Preventing Patient Falls: Establishing a Fall

"This authoritative and practical book outlines the process for developing and maintaining a fall prevention program in health care institutions. Morse presents over two decades of research as well as the highly acclaimed Morse Fall Scale, which has been adopted by the VA Hospital System and numerous hospitals around the United States." "This extensively revised edition serves the dual purpose of providing practical, "how-to" guidelines as well as presenting cutting-edge research on patient falls. The first section on clinical application discusses the complete process of implementing a fall prevention program using the Morse Fall Scale. The research section of the book explains how the scale works, and provides information on evaluating the incidence, frequency, and severity of falls."--BOOK JACKET.

Janice M. Morse is a professor and the Barnes Presidential Endowed Chair at the College of Nursing, University of Utah.

Preface	p. xi
Acknowledgments	p. xv
Preventing Patient Falls	p. 1
Creating a Fall Intervention Program: An Overview	p. 3
The Problem of Patient Falls	p. 6
Identifying Types of Falls	p. 9
Collecting Baseline Data	p. 12
Planning a Fall Intervention Program	p. 13
Institutional Coordination for Fall Prevention	p. 15
Creating a Safe Environment: Preventing Accidental Falls	p. 25
Ensuring a Safe Environment	p. 25
The Walkthrough	p. 26
Structural Features as a Threat to Patient Safety	p. 26
Conducting Equipment Safety Checks	p. 35
Patient Safety Care Practices	p. 37
Monitoring Falls in the Institution	p. 41
Recording Fall Rates	p. 41
The Injury Rate	p. 44
Classifying Injuries	p. 45
Common Errors in Reporting	p. 46
Establishing Baseline Data	p. 47
Institutional Monitoring	p. 48
Predicting Physiological Anticipated Falls	p. 51
Assessing Fall Risk: Patient Assessment	p. 52
The Morse Fall Scale	p. 53
Scoring the Morse Fall Scale	p. 54
Determining Level of Risk	p. 59
Using the MFS	p. 62
Preparing to Implement a Fall Prevention Program	p. 64
The Interdisciplinary Consultation Team	p. 67
Pediatric Falls	p. 68
Intervention: Fall Prevention and Protection	p. 71
Routine Fall Intervention Strategies	p. 71
Unanticipated Physiological Falls	p. 75
Physiological Anticipated Falls	p. 76
Interventions as Prevention Strategies and Protection Strategies	p. 80
Monitoring Individuals Who Fall: Identifying Patterns	p. 85
The Fall	p. 88
Conducting a Fall Assessment	p. 91
Components of a Fall Assessment	p. 91
Evaluating the Effectiveness of the Program	p. 97
How Do You Know If Your Fall Program Is Working?	p. 97
How Do You Know If the Morse Fall Scale (MFS) Is Working In Your Setting?	p. 98
Does the MFS Have Norms?	p. 99
Benchmarking	p. 100
Appendices: Researching Patient Falls	p. 103
Development of the Morse Fall Scale	p. 105
The Establishment of a Database	p. 105
Identifying Significant Variables	p. 106
Obtaining Scale Weights for Each Item	p. 110
Determining the Level of Risk	p. 111
Computer Testing of the Scale	p. 112
Estimation of Reliability	p. 113
Establishment of Validity	p. 113
The Morse Fall Scale: Determining Level of Risk	p. 117
Calculating Risk	p. 118
Valuing the Cost of an Incorrect Decision	p. 120
A Comparison of Methods for Calculating Fall Rates	p. 125
Patient Fall Rates	p. 126
The Number of Patients at Risk	p. 127
The Number of Patients Who Fell	p. 128
The Number of Falls per Bed	p. 128
The Probability of Falling	p. 128
Prospective Testing of the Morse Fall Scale	p. 131
Method	p. 131
Results	p. 132
Discussion	p. 139
Problems in Evaluating Fall Risk Scales	p. 143
Methods of Scale Development	p. 144
Models Used to Evaluate Fall Risk Scales	p. 147
Inappropriate Design Used for Clinical Testing	p. 147
Errors in Evaluation	p. 149
Invalid Design of Clinical Testing	p. 150
Clinical Errors When Using the Scale	p. 152
Discussion: So What? What Is at Risk?	p. 153
Translations of the Morse Fall Scale	p. 157
Danish Version	p. 159
Spanish Version	p. 160
German Version	p. 161
French Version	p. 162
Japanese Version	p. 163
Korean Version	p. 164
Mandarin Version	p. 165
Filipino Version	p. 166
Persian Version	p. 167
Index	p. 169
Table of Contents provided by Ingram. All Rights Reserved.

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Preventing Patient Falls: Establishing a Fall Intervention Program

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