CalNOC Partners to Reduce Patient Falls Project

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The primary aim of the CalNOC Partners for Quality TRIP To Reduce Patient Falls Project, a four-year quality improvement demonstration project, is to use evidence from the reported literature and the California Nursing Outcomes Coalition statewide repository to reduce the incidence of patient falls and severity of fall-related injury in California Hospitals. The proposed project builds on the established infrastructure and capacity of the California Nursing Outcomes Coalition (CalNOC). CalNOC engages California acute care hospitals in voluntarily reporting standardized nurse staffing, patient fail, and fall-related injuries, as well as other quality indicators, in a collaborative repository development and benchmarking project using American Nurses Association's quality indicators. CalNOC, described in pubications that are presented in Appendix A (Donaldson, Brown, Aydin & Burnes Bolton, 2001; Brown, Donaldson, Aydin, & Carlson, 2001), is the largest of the American Nurse's Association (ANA) nursing quality measurement research and development projects and a major contributor of data to the ANA's National Database for Nursing Quality Indicators (NDNQI). The proposed demonstration project expands and advances CaINOC's efforts to use its quality benchmarking infrastructure as a vibrant network to expedite the transfer of evidence-based knowledge into practice as the basis for improving patient care quality and safety. Reducing patient falls in acute care hospitals in California may be viewed as a first step in reducing patient falls nationally. Analysis of the quarters of CalNOC prospective hospital-generated patient falls risk assessment, incidence, and injury data reveals wide variation in fall rates, ranging from less than 1.0 to 13.0+ per 1,000 patient days and nearly 50% of patients with unknown or undocumented risk assessment status. A majority of CalNOC sites (76%) report using "home grown" fall risk assessment tools with unknown predictive validity. We believe these findings may be representative of processes of care nationwide and present a clear professional mandate to reduce patient fails in acute care hospitals by translating evidence-based knowledge of fails risk assessment and the efficacy of fall prevention interventions into nursing practice.