Date of Award

January 2026

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)

Department

Yale University School of Nursing

First Advisor

Anna-Rae Montano

Abstract

Inpatient falls remain a significant and often preventable patient safety concern that cause harmand increase health delivery costs for health systems across the United States. Communication barriers between bedside clinicians and their patients are a known contributor to falls. This Doctor of Nursing Practice (DNP) quality improvement project evaluated whether a structured communication intervention could reduce falls by improving communication in a suburban community hospital. This project was implemented on a 30-bed Observation-Medical-Surgical unit. Nurses and Patient Care Technicians (PCTs) were trained in using the Plain Language, Engagement, Empathy, Empowerment and Respect (PEEER) Model of Communication to deliver individualized fall prevention education. Outcomes included fall rates per 1000 hospital days, clinician self-efficacy in communication (pre/post survey), and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) communication scores. Fall rates decreased slightly from 2.46 to 2.41 per 1000 patient days but were not statistically significant (p = 0.97). Clinician self-efficacy improved significantly (p < 0.05), and HCAHPS communication scores exceeded organizational benchmarks during implementation. Participant feedback demonstrated improved confidence and enhanced patient engagement. Although the fall reduction was not statistically significant, finding demonstrate that a structured communication intervention can improve clinician confidence and the overall patient experience. These results support integrating patient-centered communication models into practice to strengthen patient satisfaction, safety and quality outcomes.

Comments

This is an Open Access Thesis.

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