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University of Iowa News Release


Sept. 4, 2007

Study to examine nursing care's impact on fall prevention

Patient falls persist as the largest category of hospital incident reports, despite numerous studies and interventions, including risk assessment, patient education, efforts to improve balance and environmental modifications.

The Robert Wood Johnson Foundation, as part of its Interdisciplinary Nursing Quality Research Initiative (INQRI), has awarded a $300,000 grant to a University of Iowa research team to study the impact of nursing care processes on the quality of patient outcomes regarding the prevalence of patient falls and injuries from falls in acute care hospitals. The goal of INQRI is to generate, disseminate and translate research to understand how nurses contribute to and can improve the quality of patient care. The two-year study will involve the participation of more than 180 patient care units from approximately 45 hospitals in the United States.

The principal investigator of the study is Marita Titler, Ph.D., senior assistant director at UI Hospitals and Clinics, director of Nursing Research, Quality and Outcomes Management, and clinical professor at the UI College of Nursing.

The study will examine a number of factors that may influence the prevalence of falls and injuries related to falls. The team will examine such factors as the number of nursing hours worked, the number of nursing vacancies, interventions nurses perform to prevent falls, and other structural and organizational factors within a patient care unit that may influence a patient's risk for falling.

At three points over 18 months, researchers will examine the effects of fall prevention processes, such as risk assessment, and hospital structure efforts, such as interdisciplinary teams, on fall prevalence and injuries from falls. The teams will be comprised of nurses, physicians and other health care providers working together to develop multiple strategies for fall prevention.

The study further aims to determine whether the level of professional nursing practice has an impact on adoption of evidence-based practices for fall prevention.

This study, officially titled "Impact of System-Centered Factors, and Processes of Nursing Care on Fall Prevalence and Injuries from Falls," will build on two arms of Titler's federally funded research aimed at identifying nursing outcomes effectiveness and translating research into practice.

"This project will have a direct impact on clinical practice and will provide additional knowledge for context of care delivery in hospitals and health policy formulation for nurse staffing," Titler said.

The clinical sites for the project are members of the National Nursing Practice Network (NNPN) and represent health systems, academic medical centers, and large, medium and small community hospitals, as well as Veterans Administration hospitals, across the United States.

The interdisciplinary research team from the UI includes Loreen Herwaldt, M.D., (co-principal investigator), professor of internal medicine, Roy J. and Lucille A. Carver College of Medicine; Joanne Dochterman, Ph.D., College of Nursing emerita; Gary Rosenthal, M.D., professor of internal medicine, Carver College of Medicine; Sheila Barron, Ph.D., assistant research scientist, College of Education; Toni Tripp-Reimer, Ph.D., R.N., associate dean for research, College of Nursing; and Marcia Ward, Ph.D., professor of health management and policy, College of Public Health.

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to improving the health and health care of all Americans, the foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, meaningful and timely change. For more than 35 years the foundation has brought experience, commitment and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. For more information, visit

STORY SOURCE: University of Iowa College of Nursing, 101 Nursing Building, Iowa City, Iowa 52242

MEDIA CONTACTS: Michele Francis, 319-335-8960,; Tom Moore, 319-356-3945,