Utilizing a multidisciplinary team approach to reduce falls in the inpatient psychiatric unit

Falls during hospitalization are a major health care concern (Higaonna, 2014; Shmueli et al., 2014) even more so for inpatient psychiatry (Blair and Waszynski, 2013; Irvin, 1999; Vaughn et al., 1993). The purpose of this quality improvement project was to decrease falls and falls with injury on an adult inpatient psychiatric unit. The project had three key aims: 1) decrease falls and fall-related injuries in a cost-effective manner, 2) enhance communication by embedding the Falls Risk Liaison Nurse (FRLN) within a multidisciplinary team, and 3) increase nursing staff engagement and, promote critical thinking and behaviour. A tool was developed and utilized to capture fall risk-related information. It included the amount of psychotropic medication used in the last 24 hours, vital signs, clinical presentation/complaints, and nursing judgment. The medication profile of these patients was evaluated for appropriate adjustment. At the conclusion of a six-month project, the inpatient psychiatric unit fall rate was reduced from 4.22/1000 patient days to 2.24/1000 patient days. The fall rate with injury was reduced from 0.60/1000 patient days to zero. These results confirm that the multidisciplinary approach was effective in reducing the fall rate and falls with injuries.