title: A Successful ED Fall Risk Program Using the KINDER 1 Fall RiskAssessment Tool.
abstract: Emergency nurses did not perform falls risk assessments routinely on our ED patients; the instrument used was aimed at inpatients. We identified a need to revise fall assessment practices specific to our emergency department. The purpose of the performance improvement project was to reduce ED falls and evaluate the use of an ED-specific fall risk tool, the KINDER 1 Fall Risk Assessment. The plan was to establish fall risk assessment practices at point of ED entry and to decrease total falls.
  
  
  METHODS
  We retrospectively reviewed ED fall data for each quarter of 2013, which included risk assessments scores, the total number of falls, and the circumstances of each fall. Using Kotter's framework to guide a successful change process, we implemented the KINDER 1 to assess fall risk.
  
  
  RESULTS
  During the first 4 weeks of the project, 937 patients (27%) were identified as high risk for falls using the KINDER 1. During the subsequent 3 quarters, the total number of falls decreased; reported falls without injuries dropped from 0.21 to 0.07 per 1000 patients, and falls with injuries were reduced from 0.21 to 0.0 per 1000 patients.
  
  
  CONCLUSIONS
  The results of this project represented a valuable step toward achieving our goal to keep ED patients safe from injuries as a result of falls. The findings add to the body of nursing knowledge on the application of clinical-based performance improvement projects to improve patient outcomes and to provide data on the use of the KINDER 1 tool, which has not been extensively tested.
authors.affiliation: Woodbury and Bridgeton, NJ; Philadelphia, PA. Electronic address: townsend@lasalle.edu.
authors.forename: Ann B
authors.initials: AB
authors.lastname: Townsend
authors.affiliation: Woodbury and Bridgeton, NJ; Philadelphia, PA.
authors.forename: Marisol
authors.initials: M
authors.lastname: Valle-Ortiz
authors.affiliation: Woodbury and Bridgeton, NJ; Philadelphia, PA.
authors.forename: Tracy
authors.initials: T
authors.lastname: Sansweet
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D016208:Databases, Factual; D016529:Emergency Nursing / Q000379:methods*; D004636:Emergency Service, Hospital; D006801:Humans; D007297:Inpatients; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D017751:Safety Management / Q000379:methods*
keywords: Accidental fall; ED fall prevention; ED patients; Fall risk tool; KINDER 1