Nurse Education on Patient Falls and Safety Culture
Patient falls are a major risk to patient safety in health care settings, especially for older adults who are more prone to injuries and complications from falls. According to the Agency for Healthcare Research and Quality (AHRQ), about one in 31 hospital patients experience a fall each year, and about 30% of those falls result in serious harm or death . Therefore, preventing patient falls is a priority for health care organizations and professionals.
However, preventing patient falls is not a simple task. It requires a comprehensive and multidisciplinary approach that involves assessing and addressing individual patient risk factors, environmental hazards, organizational policies and procedures, staff education and training, and safety culture. Safety culture refers to the shared values, beliefs, attitudes, and behaviors that influence how staff perceive and act on issues related to patient safety . A positive safety culture can foster teamwork, communication, learning, accountability, and patient-centeredness, which are essential for preventing patient falls.
In this blog post, I will discuss how nurse education can play a key role in improving safety culture and reducing patient falls in health care settings. I will also provide some examples of effective nurse education interventions for falls prevention that have been implemented and evaluated in recent studies.
How Nurse Education Can Improve Safety Culture and Prevent Patient Falls
Nurse education is an important component of any falls prevention program, as nurses are often the primary caregivers and the first responders to patient falls. Nurse education can improve safety culture and prevent patient falls by:
– Enhancing nurses’ knowledge, skills, and confidence in assessing and managing patient fall risk, implementing evidence-based interventions, and reporting and learning from fall incidents.
– Increasing nurses’ awareness of the prevalence, causes, consequences, and costs of patient falls, as well as their own roles and responsibilities in preventing them.
– Motivating nurses to adopt a proactive and preventive attitude towards patient falls, rather than a reactive and blameful one.
– Encouraging nurses to communicate and collaborate with other health professionals, patients, families, and managers on falls prevention strategies and policies.
– Empowering nurses to advocate for patient safety and quality improvement initiatives related to falls prevention.
Examples of Effective Nurse Education Interventions for Falls Prevention
There is no one-size-fits-all approach to nurse education for falls prevention, as different settings may have different needs, resources, and challenges. However, some common elements of effective nurse education interventions for falls prevention include:
– Using formal methods of educational delivery, such as didactic lectures, video presentations, online modules, or simulation scenarios.
– Incorporating interactive learning activities, such as case studies, role plays, quizzes, or games.
– Providing experiential learning opportunities, such as clinical placements, mentoring, coaching, or peer feedback.
– Supplementing education with written learning materials, such as manuals, guidelines, checklists, or posters.
– Applying adult learning principles, such as relevance, self-direction, feedback, reinforcement, and reflection.
– Evaluating the outcomes of education using multiple measures, such as knowledge tests,
or patient satisfaction.
Here are some examples of nurse education interventions for falls prevention that have been implemented and evaluated in recent studies:
– A scoping review by Shaw et al.  identified 39 studies that reported on education interventions for health professionals on falls prevention in health care settings from 2008 to 2019. The authors found that most interventions used formal methods of educational delivery (such as lectures or videos), followed by interactive learning activities (such as quizzes or games), experiential learning (such as coaching or mentoring), and written learning materials (such as manuals or posters). The authors also found that few studies employed comprehensive education design principles or used a reporting framework to plan,
and document the outcomes of educational interventions.
– A qualitative study by Hill et al.  explored how staff responded to an individualized patient falls prevention education program delivered by an educator who was a trained health professional but not a member of staff. The program involved providing individualized falls prevention education to patients with good levels of cognition on aged care rehabilitation wards. The authors found that staff perceived that the education created a positive culture around falls prevention,
facilitated teamwork between staff
and increased staff knowledge
and awareness about creating a safe ward environment.
– A quality improvement project by O’Connell et al.  described the implementation of an innovative employee-based education program for falls prevention in a large academic medical center. The program included information on organizational strategies for safety assessment
and individual-level changes,
such as patient communication,
safe patient handling,
and how to report
and learn from patient falls. The authors reported that the program resulted in improved staff knowledge
and attitudes about falls prevention,
as well as reduced fall rates
– A cross-sectional study by Staggs et al.  examined the impact of safety culture, quality of care, missed care, and nurse staffing on patient fall rates in 619 hospital nurses. The authors found that a strong safety climate, good working conditions, and lower rates of self-reported missed care were associated with a lower incidence of inpatient falls. The authors also found that nurse staffing was not significantly related to patient fall rates, suggesting that other factors, such as safety culture and quality of care, may be more important for preventing patient falls.
Nurse education is a vital component of falls prevention programs in health care settings, as it can improve safety culture and prevent patient falls by enhancing nurses’ knowledge, skills, confidence, awareness, motivation, communication, collaboration, empowerment, and advocacy. However, nurse education for falls prevention should be tailored to the specific needs, resources, and challenges of each setting, and should use a variety of methods, activities, materials, principles, and measures to ensure its effectiveness and impact. By investing in nurse education for falls prevention, health care organizations and professionals can improve patient safety and quality of care, as well as reduce the human and economic costs of patient falls.
 Agency for Healthcare Research and Quality. Preventing Falls in Hospitals: A Toolkit for Improving Quality of Care. Rockville: AHRQ; 2013. Available from: https://www.ahrq.gov/patient-safety/settings/hospital/resource/fallpxtoolkit/index.html
 Singer SJ, Vogus TJ. Reducing hospital errors: interventions that build safety culture. Annu Rev Public Health. 2013;34:373-96.
 Shaw L, Kiegaldie D, Farlie MK. Education interventions for health professionals on falls prevention in health care settings: a 10-year scoping review. BMC Geriatr. 2020;20(1):460.
 Hill AM, Waldron N, Francis-Coad J, Haines TP, Etherton-Beer C, Flicker L,
et al. ‘It promoted a positive culture around falls prevention’: staff response to a patient education programme—a qualitative evaluation. BMJ Open. 2016;6(12):e013414.
 O’Connell B, Hawkins M, Considine J. Improving hospital safety culture for falls prevention through interdisciplinary health education: a quality improvement project. J Interprof Care. 2020;34(5):635-42.
 Staggs VS,
The impact of safety culture,
quality of care,
and nurse staffing on patient falls:
a multisource study.
J Nurs Care Qual.