Improving falls risk screening and prevention using an e-learning approach


  • Maree Johnson RN, BAppsSci, MAppSci, PhD,

    Professor, Director, Corresponding author
    1. School of Nursing and Midwifery, University of Western Sydney, NSW, Australia
    2. Centre for Applied Nursing Research, South Western Sydney Local Health District, University of Western Sydney (Affiliated with the Ingham Institute, Liverpool NSW), Liverpool, NSW, Australia
    • Correspondence

      Maree Johnson

      School of Nursing and Midwifery

      University of Western Sydney


      Centre for Applied Nursing Research

      South Western Sydney Local Health District & University of Western Sydney

      Locked Bag 7103

      c/- 1 Campbell Street

      Liverpool 2170




    Search for more papers by this author
  • Linda Kelly RN, MN (Ed), Dip App Sci (Nursing),

    Nurse Educator
    1. Centre for Education and Workforce Development, Rozelle, NSW, Australia
    Search for more papers by this author
  • Katica Siric RN, BNurs, GDipAcuteCare, MClinLea&ClinSup,

    Acting Patient Safety Co-ordinator
    1. Concord Repatriation General Hospital, Sydney Local Health District, Sydney, NSW, Australia
    Search for more papers by this author
  • Duong Thuy Tran MIPH,

    Research Fellow
    1. Centre for Health Research, School of Medicine, University of Western Sydney, Penrith, NSW, Australia
    Search for more papers by this author
  • Bronwyn Overs BPsych (Hons)

    Research Assistant
    1. Mental Health Centre (Level 1), Faculty of Medicine, School of Psychiatry, Liverpool Hospital, Infant Child Adolescent Mental Health Service (ICAMHS) Research, University of New South Wales, Liverpool, NSW, Australia
    Search for more papers by this author



This study investigated the impact of an e-learning education programme for nurses on falls risk screening, falls prevention and post-falls management.


Falls injury within older inpatients is a major patient safety concern.


Using a pre–post design, observation of the patient and environment and patient health care record audits, were conducted following the introduction of a falls e-learning education programme.


Audits of patient health care records (using the Falls Chart Audit Tool), together with observation of practice for 119 (pre) and 99 (post) patients, were undertaken. Initial risk screening was conducted using the Modified Ontario Stratify Scale for most patients (95%). Interventions such as a falls risk flag in the records/on beds, supervision when the patient is mobilising or in the bathroom, area clear of hazards, use of chair/bed alarms, and referral to allied health staff were significantly improved.


Initial risk screening of patients and improvements in preventive interventions were demonstrated.

Implications for nursing management

This falls e-learning programme represents a cost-effective method of increasing falls mitigation strategies within large organisations. The Falls Chart Audit Tool provides a valuable monitoring tool for managers. Falls risk screening when the patient's condition changes, requires vigilance by managers or reminders within clinical information systems.