Use of the bedside mobility assessment tool to improve emergency department safety

Abstract

<p>Falls are a common occurrence in the emergency department and can lead to unintended patient harm and work-related injury. Fall rates at the site remained a concern, so an evidence-based approach was sought. The purpose of this quantitative, quasiexperimental quality improvement project was to determine if or to what degree the translation of Boynton et al.&rsquo;s research on the use of the Hillrom bedside mobility assessment tool (BMAT) used in conjunction with current evidence-based bedside practices would impact fall rates when compared to the current practice among adult patients in an emergency department in Southern California over four weeks. Nola Pender&rsquo;s middle-range theory, the health promotion model, and Roger&rsquo;s diffusion of innovation change theory framed the scientific underpinnings for the project. Data were extracted from the electronic medical record and analyzed using a chi-square test from the total sample population of <em>N</em> = 10,469; <em>n</em> = 5,456 in the comparative group and <em>n</em> = 5,013 in the implementation group. The fall rate in the comparison group was 0.05% (<em>n</em> =3), and .02% (<em>n</em>=1) in the implementation group, <em>X</em>² (1, <em>N</em> = 10, 469) = .840, <em>p</em> = .359. The <em>p</em>-value of .359 showed no statistically significant difference in fall rates. There was clinical significance as the fall rate was reduced by 0.3% over the project timeline. Based on the results of this project, completing the BMAT could reduce fall rates in the emergency department. Recommendations include sustaining the project at the current site and disseminating results.</p>