Doctor of Nursing Practice (DNP) Projects

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This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Embargo Period

5-9-2012

Degree Program

Doctor of Nursing Practice

Degree Track

Family Nurse Practioner

Year Degree Awarded

2011

Month Degree Awarded

May

Keywords

fall prevention, post-fall, accidental falls, falls in long term care and falls in the elderly

Advisor

M. Christine King

DNP Project Chair

Jacelon S Jacelon

DNP Project Member Name

Donna Zucker

DNP Project Outside Member Name

Peter S Connolly

Abstract

BACKGROUND OF PROBLEM:

Falls, can be a devastating source of morbidity and mortality for the older adult. According to a recent CDC Report, “Falls Among the Older Adult”, more than one third of adults aged 65 and older fall each year in the United States and falls are the leading cause of injury deaths. Falls are also the most common cause of nonfatal injuries and hospital admissions for trauma in the older adult population (CDC Report). Unfortunately, the rate of fall-related deaths is increasing over the last decade despite aggressive interventions. Finding the right intervention to prevent falls has been difficult, if not impossible. Because older adults living in long term care institutions continue to fall despite the implementation of evidence-based guidelines to prevent falls, identifying the causes of each fall is critical to preventing future falls. Implementing post-fall huddles (PFH) shows promise for reducing falls in individuals in long term care facilities.

OBJECTIVE:

To implement PFHs and assess the impact of PFHs on the number of patients with repeat falls, the number of falls for each patient with a fall history, and the fall rate at Tewksbury Hospital.

METHODS:

Post-fall Huddles were implemented on all Department of Public Health Units at Tewksbury Hospital for a three month period of time. The primary outcome measure was staff compliance rates for the PFH intervention, measured as a percent of huddle forms completed for each fall. Secondary indicators measured the overall fall rate per 1000 patient days, and a reduction in the number of patients who fell recurrently. Data was compared to rates from the same quarter last year, and for the quarter immediately preceding the intervention.

RESULTS:

Descriptive analysis was used to examine the PFH compliance, fall rates pre and post-intervention, and the number of recurrent fallers. Mean PFH compliance rates were 40% for the entire intervention period. The mean fall rate was 7.62 post-intervention, compared to 7.91 for the same quarter last year. The mean number of patients with repeat falls was 9 compared to 11 for the same quarter last year. Although improvements were small, they may indicate that the implementation of PFHs by a multidisciplinary team may impact patient fall rates in sub-acute long term care facilities.

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