NURS FPX 4035 Assessment 4 Improvement Plan Tool Kit
NURS FPX 4035 Assessment 4 Improvement Plan Tool Kit
Name
Capella university
NURS-FPX4035 Enhancing Patient Safety and Quality of Care
Prof. Name
Date
Improvement Plan Tool Kit
This toolkit is intended for use by medical professionals and nurses aiming to implement evidence-based safety initiatives that target hospital fall prevention. It incorporates carefully selected clinical and academic resources that outline effective strategies, risk assessment tools, patient education techniques, and technological interventions. Each tool is accompanied by descriptions, implementation guidelines, and relevance to practice, allowing seamless integration into clinical settings. By leveraging these resources, nursing staff can significantly enhance quality and safety outcomes across diverse healthcare environments.
The toolkit’s development was driven by search terms including “fall prevention,” “patient safety,” “risk assessment,” “root cause analysis,” and “evidence-based nursing practice.” These terms guided the identification of literature that supports the practical application of fall prevention measures in clinical workflows. As a result, nurses and healthcare leaders can rely on this toolkit to bridge the gap between evidence-based knowledge and daily clinical operations.
Resources provided within the toolkit offer practical applications during staff training, patient handoffs, and facility-based fall prevention initiatives. Furthermore, each tool is contextualized for specific clinical environments, such as inpatient care units, home care services, or rehabilitation centers. This comprehensive design allows healthcare professionals to implement fall prevention practices tailored to their unique care settings.
Annotated Bibliography Table
| Category | Summary of Key Resource | Practice Application |
|---|---|---|
| Organizational Safety and Fall Prevention | Garcia et al. (2021) examined nurses’ views on fall prevention strategies, emphasizing multifactorial programs that combine patient education and environmental modifications. Barriers included time constraints, lack of organizational support, and limited patient involvement. | This resource helps nursing leaders design training that addresses staff barriers. It’s most effective during planning and training phases of fall prevention initiatives, and is ideal for customizing staff education to increase engagement with safety protocols. |
| Linnerud et al. (2023) discussed a co-created implementation strategy tailored for home-care services. The study highlights stakeholder participation in developing community-specific fall prevention plans. | Nurse managers and QI teams can use this during initial planning phases to foster collaboration. The document supports designing workshops to engage stakeholders and develop sustainable strategies, particularly in home-care environments. | |
| Mulfiyanti & Satriana (2022) focused on the SBAR (Situation, Background, Assessment, Recommendation) method’s role in improving nursing handovers and reducing safety incidents like falls. | Nurses should use SBAR during handovers, interprofessional communications, and urgent care reporting. The study suggests that SBAR fosters team confidence and minimizes errors in high-risk environments. | |
| Environmental Risk Reduction & Safety Assessment | Campani et al. (2021) evaluated environmental risk factors contributing to falls among the elderly, offering tools to assess and mitigate hazards such as poor lighting and cluttered spaces. | Nurses and discharge planners can apply this tool for home visits and hospital safety checks. It enables healthcare teams to teach environmental safety and identify high-risk settings, aiding in both community and institutional fall prevention planning. |
| Locklear et al. (2024) presented a narrative review of fall epidemiology, emphasizing early risk assessment using tools like the Morse Fall Scale. Their data showed a major reduction in costs due to structured interventions. | Nurse leaders can use this for training and patient risk evaluation. The tool supports early identification of fall risks during admissions and ongoing care, and demonstrates cost-effectiveness of proactive measures in acute care settings. | |
| Stathopoulos et al. (2021) investigated how overcrowding and poor hospital design contribute to in-patient falls. Results showed that neurology and orthopedic units experienced most incidents, often when staff were not present. | This tool supports administrative decisions on staffing and space allocation. Nurse managers and QI teams can use it to analyze incident data and support policy proposals for improved hospital design and staffing levels. | |
| Staff Education & Patient-Centered Strategies | Albertini et al. (2022) implemented a person-centered model for fall prevention in Brazilian hospitals. They found that staff compliance with fall protocols improved significantly through individualized care and targeted education. | Clinical leaders can implement this protocol to promote personalized fall prevention care. The approach emphasizes staff-patient collaboration and is especially valuable in units managing elderly or high-risk patients. |
References
Albertini, A. C. da S., Fernandes, R. P., Püschel, V. A. de A., & Maia, F. de O. M. (2022). Person-centered care approach to prevention and management of falls among adults and aged in a Brazilian hospital: A best practice implementation project. JBI Evidence Implementation, 21(1), 14–24. https://doi.org/10.1097/xeb.0000000000000356
Campani, D., Caristia, S., Amariglio, A., Piscone, S., Ferrara, L. I., Barisone, M., Bortoluzzi, S., Faggiano, F., Dal Molin, A., Silvia Zanetti, E., Caldara, C., Bellora, A., Grantini, L., Lombardi, A., Carimali, C., Miotto, M., Pregnolato, A., & Obbia, P. (2021). Home and environmental hazards modification for fall prevention among the elderly. Public Health Nursing, 38(3), 493–501. https://doi.org/10.1111/phn.12852
Garcia, A., Bjarnadottir, R. (Raga) I., Keenan, G. M., & Macieira, T. G. R. (2021). Nurses’ perceptions of recommended fall prevention strategies. Journal of Nursing Care Quality, Publish Ahead of Print(3). https://doi.org/10.1097/ncq.0000000000000605
Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A.-M., & Morris, M. E. (2020). Hospital falls prevention with patient education: A scoping review. BMC Geriatrics, 20(1), 1–12. https://doi.org/10.1186/s12877-020-01515-w
NURS FPX 4035 Assessment 4 Improvement Plan Tool Kit
Heng, H., Kiegaldie, D., Shaw, L., Jazayeri, D., Hill, A.-M., & Morris, M. E. (2022). Implementing patient falls education in hospitals: A mixed-methods trial. Healthcare, 10(7), 1298. https://doi.org/10.3390/healthcare10071298
Lakbala, P., Bordbar, N., & Fakhri, Y. (2024). Root cause analysis and strategies for reducing falls among in-patients in healthcare facilities: A narrative review. Health Science Reports, 7(7). https://doi.org/10.1002/hsr2.2216
Linnerud, S., Aimée, L., Graverholt, B., Idland, G., Taraldsen, K., & Brovold, T. (2023). Stakeholder development of an implementation strategy for fall prevention in Norwegian home care – a qualitative co-creation approach. BMC Health Services Research, 23(1). https://doi.org/10.1186/s12913-023-10394-x
Locklear, T., Kontos, J., Brock, C. A., Holland, A. B., Hemsath, R., Deal, A., Leonard, S., Steinmetz, C., & Biswas, S. (2024). In-patient falls: Epidemiology, risk assessment, and prevention measures. A narrative review. HCA Healthcare Journal of Medicine, 5(5). https://doi.org/10.36518/2689-0216.1982
Miura, T., & Kanoya, Y. (2025). Fall risk assessment and prevention strategies in nursing homes: A narrative review. Healthcare, 13(4), 357–357. https://doi.org/10.3390/healthcare13040357
Mulfiyanti, D., & Satriana, A. (2022). The correlation between the use of the SBAR effective communication method and the handover implementation of nurses on patient safety. International Journal of Public Health Excellence (IJPHE), 2(1), 376–380. https://doi.org/10.55299/ijphe.v2i1.275
NURS FPX 4035 Assessment 4 Improvement Plan Tool Kit
Ruiz, J. F.-B., Chaparro, J. D., Romero, M. J. S., Molina, F. J. V., García, X. del T., Peño, C. B., Solano, H. L., Colantonio, S., Revuelta, F. F., & López, J. C. (2022). Bedtime monitoring for fall detection and prevention in older adults. International Journal of Environmental Research and Public Health, 19(12), 7139. https://doi.org/10.3390/ijerph19127139
Stathopoulos, D., Hansson, E. E., & Stigmar, K. (2021). Exploring the environment behind in-patient falls and their relation to hospital overcrowdedness—a register-based observational study. International Journal of Environmental Research and Public Health, 18(20), 10742. https://doi.org/10.3390/ijerph182010742
