Date of Award
Spring 5-25-2024
Document Type
Doctor of Nursing Practice Final Manuscript
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Joseph Burkard, DNSc, CRNA
Abstract
Falls in the elderly over the age of 65 are the highest mechanism of injury in a Level II TraumaCenter in the SanGabriel Valley. In reviewing the data from 2021-2022, there were 20,653 patients over the age of 65 that arrived in the EmergencyDepartment, 12.3% of those patients had falls. The Senior Care Network is a service line of Huntington Hospital whose mission is to support the health and well-being of older adults living in and around Pasadena and the San Gabriel Valley. To meet this mission, the Multipurpose Senior Services Program (MSSP) supports community members 65 and older covered by Medi-Cal and those who are at risk of being admitted to a skilled nursing facility. Of the 400 patients in the MSSP, 80 clients or 20% had falls that required admittance to the hospital. The clients and staff of the Senior Care Network who are enrolled in the MSSP have no formalized fall prevention education.
Five participants enrolled in the pilot project, with two completing the pilot. Participants lived with their family members and had a history of falling in their homes. The pilot program included assessment of the members knowledge of fall risk in their homes utilizing the Fall Risk Assessment Questionnaire (FRAQ) and the Fall Risk for Older People in the Community (FROP-Comm) which assesses the client’s risk of falling in their homes. Education materials and environmental assessment tools were utilized from the Centers for Disease Control and Prevention STEADI comprehensive fall program. Materials were reviewed with the patients and their families at the home visit. Post-intervention phone calls were made for two subsequent months. A final visit to their home was done to re-evaluate fall risk understanding and whether they had fallen. Of the two participants that completed the program none of them had a recurrence of falls in their homes.
In addition to providing falls education to the patients and their families, another goal of thisproject was to share the falls education with the community at large. To reach greater numbersof community members with fall prevention education a partnership with the Trauma Injury Prevention Specialist and a Physical Therapist was developed. An Ambulatory Falls Taskforce has been initiated with the goal of standardizing patient discharge education for patients who have been admitted for falls, total knee and hip replacement patients. The new task force will work with the Enterprise Information System to incorporate this functionality in the EPIC electronic medical record and the nursing workflow for discharging patients.
The fall reduction community education program is an interdisciplinary team that provides education sessions throughout the San Gabriel Valley. Additional sessions have been scheduled for 2024 in Spanish and Mandarin. The goal of the education program continues to be reduction of falls in the community.
The fall education curriculum will be included in the onboarding packets for clients of the Senior Care Network and yearly education sessions will be provided to the staff.
Digital USD Citation
Birnie, Alison, "Fall Reduction in the Home Setting for Older Adults: An Evidenced Based Practice Project" (2024). Doctor of Nursing Practice Final Manuscripts. 273.
https://digital.sandiego.edu/dnp/273
Copyright
Copyright held by the author