Date of Award

Fall 12-2014

Degree Name

Doctor of Nursing Practice (DNP)

Committee Chair

Dr. Anita Boykins

Committee Chair Department

Nursing

Committee Member 2

Dr. Janie Butts

Committee Member 2 Department

Nursing

Abstract

Falls are serious unwanted events that are a common occurrence among older adults in long term care facilities (LTC). Fall prevention in LTC facilities requires the efforts of an interprofessional team that promotes safety within an organization. The purpose of this capstone project is to implement and evaluate evidence-based fall prevention interventions at a LTC facility. Specific objectives of the project include: (a) providing education to healthcare professionals on evidence-based practices to recognize, assess, and prevent falls among older adults in a long term care facility and (b) replacing the existing fall prevention policy and program with a falls and fall risk clinical guideline.

An evidence-based fall prevention program was implemented over a six week period in a LTC facility to recognize risk factors for falls, conduct a validated fall risk assessment, and develop an individualized care plan for managing fall risk. Educational sessions were provided to all healthcare professionals on factors associated with falls among older adults in LTC facilities, the use of the evidence-based fall risk assessment, and individualized care plan to prevent falls.

All of the participants (N=120) in the educational session rated the trainer as excellent, and the majority of the participants (n=80; 67%) rated the overall training session as excellent. A retrospective chart review of 53 charts was conducted to evaluate the fall prevention program including monitoring of performance measures for evidence of documentation. The majority of the charts reviewed were female (n=34; 64%), had a diagnosis of cognitive impairment (n=50; 89%), and were 65 years of age and older (n=50; 94%). All charts reviewed had a fall risk assessment, fall risk score, and care plan documented. All of the assessments completed identified the resident at risk for falling, and over half of the fall risk assessments completed (n=29; 55%) had a history of previous falls.

The implementation of the evidence-based fall prevention interventions and educational sessions enhanced the LTC facility staff’s knowledge in recognizing, assessing, and managing falls. This project has provided a foundation for improving communication among interprofessional members and incorporating current evidence-based recommendations into practice.

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