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Patient falls are the “second leading cause of unintentional injury death” (World Health Organization [WHO] (2018), para. 3) and increase healthcare costs by an estimated $13,806 per fall (Walsh et al., 2018). These fall-related costs translate to a potential savings of approximately $400,374 to the selected organization since the unit chosen for the practice change project experienced 29 falls in the fiscal year 2019 (C. Hernandez, personal communication, September 23, 2019). The PICOT question that guided this project was: In a medical/surgical inpatient population in acute care (P) how does realigning the Nursing Hours per Patient Days (NHPPD) (I) compared to the patient population in medical/surgical units without an adjusted NHPPD (C) affect the fall rate (O) within 60 days (T)? The literature search returned ten studies that matched the inclusion and exclusion criteria, promoting NHPPD to prevent patient falls in inpatient, acute care, medical/surgical hospital settings. The evidence-based intervention was a realignment of the approved and budgeted 9.4 NHPPD. The realignment was completed to increase the direct care nursing hours to meet the patient care demands during the 4-hour intervals with the highest reported falls (Taylor et al., 2015). The rate of falls observed between 1600-2000, the period evaluated, was 0 since no falls were reported during this project’s duration. However, even though the t-test calculation returned a p-value ≤ 0.05, the statistical significance was rejected since the correlation coefficient calculation between NHPPD and falls showed a weak relationship. Since there were no falls reported during the period evaluated, the clinical significance was established and correlated with the literature review evidence. REDUCING PATIENT FALLS BY REALIGNING NURSING HOURS 1 Reducing Patient Falls by Realigning Nursing Hours per Patient Days Patient falls are detrimental not only as it relates to a patient’s safety and quality of life, but it also adds unnecessary costs to our already burdened healthcare system. According to the Centers for Disease Control and Prevention [CDC] (2017), medical costs associated with falls exceed $50 billion per year. Additionally, if the current trends continue, the CDC (2017) projects that by 2030 there will be seven fall-related deaths every hour. This paper discusses an evidencebased practice (EBP) change in a medical/surgical acute care unit. The project aimed to reduce the fall rate by realigning the Nursing Hours per Patient Days (NHPPD). Significance of the Practice Problem Patients who experience a fall are affected by the potential physical injury and experience fear, anxiety, and depression. This experience can result in “social isolation, and feelings of helplessness” (National Council on Aging [NCOA], n.d., para. 3). Families and caregivers are also affected and often encounter similar psychological, emotional, financial, and social manifestations that compromise their quality of life (Golics et al., 2013). The economic impact associated with patient falls is substantial and presents opportunities for organizations to consider fall prevention. In adult medical-surgical units in the United States, patients fall at a rate of “3.56 times per 1,000 patient days, with 26.1% of falls resulting in patient injuries” (Walsh et al., 2018, p. 75). Additionally, falls with injuries add 6.9 days to their hospital length of stay (LOS) and increases the cost by $13,806 per fall with injuries (Walsh et al., 2018). The reported cost per fall translates to a potential savings of approximately $400,374 to the selected organization since the unit chosen for the practice change experienced 29 falls in the fiscal year 2019 (C. Hernandez, personal communication, September 23, 2019). The national-level estimate is that approximately REDUCING PATIENT FALLS BY REALIGNING NURSING HOURS 2 700,000 to 1,000,000 patients fall in hospitals in the United States each year, adding a burden to the already stressed healthcare system (Ganz et al., 2013). Furthermore, the World Health Organization [WHO] (2018) cites that globally, falls are the “second leading cause of unintentional injury death” (para. 3). Therefore, a practice change that aims to reduce patient falls has the potential to impact the organization’s finances, the patient’s and family’s quality of life, and patient and staff satisfaction.