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Martie Moore

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Executive Summary Checklist Organizational Check:  Does your organization believe patient falls is a Nursing issue, or is there accountability throughout the organization for fall prevention and protection from injury?Fall prevention and protection from injury reduction requires an organizational understanding and commitment to safety \cite{France_2017}. A patient fall is defined as an unplanned descent to the floor, on or against some other surface, another person or object, with or without injury to the patient \cite{Morse_1989}. Creating a culture of safety within a fall initiative requires a perpetual focus on the continuous advancement of practice and safety strategies \cite{culture,trust2016}.Healthcare administration develop, revise and support the plan through the following actionable steps: \cite{al2013,boushon2008transforming}Assess the existing fall prevention and protection from injury policies, procedures, protocols, and educational programs in relation to current evidence and emerging research.  Identify existing needs or gaps in the fall prevention and protection from injury policies, procedures, protocols, and knowledge application for employees. Identifying Opportunities for Improvement and Set Aims \cite{Goodwin_2014,Mion2012,mccurley2014new,Waters_2015}. Collect fall and injury data to assist in advancing precision performance of fall prevention and protection from injury program.  Debrief all falls, including non-injury falls.  Analyze for trends or patterns that assist in advancing performance of the fall prevention and protection from injury strategy.  Consider bundling evidence-based recommendations to achieve greater outcomes.  Consider provider training on how to partner with patients and their loved ones on safety strategies to prevent falls and protect from injuries. Consider technological advancements to advance performance and reduce injuries. Develop a multidisciplinary team to create, implement, and sustain fall prevention and protection from injury initiatives. This team should include, but is not limited to, Executive sponsor, Environmental Manager, Risk Manager, Physical Therapist, Occupational Therapist, Medical Doctor, Unit Manager, frontline nursing staff, or Certified Nursing Assistant. Efforts should be made to get as many representatives from all shifts. Develop fall champions throughout all departments who further drive organizational knowledge and action in the healthcare setting. Provide clear and concise communication regarding the champion's role and responsibilites.Develop feedback mechanisms to learn what is workign and what can be improved upon in the fall prevention and protection from injury plan from the champion's perspective.Performance Gap Organizational Check:  Does your organization understand the differences between a tool that triages and one that assesses for fall prevention and protection from injury?Fall prevention and protection from injury is an organizational issue and needs to be addressed by all employees who might encounter a potential individual who is at risk for a fall.  Consider assuring that rotations of students, volunteers and new employees understand the importance of the fall prevention and protection from injury actions.  Clarity of their role and expectation of their actions must be clearly defined.Guiding Principles related to fall prevention and protection from injury: \cite{ontario}