Fall Risk Prevention in Obstetric and Newborn Patients

Abstract

Fall risk assessment and prevention strategy in pregnant women and their newborns. Develop a risk assessment tool and prevention strategy specific to pregnant women and their newborns. In a literature review, it was determined that there are no fall risk assessment tools that have been proven valid and reliable in the obstetric population. Our team developed a risk assessment tool and prevention strategy for maternal and newborn falls. Our facility has approximately 8,000 deliveries per year. We gathered details on each of the maternal and newborn falls our service line experienced over the past 3 years. Our review of patient falls showed increased falls during the first 6 hours postbirth, during times of maternal exhaustion, in the bathroom, with non-English speaking patients, and with patients who experienced higher amounts of quantified blood loss at birth. Patient and family participation in fall prevention was found to be a key factor, as many patients expressed a desire to “not bother the nurse” for help in getting up. The next step was to develop a risk assessment tool and correlate prevention strategies with the components of the tool. A seven-category risk assessment tool was developed. Institutional Review Board exemption was received to complete a quality improvement trial of the tool on one of our postpartum units. Fifty patients were assessed. Each assessment was completed by two separate nurses to determine interrater reliability. The fall risk tool was found to have high interrater reliability and was rated by the nurses as easy to use. The prevention strategies correlate with areas of risk to assist the nurse in determination of prevention steps. The fall risk assessment tool we created at Spectrum Health has improved our ability to predict which maternal and newborn patients are at a higher risk for falls. The inclusion of a prevention strategy that correlates with the tool provides further assistance to bedside nurses in fall prevention. Additional development of patient and family involvement will strengthen the prevention process at Spectrum Health.