TY  - JOUR
PY  - 2014//
TI  - Shifting the paradigm: an assessment of the quality of fall risk reduction in Nebraska hospitals
JO  - Journal of rural health
A1  - Jones, Katherine J.
A1  - Venema, Dawn M.
A1  - Nailon, Regina
A1  - Skinner, Anne M.
A1  - High, Robin
A1  - Kennel, Victoria
SP  - 135
EP  - 145
VL  - 31
IS  - 2
N2  - PURPOSE: To assess the prevalence of evidence-based fall risk reduction structures and processes in Nebraska hospitals; whether fall rates are associated with specific structures and processes; and whether fall risk reduction structures, processes, and outcomes vary by hospital type-Critical Access Hospital (CAH) versus non-CAH. <br><br>METHODS: A cross-sectional survey of Nebraska's 83 general community hospitals, 78% of which are CAHs. We used a negative binomial rate model to estimate fall rates while adjusting for hospital volume (patient days) and the exact Pearson chi-square test to determine associations between hospital type and the structure and process of fall risk reduction. <br><br>FINDINGS: Approximately two-thirds or more of 70 hospitals used 6 of 9 evidence-based universal fall risk reduction interventions; 50% or more used 14 of 16 evidence-based targeted interventions. After adjusting for hospital volume, hospitals in which teams integrated evidence from multiple disciplines and reflected upon data and modified polices/procedures based upon data had significantly lower total and injurious fall rates per 1,000 patient days than hospitals that did not. Non-CAHs were significantly more likely than CAHs to perform 5 organizational-level fall risk reduction processes. CAHs reported significantly greater total (5.9 vs 4.0) and injurious (1.7 vs 0.9) fall rates per 1,000 patient days than did non-CAHs. <br><br>CONCLUSIONS: Hospital type was a significant predictor of fall rates. However, shifting the paradigm for fall risk reduction from a nursing-centric approach to one in which teams implement evidence-based practices and learn from data may decrease fall risk regardless of hospital type.<p />  <p>Language: en</p>
LA  - en
SN  - 0890-765X
UR  - http://dx.doi.org/10.1111/jrh.12088
ID  - ref1
ER  -