Graduation Semester and Year
Fall 2025
Language
English
Document Type
DNP Project
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Thomas Dombrowsky
Abstract
Background: Falls remain the leading cause of injury-related deaths among hospitalized older adults, contributing to significant morbidity, extended hospital stays, and increased healthcare costs. Implementing effective fall prevention strategies is especially challenging in rural hospitals due to staffing shortages, limited funding, and variability in clinical practice.
Local Problem: A 30-bed Medical-Surgical Unit in a rural Southwest Texas hospital experienced a rise in patient falls among older adults aged 65 and older, including several incidents requiring advanced medical treatment and one resulting in serious injury. A gap analysis revealed inconsistent implementation of tailored fall prevention strategies.
Methods: A quality improvement (QI) project was conducted over an 8-week period using the Plan-Do-Study-Act (PDSA) framework. Baseline data were collected from fall incident reports and staff knowledge assessments.
Interventions: The Tailoring Interventions for Patient Safety (TIPS) Toolkit was implemented and integrated into the unit’s workflow. Key components included standardized fall risk assessments using the Morse Fall Scale, development of patient-specific fall prevention plans, use of the TIPS Toolkit poster, and six staff education sessions. Staff completed both pre- and post-intervention knowledge assessments.
Results: Staff knowledge scores significantly improved following the intervention, t (14) = 3.50, p = .002, indicating a large effect size (d = 0.904). All moderate to high-risk patients received individualized fall prevention interventions, as it was integrated into the admission and shift assessments. Additionally, fall incidents decreased compared to baseline, supporting the effectiveness of the intervention.
Conclusions: Implementing the TIPS Toolkit in a rural hospital setting led to significant improvements in staff knowledge and consistent delivery of individualized fall prevention interventions. By integrating fall risk assessments and tailored interventions into admission workflows, the project improved patient safety and reduced fall rates. These results support the TIPS Toolkit as an effective solution for addressing fall risks in older adult inpatients.
Keywords
Falls, Fall prevention, Hospitalized older adults, Rural hospital, TIPS toolkit, Morse Fall Scale.
Disciplines
Geriatric Nursing
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Gonzalez, Viridiana G. MSN, RN, "Implementing the TIPS Toolkit to Prevent Falls in Hospitalized Older Adults: A Rural Hospital Approach" (2025). Doctor of Nursing Practice (DNP) Scholarly Projects. 110.
https://mavmatrix.uta.edu/nursing_dnpprojects/110
Comments
I would like to express my heartfelt gratitude to my mom and dad for their unwavering love, encouragement, and hard work that have allowed me to pursue and fulfill my dreams, and to Teddy for being my loyal companion throughout these years.
I am also sincerely grateful to my faculty advisor and the University of Texas at Arlington College of Nursing and Health Innovation for their guidance and support throughout this Doctor of Nursing Practice project.