Spring 2023

Document Type

Scholarly Project


College of Nursing

First Advisor

Dr. Beverly Baliko


In the United States, the highest rates of falls are in the psychiatric inpatient population. Fall reduction was as an organizational goal of the project site, a 352-bed hospital in the Southeastern United States. The Epic Predictive Index (EPI), an automated fall risk assessment tool, had recently been adopted. This project evaluated the impact of an enhanced fall reduction strategy involving the use of Kamishibai Cards (K-Cards), which are a compliance reminder for healthcare staff, to support additional evidence-based identification of fall risk among adults receiving inpatient psychiatric care at the facility. The use of K-Cards with each patient’s current EPI score, assessment factors from the Edmonson Psychiatric Fall Risk Assessment Tool (EPFRAT), and the inclusion of nurse judgment, was implemented by nursing staff for a period of three months. The impact of the intervention was analyzed using a two proportion Z-test for fall incidence, a nonparametric T-test for mean EPI scores, and descriptive statistics. There was a clinically significant decrease in falls during the project and a lower mean EPI score among patients that fell. All patients that fell scored low risk per the EPI, high risk per nursing judgment, and had at least one high risk EPFRAT factor. The results of this project indicate that nursing judgment is an important factor in predicting fall risk and adding this to the EPI may prevent future falls.


© 2023, Katelyn Dunn

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