Managing Falls: Implementation of a Three-Intervention Initiative to Improve Quality of Care for Patients With Cancer

Background: All healthcare institutions prioritize falls as a major safety issue. Falls are of particular concern on inpatient oncology units where patients are substantially at risk for injury related to falls. Objectives: This article describes a multifaceted fall-prevention initiative that can be implemented on oncology units using evidence-based interventions in the key areas of communication, toileting, and hourly rounding. The Visual Rounding Tool for communication around hourly rounding and proactive toileting is also introduced. Methods: Based on a root cause analysis and literature review, the inpatient oncology unit–based committee launched a three-intervention initiative, carried out during three consecutive months, to address patient falls. Findings: Fall rates decreased using the three- intervention initiative. Systematic improvement in processes enabled an increased occurrence of communication between nurses and assistive personnel, increased use of the Visual Rounding Tool for proactive toileting and hourly rounding, and a significant but short-lived decrease in call light use.