Mastering fall prevention through a card game  

Background Fall prevention is essential for hospitalized patients. However, traditional teaching methods often fail to effectively engage nurses or translate guidelines into clinical practice. Summary of work We designed a card game, inspired by the classic “Old Maid” or “Old Bachelor” game to reinforce fall prevention knowledge among nurses. The game includes 30 pairs of cards illustrating fall prevention strategies, such as frequent monitoring, clutter-free walkways and muscle-strengthening exercises, and 25 pairs illustrating fall risk factors, such as sedative use, oversized clothing and wet floors. The unmatched card features a patient falling. Players match pairs while identifying whether they represent fall prevention or risk. The player left with the "falling patient" card participates in a simulated scenario, identifying fall risks and applying appropriate measures. Since March 2023, this game has been used in our ward. Additionally, we identified the top three high-risk patients upon admission and designed targeted prevention strategies. The monthly fall rate was calculated by dividing the number of falls, retrieved from the Taiwan Patient-Safety Reporting System, by the total patient days and multiplying by 1,000. The Wilcoxon rank-sum test compared the monthly fall rate between two periods. Summary of Results From March 2023 to December 2024, the monthly fall rate per 1,000 patient days (median, 0.855; range, 0-2.545) was lower than the rate from January 2022 to February 2023 (median, 1.247; range, 0-2.404), showing borderline significance ( p =0.083). Nurses provided positive feedback, describing the game as interesting, engaging and helpful for reinforcing knowledge. Discussion and Conclusion The implementation of this card game demonstrated a trend toward reducing falls, emphasizing its potential as a tool for improving patient safety. By gamifying the learning process, the game reinforced nurses’ knowledge and increased attentiveness in identifying risks and implementing preventive measures. While statistical significance was not achieved, the trend toward fall reduction and the positive feedback suggest that this innovative approach can contribute to patient safety. Take Home Message Promoting patient safety requires innovative and engaging strategies. This fall prevention card game provides nurses with an interactive way to learn, apply, and internalize fall prevention guidelines, contributing to safer care environments and better patient outcomes.