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Creating a Culture of Collaborative Fall Prevention: Guidance for Chief Nursing Officers

Written by: Michael Fragala, PhD, MBA, RN, WCC, CSPHP, AMS

Falls represent a significant concern for skilled nursing facilities, with each resident who falls potentially experiencing a severe injury, reduced quality of life, and increased healthcare costs. The skilled nursing facility also faces risks, with fines, lawsuits, and a damaged reputation being a possibility each time a resident falls.

Preventing falls is a complex, multifaceted undertaking that requires more than just the vigilance of nursing staff. It requires a comprehensive, collaborative approach that involves any and all stakeholders. This can include direct care staff, environmental services, nursing leadership, physical therapy, and residents and their families.

Chief nursing officers are uniquely positioned to lead this effort and are ultimately responsible for fostering a collaborative fall prevention culture of patient safety. While each team member bears responsibility for patient safety, nursing leadership must coordinate these moving parts and ensure patient safety.

Tips for Implementing Collaborative Fall Prevention

Empower and Involve Everyone

The first step to creating a collaborative fall prevention culture is recognizing that every team member plays a crucial role in preventing falls. Everyone’s contribution is vital, from the direct care staff who provide personal care to patients to environmental services that ensure the facility is safe and free of hazards. Having widespread involvement with everyone taking ownership of fall prevention will promote increased awareness of patient safety.

It is vital that those in leadership roles encourage active participation and open dialogue within the team. Empowering staff with the knowledge and tools they need to identify risk factors and intervene appropriately will ensure staff promotes resident safety every time they interact with a resident. A culture where everyone is involved will help prevent falls and improve overall safety for residents.

Nurture Interdisciplinary Communication and Teamwork

Effective communication and teamwork among interdisciplinary team members are among the most important keys to a successful fall prevention plan. Different disciplines tend to silo themselves naturally. It is up to leadership to help break down the barriers that naturally develop between other disciplines and ensure a culture of clear communication.

Promoting working together as a team rather than as distinct disciplines promotes interdisciplinary collaboration. Regular interdisciplinary meetings are a good strategy for achieving teamwork. These meetings facilitate the sharing of ideas and information, allowing for the developing of comprehensive, individualized care plans. Leaders should foster a culture where different departments feel comfortable communicating and collaborating to achieve a common goal.

Implement Risk Assessment Tools

Risk assessment tools provide a structured way to identify patients at high risk of falls and allow for consistent information communication between team members. Evidence-based tools consider various factors, such as the patient’s age, medication, physical health, and mental status.

Nursing leaders must ensure their facility utilizes a reliable and validated risk assessment tool. This tool should be used consistently to assess each patient’s risk frequently. This will allow for timely interventions and adjustments in care and ensure each team member has a consistent way of communicating changes in a resident’s fall risk.

Prioritize Patient and Family Education

Patient and family education is an essential but often-overlooked aspect of collaborative fall prevention. Informed patients and families can significantly contribute to fall prevention efforts. Having involvement from patients or their family members helps improve compliance with fall prevention interventions and helps improve their confidence in the safety provided by the skilled nursing facility.

Nurse leaders should ensure their facility provides clear and accessible information about fall risks and prevention strategies to both patients and family members involved in their care. Patient education should be an ongoing process, not a single event. This helps keep fall prevention at the forefront of patients’ minds and ensures they are aware of any changes in their condition that could increase their fall risk.

Implement Continuous Learning and Training

Keeping abreast of the latest research and best practices in fall prevention is crucial. Falls are a significant problem in healthcare, and considerable resources are dedicated to providing new interventions and strategies for preventing falls. New processes and products frequently become available, making it essential to stay current with any field advances.

Nursing leaders should also champion ongoing education and training for all staff, emphasizing evidence-based strategies and interventions. This enhances the staff’s skills and reinforces the importance of collaborative fall prevention, keeping it at the forefront of everyone’s minds. It is crucial to develop an educational strategy that includes all staff who may have any influence on fall risk, not just clinical staff.


Fall prevention in skilled nursing facilities requires a team-oriented, comprehensive approach. Chief nursing officers are ultimately responsible for organizing and implementing a culture of collaboration. Nursing leaders can significantly enhance their facilities’ fall prevention strategies by ensuring that all stakeholders are involved.

While the task may seem daunting, remember that every step taken towards a safer, more collaborative environment can make a significant difference in patients’ lives.

Do you need further guidance or resources for implementing a collaborative fall prevention program at your facility? Don’t hesitate to contact us at Joerns. We offer many tools and resources to support your journey toward creating a safer patient environment.

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