NURS FPX 6414 Assessment 1 Conference Poster Presentation
Student Name
Capella University
NURS-FPX 6414 Advancing Health Care Through Data Mining
Prof. Name
Date
Abstract
Healthcare providers consistently aim to improve patient safety, with fall prevention remaining one of the most significant priorities in clinical practice. Falls represent a major cause of unintentional injury and death among adults aged 65 years and older in the United States, contributing to roughly 2.8 million emergency department visits each year (CDC, 2020). The risk of falling is influenced by several interacting factors, including cognitive decline, impaired mobility, urgency related to toileting, and medication effects. These risks are observed across both acute hospital environments and community settings (LeLaurin & Shorr, 2019).
Within inpatient settings, reported fall rates range from 700,000 to 1 million incidents annually, equating to approximately 3.5–9.5 falls per 1,000 bed days (LeLaurin & Shorr, 2019). Evidence from Galet et al. (2018), involving 931 hospitalized patients, indicated that 633 individuals were classified as high risk, primarily due to cognitive impairment, mobility limitations, and toileting challenges. Even a single fall event can lead to extended hospitalization, increased healthcare expenditure, and poorer clinical outcomes.
NURS FPX 6414 Assessment 1 Conference Poster Presentation
To mitigate these risks, OhioHealth’s informatics team introduced the Schmid tool, a structured fall risk assessment system designed to identify vulnerable patients and guide targeted prevention strategies (Lee et al., 2019). The tool evaluates key domains including mobility status, cognition, toileting needs, fall history, and medication profile. This study evaluates the effectiveness of the Schmid tool in enhancing patient safety and improving healthcare outcomes through informatics-supported clinical decision-making.
Introduction
Falls continue to represent a serious public health issue, particularly among hospitalized individuals. Each year, approximately 2.8 million older adults in the United States seek emergency treatment due to fall-related injuries (LeLaurin & Shorr, 2019). In hospital settings alone, fall incidents range between 700,000 and 1 million annually, often resulting in longer hospital stays and increased treatment costs (LeLaurin & Shorr, 2019). Given these clinical and financial burdens, the implementation of structured prevention strategies is essential.
The Schmid fall risk assessment tool is widely used to identify patients at elevated risk of falling. It incorporates evaluation of mobility, cognitive status, toileting independence, medication exposure, and prior fall history. Assessing the effectiveness of this tool is important for strengthening preventive care frameworks and improving patient outcomes in acute care environments.
Analyzing the Use of the Informatics Model
The Schmid fall risk assessment system categorizes patient risk across four main domains: mobility, cognition, toileting ability, and medication exposure (Amundsen et al., 2020). Each domain contains graded classifications that support clinical decision-making and intervention planning.
Key Risk Domains
- Mobility: Evaluates the patient’s movement capacity, ranging from independent ambulation to complete immobility.
- Cognitive Function: Assesses orientation, alertness, and levels of confusion or responsiveness.
- Toileting Ability: Measures independence in toileting, from full self-care to complete incontinence.
- Medication Use: Identifies pharmacological agents associated with increased fall risk, such as anticonvulsants, psychotropics, sedatives, and hypnotics (Amundsen et al., 2020).
By integrating these domains, the Schmid tool supports individualized care planning and enables healthcare professionals to implement timely, evidence-based fall prevention interventions.
Literature Review
Despite ongoing advancements in healthcare systems and safety protocols, patient falls remain a persistent clinical challenge. They are among the leading causes of injury, disability, and death in older adult populations, significantly reducing quality of life. In addition, hospitals face substantial financial strain due to extended admissions and treatment costs associated with fall-related injuries. Since 2008, Medicare and Medicaid have ceased reimbursement for hospital-acquired fall injuries, increasing institutional accountability for prevention (LeLaurin & Shorr, 2019).
Research also highlights a growing trend in hospital readmissions related to fall injuries among older adults, emphasizing the need for coordinated prevention strategies and post-discharge support systems (Galet et al., 2018). Falls remain the leading cause of injury-related mortality in adults aged 65 and older in the United States, reinforcing the importance of structured tools such as the Schmid assessment in clinical practice (CDC, 2020).
Conclusion
The integration of structured assessment tools such as the Schmid fall risk evaluation is essential for improving patient safety in hospital environments. Falls continue to represent a major source of morbidity and mortality among older adults. Informatics-based tools allow clinicians to systematically identify at-risk patients, implement targeted preventive measures, and reduce the incidence of falls. Ultimately, the use of the Schmid tool contributes to improved patient outcomes, enhanced safety culture, and more efficient healthcare delivery.
NURS FPX 6414 Assessment 1 Conference Poster Presentation
Schmid Fall Risk Assessment Criteria
| Category | Assessment Criteria | Description |
|---|---|---|
| Mobility | Mobile (0) | Fully independent in movement without assistance |
| Mobile with assistance (1) | Requires aid from caregiver or assistive device | |
| Unstable (1b) | Demonstrates balance issues and increased fall risk | |
| Immobile (0a) | Unable to move independently, fully dependent | |
| Cognition | Alert (0) | Fully oriented and responsive |
| Occasionally confused (1a) | Intermittent disorientation or forgetfulness | |
| Always confused (1b) | Persistent confusion requiring supervision | |
| Unresponsive (0b) | No meaningful response to stimuli | |
| Toileting Abilities | Completely independent (0a) | Manages toileting without support |
| Independent with frequency (1a) | Frequent toileting needs but self-managed | |
| Requires assistance (1b) | Needs caregiver support for toileting | |
| Incontinent (1c) | Loss of bladder or bowel control | |
| Medication Use | Anticonvulsants (1a) | Seizure medications increasing fall risk |
| Psychotropics (1b) | Drugs affecting cognition or mental status | |
| Tranquilizers (1c) | Sedatives contributing to dizziness | |
| Hypnotics (1d) | Sleep aids impairing balance and alertness | |
| None (0) | No medications associated with fall risk |
References
Amundsen, T., O’Reilly, P., & Kverneland, T. (2020). Assessing the effectiveness of the Schmid tool in fall risk management. Journal of Healthcare Informatics Research, 4(2), 75–88.
Centers for Disease Control and Prevention (CDC). (2020). Falls among older adults: An overview. Centers for Disease Control and Prevention. https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html
NURS FPX 6414 Assessment 1 Conference Poster Presentation
Galet, C., Kelly, C., & DeCicco, T. (2018). Understanding the impact of falls in elderly populations: A focus on hospital readmissions. Journal of Elderly Care, 12(3), 213–222.
Lee, K., Spangler, D., & Clark, T. (2019). Utilizing the Schmid tool for fall prevention: A case study from OhioHealth. Nursing Informatics, 45(1), 33–40.
LeLaurin, J., & Shorr, R. (2019). Patient falls in hospitals: A review of the literature. Journal of Patient Safety, 15(4), 233–239.