| Sumario: | Significance & Background: Patient falls pose a major safety concern in oncology units, contributing to adverse outcomes, extended hospitalizations, and increased costs. The baseline fall rate on the oncology unit was 2.61 per 1,000 patient days, exceeding the institutional benchmark. Evidence supports that proximity and timely response to patient needs reduce falls. To address this, a zoning strategy was implemented, assigning nurses to designated areas of the unit to increase visibility and responsiveness. The project's aim was to reduce fall rates by 25%. Purpose: The purpose of this quality improvement project was to evaluate the impact of zoning on fall reduction in an inpatient oncology unit. By positioning nurses in closer proximity to patient rooms, the intervention sought to improve response times to call lights and bed exit alarms, thereby enhancing patient safety and achieving a fall rate below the target of 1.95 per 1,000 patient days. Interventions: Zoning was implemented through a structured, unit-based rollout designed to enhance efficiency and patient care. Education sessions introduced the zoning concept and its application tailored to the oncology unit's layout and nurse-to-patient ratios. Charge nurses participated in a mandatory planning meeting to establish clear expectations and responsibilities. Nurses were assigned to specific zones, with the majority of their patients located within that designated area to ensure proximity and enable rapid response. To reinforce these practice changes and address any concerns, the nurse educator and nurse manager conducted ongoing rounding and provided staff support. Continuous training and feedback were also integrated to promote adherence to the zoning strategy. Results: The unit's fall rate de-creased from 2.61 to 1.66 per 1,000 patient days. This demonstrated a 36% reduction in falls. This confirmed that zoning enhanced nurse responsiveness and patient safety. Discussion: The success of this initiative highlights zoning as a simple, cost-neutral strategy to reduce falls in oncology care. Proximity-based nurse assignment directly influenced patient safety outcomes by decreasing response times to patient needs. This quality improvement project offers a replicable model for fall prevention that can be adapted across diverse inpatient settings. Furthermore, these findings emphasize the need for nursing education and policy to incorporate innovative unit-based strategies, such as zoning, that promote safe, timely, and effective patient care. Future research should explore sustainability and scalability in broader clinical contexts.
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