How to Reduce fall rates in post-operative patients Capstone proposal

How to Reduce fall rates in post-operative patients Capstone proposal

Capstone proposal on how to reduce fall rates in post-operative patients on the surgical unit

The proposed problem description for your EBP project, should address the following:
My capstone proposal


How to reduce fall rates for post-operative patients in the surgical unit
1)Describe the background of the problem. Tell the story of the issue and why it deserves attention.
2)Identify the stakeholders/change agents. Who, or what organizations, are concerned, may benefit from, or are affected by this proposal. List the interested parties, patients, students, agencies, Joint Commission, etc
3) State the purpose and project objectives in specific, realistic, and measurable terms. The objective should address what is to be gained. This is a restatement of the question, providing focus. Measurements need to be taken before and after the evidence‐based practice is introduced to identify the expected changes.
4) Provide supportive rationale that the problem or issue is an important one for nursing to resolve using relevant professional literature sources.
5)Develop an initial reference list to assure that there is adequate literature to support your evidence‐based practice project. Follow the ”Steps to an Efficient Search to Answer a Clinical Question” box in chapter 3 of the textbook. Use ”NUR‐699 Search Method Example” to assist you.
6) The majority of references should be research articles. However, national sources such as Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Department of Health and Human Resources (HHS), or the Agency for Healthcare Research and Quality (AHRQ) and others may be used when you are gathering statistics to provide the rationale for the problem. How to Reduce fall rates in post-operative patients Capstone proposal


Capstone Proposal




Capstone Proposal on how to Reduce Fall Rates in Post-Operative Patients on the Surgical Unit

Background of the Problem

Falls and their ensuing injuries significantly impact the physical, social and mental health of patients within a healthcare organization (Wildes et al, 2015). The length of the hospital stay of patients who sustain fall can extend for almost 13 days, and the incidence of such events can increase healthcare costs by about 61 percent (Mata et al, 2017). According to Luzia et al (2014) falls of hospitalized patients can lead to fracture or trauma that cause a reduction in activities of daily living. Sometimes the falls can be fatal. Accordingly, fall prevention is an important element of nursing care during patients’ hospital stay.

Patients are not normally familiar with the hospital environment and this increases the risk of falls. The arrangement of wards differs since light switches are located at different locations, and so are other facilities such as bathroom and the toilet; this can confuse post-operative patients and increase the risk of such patients falling and sustaining injuries (Vitor et al, 2015).

Surgical recovery is the time in which patients strive to regain their independence and as a result, achieve their return to activities of daily living. However, the surgical procedure increases the risk of fall for post-operative patients due to the weak physical state associated with the illness, and the subsequent surgery (Shida et al, 2015). Therefore, post-operative patients are weaker and can sustain falls afterward.

Therefore, there indicates the need to implement strategies to reduce fall rates for post-operative patients in the surgical unit.

The Stakeholders/Change Agents

  • Registered nurses
  • Unit manager
  • Physicians
  • Orthopedic specialists
  • Nurse champions
  • Pharmacy representative
  • Risk management department
  • Patients
  • American Nurses Association
  • National Database of Nursing Quality Indicators (ANA–NDNQI)

The Purpose and Project Objectives

The specific aim of the proposed project is to attain a 50% decrease of the overall fall incidents per 1000 patient days in the surgical unit and to lengthen days between falls to an average of 30 days within six months. The objective of the program is thus to establish a culture of safety in the surgical unity by decreasing fall events within the unit. Fall events among post-operative patients can lead to patient injury, patient mortality, reduce the functional mobility of the patient, increase the hospital length of stay, as well as raise the healthcare cost (Kobayashi et al, 2018).

The proposed project also aims to prevent patient harm and injury that results from fall incidents using a sustainable fall prevention program. In addition, the proposed project aims to engage the organizational staff members to drive a culture of safety through improved communication and also identify lessons from each fall incident. Finally, the project aims to decrease the cost for fall with injury as well as lower exposure to lawsuits, and improve the unit’s and hospital’s public image (Everhart et al, 2014). Basically, the proposed project can significantly impact the safety and quality of care in the surgical unit and the hospital at large. How to Reduce fall rates in post-operative patients Capstone proposal

The proposed model to guide the surgical unit in reducing the fall rate is the Kotter change model. The model will help in identifying the driving and restraining forces during the fall reduction process. Using the Kotter change model, the hospital leadership will be informed about the urgency and the significance of the fall reduction project and request for aid to support and facilitate the implementation of the proposed project (Vitor et al, 2015).

The project’s efficacy will be measured by measuring the percentage of the fall rate per 1000 patient days pre-project and post-project. The other measurement will involve measuring the number of days between falls for the patients sustaining falls within the surgical unit. Data about fall events within the surgical unit will be collected and entered into the system as falls happen for six months. This will assist in establishing baseline data regarding the rate of falls as well as falls with injury in the unit.  Similarly, after the end of the project’s implementation, data on the same will be collected. The baseline data and the post-project data will be analyzed and compared in order to determine the efficacy of the project and at the same time identify the key contributing factors that cause falls in the surgical unit.

Rationale that the Problem or Issue Needs to be Addressed

As aforementioned, falls are associated with poor health outcomes, increased mortality rate, loss of function, inability to perform activities of daily living, increased the length of hospital stay and increased healthcare costs (Shida et al, 2015). In addition, pre-operative patients are weaker and hence at an increased risk of sustaining falls. This is made worse by the fact that when pre-operative patients sustain falls, this may adversely affect the surgical procedure and even lead to severe injury or fatality (Mata et al, 2017). It is, therefore, the duty of clinicians to influence quality and safe care to the unit they provide care. The proposed project, therefore, aims to reduce the fall rate in the surgical unit and thus improve safety and health outcomes for the pre-operative patients.




Everhart D, Jessica S, Duncan P, Hall A, Neff D & Shorr R. (2014). Determinants of hospital fall rate trajectory groups: A longitudinal assessment of nurse staffing and organizational characteristics. Health Care Manage Rev. 39(4), 352–360.

Kobayashi K, Kei A, Yuko I, Yusuke S, Nagao Y, & Shiro I. (2018). Characteristics of falls in orthopedic patients during hospitalization. Nagoya J Med Sci. 80(3), 341–349.

Luzia M, Victor G & Lucena F. (2014). Nursing Diagnosis Risk for falls: prevalence and clinical profile of hospitalized patients. Rev. Latino-Am. Enfermagem. 22(2), 262–268.

Mata L. Cissa A, Gabrielle P & Moraes T. (2017). Factors associated with the risk of fall in adults in the postoperative period: a cross-sectional study. Rev Lat Am Enfermagem. 25(2904). How to Reduce fall rates in post-operative patients Capstone proposal

Shida D, Wakamatsu K, Tanaka Y, Yoshimura A, Kawaguchi M, Miyamoto S, et al. (2015). The postoperative patient-reported quality of recovery in colorectal cancer patients under enhanced recovery after surgery using QoR-40. BMC Cancer. 15(799), 1–6.

Vitor A, Moura L, Fernandes L, Botarelli FR, Araújo J & Vitorino I. (2015). Risk for falls in patients in the postoperative period. Cogitare Enferm. 20(1), 29–37.

Wildes T, Dua P, Fowler SA, Miller JP, Carpenter CR, Avidan MS, et al. (2015). Systematic review of falls in older adults with cancer. J Geriatr Oncol. 1(6), 70–83.


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