The HDS was developed over two years through research involving retrospective evaluation of patient characteristics of those patients who fell in our organization.

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We collected data from variance reports and patient records, constructed the scale and tested it initially in one nursing unit. We asked staff nurses to use the scale, give us their feedback and revised the scale based on their recommendations.

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The revised version of was then implemented in a unit experiencing problems with falls. After a short time it was clear tests in both units were successful in utilizing the HDS and the program was implemented in the remainder of the facility. To this day the HDS scale continues to yield positive results for both facilities and patients.