Fall prevention protocol for adult patients in an inpatient unit: implementation and maintenance costs

Raimundo, Juliana Cristina da Silva; Lima, Antônio Fernandes Costa

doi:10.1590/1980-220X-REEUSP-2025-0138en

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ORIGINAL ARTICLE • Rev. esc. enferm. USP 59 • 2025 • https://doi.org/10.1590/1980-220X-REEUSP-2025-0138en linkcopy

Fall prevention protocol for adult patients in an inpatient unit: implementation and maintenance costs^*

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective To analyze the average direct costs related to nursing professionals’ labor and materials required to implement and maintain a fall prevention protocol for adult patients in a Clinical and Surgical Inpatient Unit.

Method: Quantitative, exploratory-descriptive research, of the single case study type, based on absorption microcosting, carried out from August to October/2024 in a Medium-sized General Private Hospital.

Results: The direct cost for implementing the protocol totaled US$ 819.24, of which US$ 218.44 related to the direct labor of nursing professionals and US$ 600.80 to the acquisition of material resources. For protocol maintenance, the average total direct cost was US$ 1.77/patient for nursing activities and US$ 10.10 for direct monthly expenditure on materials.

Conclusion: Knowledge of the financial aspects associated with nursing professionals and the acquisition of material resources aimed at implementing and maintaining an adult fall prevention protocol may support decision-making regarding the rational allocation of required resources.

DESCRIPTORS
Hospital Units; Hospital Nursing Service; Accidental Falls; Security Measures; Direct Service Costs

Resources	Total direct cost US$*	%
Care Practice Nurse and UICCCoordinator Nurse: training organization and delivery	100.95	12.32
Coordinating Nurse, Clinical Nurses and Nursing Technicians at UICC: participation in training	117.49	14.34
Subtotal of direct human resources costs	218.44	26.66
Materials for implementing the protocol	600.80	73.34
TOTAL	819.24	100.00

Activities (number of observations)	ADC	Standard deviation	Minimum cost	Maximum cost	Median
1) History taking and physical examination (n = 75)	0.13	0.04	0.08	0.24	0.12
2) Risk management and whiteboard completion (n = 75)	0.09	0.03	0.08	0.26	0.08
3) Daily Orientation/Inspect Bracelet/Install Bracelet (n = 75)	0.09	0.03	0.06	0.30	0.09
4) Apply Morse scale (n = 75)	0.13	0.03	0.07	0.22	0.12
5) Prepare the SAE (n = 75)	0.45	0.18	0.20	1.12	0.41
6) Apply fall form (n = 75)	0.11	0.06	0.06	0.29	0.09
7) Prepare form/bracelet (n = 75)	0.12	0.07	0.06	0.29	0.09
8) Mobilize patient/Assist with walking (n = 75)	0.11	0.01	0.10	0.12	0.11

Activities (number of observations)	ADC	Standard deviation	Minimum cost	Maximum cost	Median
1) Daily orientation/Inspect bracelet/Install bracelet/Raise railings/Position bell (n = 96)	0.20	0.09	0.09	0.54	0.18
2) Mobilize patient/Assist with walking (n = 96)	0.13	0.08	0.03	0.41	0.12
3) Make nursing notes (n = 96)	0.20	0.07	0.05	0.38	0.21

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[T1FN1] *Exchange rate: R$ 5.46/US$ 1.00. Central Bank, based on the quotation of 08/31/2024.

Fall prevention protocol for adult patients in an inpatient unit: implementation and maintenance costs*

Fall prevention protocol for adult patients in an inpatient unit: implementation and maintenance costs^*