Falls prevention strategies among acute internal medicine unit inpatients in a university hospital: A best-practice implementation project




Poster session 4 Saturday: Evidence implementation and evaluation


Saturday 16 September 2017 - 12:30 to 14:00


All authors in correct order:

Maia F1, Cruz D1, Shimoda G1
1 University of São Paulo, Brazil
Presenting author and contact person

Presenting author:

Gilceria Shimoda

Contact person:

Abstract text
Background: Falls are a challenge for professionals and healthcare services as they may result in high-impact outcomes for patients, such as functional decline, increase in length of hospital stay, increase in the cost of healthcare services, and death. In an attempt to promote safe care, the WHO launched the World Alliance for Patient Safety that encourages the adoption of best practices to reduce adverse events in healthcare services.

Objectives: The main objective of this project was to reduce the incidence and damage from falls that occur in the acute Internal Medicine Unit in a public teaching hospital in São Paulo, Brazil.

Methods: The project used the Joanna Briggs Institute’s Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) audit tool for promoting change in health practice. A baseline audit was conducted measuring eight best-practice recommendations, followed by the implementation of target strategies and follow-up audit.

Results: The results of the baseline audit identified large gaps between current practice and overall performance with best practice. The GRIP results showed that strategies including an education package to patients, families and nursing team, and falls risk assessment with an accurate tool were suitable. The follow-up audit cycle was pleasing to review as all the best-practice audit criteria showed an improvement as an aggregated result. The incidence of falls in Internal Medicine Unit was reduced in the months after project started, however, future audits are required to sustain the improvements.

Conclusions: The project used the audit strategy to translate evidence into practice. Some of the measured criteria improved to moderate-high compliance with best practice. The results showed that implementation of evidence-based practice was possible and led to an improvement of falls prevention. Future audits are required to sustain the improvements.