S.
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digital.ahrq.gov/ahrq-funded-projects/care-transitions-app-patients-multiple-chronic-conditions
January 01, 2023 - Care transitions are a vulnerable period for patients, leading to post-discharge adverse events, falls … Care Transitions App will incorporate components from the research team’s prior work, specifically falls-reduction … Complications, such as falls or medication errors, could lead to readmissions. … The app will facilitate pre-discharge conversations with providers, provide personalized falls-reduction … The team will study the app’s effectiveness, noting whether its use decreases falls, adverse medication
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psnet.ahrq.gov/issue/learning-mistakes-and-near-mistakes-using-root-cause-analysis-risk-management-tool
June 19, 2024 - Related Resources
Patient Safety Innovations
Preventing Falls … Safety and Quality
April 26, 2023
Root cause analysis of reported patient falls … July 16, 2015
Effects of an intervention to increase bed alarm use to prevent falls in
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qualityindicators.ahrq.gov/Downloads/Resources/Publications/2012/Appendix_1A_Details_of_literature_review.pdf
January 01, 2012 - examining falls among older adults. … • The risk of falling increases as the number of risk factors increases (from 8% with no risk
factors … (Chang and Ganz, 2007)
• Age is a major risk factor for falls (one third of those experiencing falls … Examples of such consequences include
inability to eat, falling, soiling oneself and missing doctor’ … Accidental Injuries Potentially Due to Neglect
“wounds and injuries”[MeSH] OR “accidental injury”[MeSH]
“accidental
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digital.ahrq.gov/ahrq-funded-projects/evaluation-ahrqs-time-pressure-ulcer-program/annual-summary/2010
January 01, 2010 - Target Population: Elderly *
Summary: Pressure ulcers and injurious falls … Substantial research has documented that prevention of pressure ulcers and falls is possible, yet these … home staff to intervene in a timely manner with at-risk residents to reduce the incidence of injurious falls … Standardized set of documentation data elements and definitions
Clinical Reports and Tracking Tools
Falls … Prevention: High Risk Report
Falls Quality Improvement Monitor Reports
The avoidable hospitalization
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psnet.ahrq.gov/issue/revitalizing-established-rapid-response-team
September 23, 2020 - July 5, 2017
Cost of inpatient falls and cost-benefit analysis of implementation of an … November 16, 2022
Evaluation of a patient-centered fall-prevention tool kit to reduce falls … Use of high-fidelity simulation to enhance interdisciplinary collaboration and reduce patient falls
-
psnet.ahrq.gov/node/33823/psn-pdf
January 01, 2017 - is important to recognize conditions that lead to injury, such as a wet floor leading to slips and falls … Slips and falls on wet floor
Planned change to microfiber mop
leaving floor drier than string mop … Attendant cleans &
replaces step stools
Trips &
Falls
Tripping and falling on stools
Step stools … lead
Always have a person at each leg
ready to lift together
Secure electrical
cords
Trips &
Falls … Trips/falls
Explore options (other than blankets)
to cover/secure cords
Check & replace
oxygen tank
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psnet.ahrq.gov/node/48116/psn-pdf
July 17, 2019 - https://psnet.ahrq.gov/primer/medication-errors-and-adverse-drug-events
https://psnet.ahrq.gov/primer/falls … https://psnet.ahrq.gov/primer/falls