Graduation Semester and Year

Spring 2024



Document Type


Degree Name

Doctor of Nursing Practice



First Advisor

Dr. Kirsten Drake



Hospital falls are rising in inpatient facilities, requiring analysis and a plan of action to address the ongoing falls. A strategy taken among facilities is implementing a 4Ms Framework that allows the nurse to address what matters to the patient and assess their mentation, medications, and mobility upon admission. With an increase in falls on a med-surg unit, it was found that there was no straightforward process for addressing the needs and concerns of patients and no assessment of medications, mobility, or mentation for those aged 65 years and older. This knowledge gap prevents nurses from providing a structured framework that allows for these specific things to be discussed with the patient upon admission. This Quality Improvement project was reviewed and exempted by the facilities’ Institutional Review Board (IRB). Using descriptive statistics with SPSS and Excel, after implementing the 4Ms framework, a chart review found no change in falls on the unit during an eight-week timeframe compared to the same time frame the previous year. However, limitations to the implementation of this project included that out of 80 audits, only 36% of audits addressed all 4Ms framework. It is unknown why there may have been a lack of documentation by nursing staff. This could have directly affected results, including a possible decrease in falls. If this framework had received full participation from staff, the fall rate might have decreased as compared to the previous year and time frame using the framework. It was found that the two patients who fell did not have the 4Ms documented, and those who did document the 4Ms framework did not have a fall incur.


Falls, 4Ms Framework, Inpatient unit, Med-Surg, Hospital, Assessments, What Matters


Critical Care Nursing | Family Practice Nursing | Geriatric Nursing | Nursing Administration | Nursing Midwifery | Occupational and Environmental Health Nursing | Palliative Nursing | Psychiatric and Mental Health Nursing



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