Kinder Fall Risk Assessment Tool for Emergency Department Patients to Reduce Falls and Fall Injuries (Spotlight Poster)

There are limited studies regarding falls and fall injuries specific to the emergency department. The emergency department (ED) is a unique environment with a complex/diverse patient population and extrinsic factors that raise the risk of patient falls and fall injuries.

PICOT question: In the adult emergency department (ED) patient population, would utilizing the Kinder fall risk assessment tool (KINDER1), as compared to the current fall risk assessment, lead to a decrease in falls and fall injuries four months post-implementation? The purpose of this project was to assess ED patients for fall risk with KINDER1 to initiate patient-specific multicomponent fall prevention programs (MFPP) to reduce patient falls and fall injuries.

A fall committee was organized that included nursing leadership, ED nurses, and support staff who decided to adopt the KINDER1 at the time of the triage process. This committee used the plan-do-check-act cycle for this quality improvement project to identify and implement patient-specific MFPP for patients with fall risk at the point of ED triage. Education was provided to the nurses and support staff to identify and implement KINDER1. With the correct MFPP in place, patient falls should either be preventable or simply should not occur. It focuses on four simple questions: presented to ED because of falls, age >70, altered mental status, impaired mobility, and nursing judgment. Data on patient fall and fall injury were collected retrospectively before and after the project implementation. After implementing the KINDER1, the compliance rate was monitored by random chart audits and staff compliance with fall risk assessment at the point of ED triage for four months.

The compliance rate increased as staff became more knowledgeable about the new KINDER1. Fall risk identification compliance increased from 73% to 88%. MFPP initiation compliance improved from 57% to 91%. Bed alarm usage compliance rate improved from 10% to 53%. The number of fall/fall injuries rate decreased from 0.15/0.06 in December 2020 to 0.08/0 in April 2021.

The learning objective for this project will be to reduce falls and fall injuries for the complex and diverse patient population in the emergency department, identify the high fall risk and develop patient-specific MFPP and increase interprofessional education compliance to reduce falls and fall injuries.