Doctor of Nursing Practice
Psychiatric Mental Health Nurse Practitioner (PMHNP)
Year Degree Awarded
Month Degree Awarded
Julia M. Ronconi, DNP, APDN PMHNP-BC
Background and Review of Literature: Adults with intellectual disabilities are vulnerable to falls. Proper intervention results in enhanced health outcomes. Implementing Otago Exercise Program (OEP), an evidence-based exercise intervention, has been shown to reduce fall rates among adults with ID.
Purpose: To use evidence-based preventive measures for reducing falls among intellectually disabled mental health facility residents over the age of 55.
Methods: An OEP was provided to adults with Intellectual Disabilities aged 50 and above at a chronic mental health facility for eight weeks. The implementation involved four phases. Phase one included organizing meetings with stakeholders and gathering pre-intervention data. In phase two, staff were trained through pamphlets and educational sessions. Phase three involved the implementation of the project interventions. The intervention involved exercise and a walking program administered by the Doctor of Nursing Practice (DNP) student and physical therapists and direct care staff.
Results: The paired t-test demonstrated that there was a significant difference in Mores Fall Scale (MFS) scores before and after the implementation of OEP (Paired t=-2.96, p=.005). After OEP implementation, the MFS mean score was decreased from 11.22 (2.31) to 8.12 (2.19). Next, there was a fall rate reduction from 60% before implementation to 32% after implementation. Again, the self-report questionnaire results show significant improvement in staff’s knowledge of fall prevention practices. Finally, the Otago Exercise Program was well received by the nurses with almost all the nurses participating in the program from start to the end recording a 90% attendance.
Implications/Conclusion: The project's findings are likely to demonstrate the implementation of exercise and walking programs in reducing fall rates among adults with ID. The project may also have policy implications. Overall, the OEP portrayed a positive trend in improving staff knowledge and engagement of falls prevention practices. This project has shown the OEP is one of the preventive measures to help reduce falls among older people with ID.
Keywords: Otago Exercise Program, walking, intellectual disability, fall, exercise, adults
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