title: Breaking the fall.
abstract: OBJECTIVE
  : The Helping Hands program is a nurse-directed falls prevention program designed to support a hospital-wide culture of safety and reduce harm from falls.
  
  
  BACKGROUND
  : Patient falls and the associated morbidity and mortality represent a significant risk for patients and healthcare facilities. Age-adjusted fatalities from falls increased significantly from 1993 to 2003. By 2020, the annual cost of injuries from falls is expected to exceed $40 billion.
  
  
  METHODS
  : Components of the Helping Hands falls prevention program worked synergistically to support the development of a culture of safety at Robert Wood Johnson University Hospital. The program consisted of nursing assessment of fall risk with the Johns Hopkins Fall Risk Assessment Tool; reviews of fall risk and intervention efficacy; creation of communication mechanisms, reporting processes, and change champion roles; engagement of patients and families in falls prevention; increased public awareness of fall risk through signage; nursing interventions; and utilization of nursing performance improvement analysts.
  
  
  RESULTS
  : Over 3 years, 65% (N = 7,900) of more than 12,000 patients assessed were at risk of falling. Most falls caused no or little harm, and at 3 years of follow-up, total falls decreased by 16.6 %, and severe falls accounted for 0.009 % (n = 2) of all falls.
  
  
  CONCLUSIONS
  : The data offer a hopeful perspective on the role of nursing engagement in developing a hospital-wide culture of safety and protecting patients from permanent harm caused by fall events.
authors.affiliation: College of Nursing, University of Rutgers, New Brunswick, New Jersey, USA. joyce.johnson@rwjuh.edu
authors.forename: Joyce E
authors.initials: JE
authors.lastname: Johnson
authors.forename: Teresa
authors.initials: T
authors.lastname: Veneziano
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Green
authors.forename: Eileen
authors.initials: E
authors.lastname: Howarth
authors.forename: Tracey
authors.initials: T
authors.lastname: Malast
authors.forename: Kari
authors.initials: K
authors.lastname: Mastro
authors.forename: Annlouise
authors.initials: A
authors.lastname: Moran
authors.forename: Lori
authors.initials: L
authors.lastname: Mulligan
authors.forename: Alicia
authors.initials: A
authors.lastname: Smith
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D006801:Humans; D007297:Inpatients; D009730:Nursing Assessment; D009732:Nursing Care / Q000458:organization & administration*; D015279:Organizational Culture; D058996:Quality Improvement; D018570:Risk Assessment; D014481:United States