Reducing Patient Falls by Realigning Nursing Hours per Patient Days

Patient falls are the “second leading cause of unintentional injury death” (World Health Organization [WHO] (2018), para. 3) and increase healthcare costs by an estimated $13,806 per fall (Walsh et al., 2018). These fall-related costs translate to a potential savings of approximately $400,374 to the selected organization since the unit chosen for the practice change project experienced 29 falls in the fiscal year 2019 (C. Hernandez, personal communication, September 23, 2019).The PICOT question that guided this project was: In a medical/surgical inpatient population in acute care (P) how does realigning the Nursing Hours per Patient Days (NHPPD) (I) compared to the patient population in medical/surgical units without an adjusted NHPPD (C) affect the fall rate (O) within 60 days (T)? The literature search returned ten studies that matched the inclusion and exclusion criteria, promoting NHPPD to prevent patient falls in inpatient, acute care, medical/surgical hospital settings. The evidence-based intervention was a realignment of the approved and budgeted 9.4 NHPPD. The realignment was completed to increase the direct care nursing hours to meet the patient care demands during the 4-hour intervals with the highest reported falls (Taylor et al., 2015). The rate of falls observed between 1600-2000, the period evaluated, was 0 since no falls were reported during this project’s duration. However, even though the t-test calculation returned a p-value ≤ 0.05, the statistical significance was rejected since the correlation coefficient calculation between NHPPD and falls showed a weak relationship. Since there were no falls reported during the period evaluated, the clinical significance was established and correlated with the literature review evidence.