Mm 2 forms

ImplementingaNurse2.docx

2

Implementing a Nurse-Led Fall Risk Assessment and Prevention Program

Students name

Institution affiliation

Course

Instructors name

Date

Implementing a Nurse-Led Fall Risk Assessment and Prevention Program

Older adults have falls as a significant issue of public health in the United States, especially in the adult day care facilities where the older adults spend a considerable amount of time. The impact of falls may be severe, such as injury, loss of independence, long-term disability, and death. The paper will discuss the problem of fall prevention in an adult day care setting, provide a clear problem statement and aim of the paper, and outline a suitable theoretical framework that will be used to implement a nurse-led fall risk assessment and prevention program.

Practice Setting

The targeted project will occur in an adult day care center where the target population will be the elderly population who are mostly frail, living with chronic age-related ailments, and having different levels of mobility restrictions. Social interaction, health care, and organized activities are some of the services, which are important in adult day care facilities and give the family caregivers a break. Although those are advantages, the safety of participants is still a problem. A high number of people in this environment have several risk factors of falls, such as cognitive impairment, vision loss, muscle weakness, and balance problems caused by medications, and tend to argue in favor of fall-related injuries.

Population of the Practice Setting.

The target population comprises of the adults aged 65 years and above who visit the adult day care facility. Most of the participants have a variety of chronic illnesses including arthritis, dementia, and cardiovascular disease, which puts them at risk of falling. Independence among the participants is differentiated but they usually need help with their activities of daily living. As the health requirements of this group are complex, a comprehensive fall risk assessment and prevention course should be applied to enhance the overall level of safety and health outcomes.

Problem Identification

Older falls in adult day care programs are known to be a huge and common problem. The lack of a unified and evidence-based fall risk assessment and prevention program is one of the key factors. The Centers for Disease Control and Prevention (CDC) explains that around a quarter of adults aged 65 and above suffer a fall annually with most of them incurring injuries like fractures, head trauma, and hospitalization (Wilkerson, 2022). Falls in the adult day care setting is possibly underreported and not always mitigated because routine screening and recommended prevention efforts are not routine. The conditions observed in the setting also suggest that the risk of falls and individual intervention are not conducted regularly, which results in the lack of prevention opportunities.

Problem Statement

Falls in older adults living in adult day care facilities are a critical problem, but due to lack of standardized and evidence-based fall risk assessment and prevention program, it leads to insufficient identification of risk factors and subsequent timely preventive measures. This disparity in care is one of the factors that has led to the rising number of falls and associated injuries among this susceptible population.

Aim Statement

This project will seek to carry out a nurse-led fall risk assessment and prevention initiative in an adult day care facility among adults aged 65 years and above. The program aims at the 30% reduction of falls in half a year of the program. The main elements of the intervention are the development of the individual fall risk assessment and prevention plans, the staff training, and continuous monitoring and evaluation. The outcome measures of the program will include the number of falls and the health outcomes of participants.

Framework Selection

The Health Belief Model (HBM) will be used as the theoretical framework of this project. Some of the common theoretical models that are used to explain and predict health behaviors are the HBM in which people base their beliefs and perceptions on (Vincenzo et al., 2022). It is especially suited to the health promotion programs, to which fall prevention belongs, and behavior change and heightened awareness are the keys to success.

The key constructs of the health belief model are:

Perceived Susceptibility: Respondents will be required to be aware of their individual risks of falling.

Perceived Severity: The participants have to learn about severe physical and functional impacts that could occur as a result of falls.

Perceived Benefits: This needs to be believed by the participants that the preventive measures, including the balance training or assistive devices, will lower the risk of falls.

Perceived Barriers: The program should recognize and deal with barriers like the fear of falling, unwillingness to use assistive devices or issues related to stigma.

Prompts of Action: Prompts will be provided to continue fall prevention behaviors by use of cues such as nurse-led assessment, education sessions, and regular follow-ups.

Framework Implementation.

Health Belief Model offers a great basis in dealing with the issue of fall prevention in the adult day care facility in both identifying the risks and behavior modification (Giovanni et al., 2022). Individualized fall risk assessment will enhance the perceived risk and severity of the participants as personal risk factors will be communicated effectively. Perceived advantages of preventive behaviors will be emphasized through education and interventions, like strength and balance training or medication education. The perceived barriers will be overcome with the help of the staff, motivation, and specific interventions that do not violate the wishes of the participants. Prompts to act will be incorporated in the form of planned reviews, alerts and regular staff interaction to remind the staff of fall prevention measures.

Conclusion

The problem of falls in older adults in the environment of adult day cares is a severe challenge to the safety and quality of life and requires an organized and evidence-based prevention method. A nurse-based program of assessing and preventing falls, based on the Health Belief Model, is an efficient way of preventing the number of falls among this high-risk group of patients. The proposed program can change the situation by targeting personal risk factors, increasing awareness, and encouraging more proactive behaviors to enhance the safety outcomes and health outcomes of older adults that receive care at adult day care institutions.

References

Giovannini, S., Brau, F., Galluzzo, V., Santagada, D. A., Loreti, C., Biscotti, L., ... & Bernabei, R. (2022). Falls among older adults: screening, identification, rehabilitation, and management. Applied Sciences, 12(15), 7934. https://www.mdpi.com/2076-3417/12/15/7934

Vincenzo, J. L., Patton, S. K., Lefler, L. L., McElfish, P. A., Wei, J., & Curran, G. M. (2022). A qualitative study of older adults' facilitators, barriers, and cues to action to engage in falls prevention using health belief model constructs. Archives of gerontology and geriatrics, 99, 104610. https://pmc.ncbi.nlm.nih.gov/articles/PMC9344858/pdf/nihms-1766757.pdf

Wilkerson, J. L. (2022). Has Productivity Improved in the Treatment of Traumatic Brain Injury from Falls Among Older Adults?. University of Arkansas for Medical Sciences. https://search.proquest.com/openview/3fff7b259e21aec9c9a256cf3e04b957/1.pdf?pq-origsite=gscholar&cbl=18750&diss=y

JHEBPModelforNursingHierarchyEvidenceGuide.pdf

Johns Hopkins Evidence-Based Practice Model for Nursing and Healthcare Professionals Hierarchy of Evidence Guide Appendix D

Note: Refer to the appropriate Evidence Appraisal Tool (Research [Appendix E] or Nonresearch [Appendix F]) to determine quality ratings.

Evidence Level Types of Evidence

R es

ea rc

h E

vi de

nc e

(A pp

en di

x E

)

Level I • Experimental study, randomized controlled trial (RCT) • Explanatory mixed methods design that includes only a Level I quaNtitative study • Systematic review of RCTs, with or without meta-analysis

Level II • Quasi-experimental study • Explanatory mixed methods design that includes only a Level II quaNtitative study • Systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysis

Level III

• Nonexperimental study • Systematic review of a combination of RCTs, quasi-experimental and nonexperimental studies, or nonexperimental studies only, with or without meta-analysis. • Exploratory, convergent, or multiphasic mixed methods studies • Explanatory mixed methods design that includes only a Level III quaNtitative study • QuaLitative study • Systematic review of quaLitative studies with or without meta-synthesis

N on

re se

ar ch

E vi

de nc

e

(A pp

en di

x F)

Level IV Opinion of respected authorities and/or nationally recognized expert committees or consensus panels based on scientific evidence. Includes:

• Clinical practice guidelines • Consensus panels/position statements

Level V

Based on experiential and non-research evidence. Includes: • Scoping reviews • Integrative reviews • Literature reviews • Quality improvement, program or financial evaluation • Case reports • Opinion of nationally recognized expert(s) based on experiential evidence

NU760Unit3SynthesisMatrixTable.docx

INSERT YOUR NAME HERE

	In-text citation for the resource – in the References list below this table include a full citation. You are required to upload the full-text file for each article represented in the matrix table into the assignment drop box.	What is the purpose of the resource to support the prompt for the unit?	1. Is the resource a research or non-research study (Hint: JH EBP Rating Scale notes which are research or non-research at the side of the scale) ? 2. What is the study design (i.e., Systematic Review of RCTs, Prospective Cohort, etc.) ? 3. If not a research study, what type of literature is represented in the resource (i.e., peer-review like narrative review, case reports, clinical guidelines in published journals or non-peer review like editorials, policy briefs, opinion pieces) ?	What are the findings and the recommendations in this resource that are relevant to your proposed graduate scholarship project?	How does this resource support your proposed project?
Articles/resources #1-2 in the table need to demonstrate the observation of the problem you identified for which you are designing a project to address. ***Input your Problem Statement here from your unit #2 assignment here :
1
2

Articles/resources #3 -6 in the table need to demonstrate support for the intervention you have selected to address the identified problem. ***Input your Intervention here from your unit #2 assignment here :
3
4
5
6

References

ImplementingaNurse2.docx

2

Implementing a Nurse-Led Fall Risk Assessment and Prevention Program

Students name

Institution affiliation

Course

Instructors name

Date

Implementing a Nurse-Led Fall Risk Assessment and Prevention Program

Older adults have falls as a significant issue of public health in the United States, especially in the adult day care facilities where the older adults spend a considerable amount of time. The impact of falls may be severe, such as injury, loss of independence, long-term disability, and death. The paper will discuss the problem of fall prevention in an adult day care setting, provide a clear problem statement and aim of the paper, and outline a suitable theoretical framework that will be used to implement a nurse-led fall risk assessment and prevention program.

Practice Setting

The targeted project will occur in an adult day care center where the target population will be the elderly population who are mostly frail, living with chronic age-related ailments, and having different levels of mobility restrictions. Social interaction, health care, and organized activities are some of the services, which are important in adult day care facilities and give the family caregivers a break. Although those are advantages, the safety of participants is still a problem. A high number of people in this environment have several risk factors of falls, such as cognitive impairment, vision loss, muscle weakness, and balance problems caused by medications, and tend to argue in favor of fall-related injuries.

Population of the Practice Setting.

The target population comprises of the adults aged 65 years and above who visit the adult day care facility. Most of the participants have a variety of chronic illnesses including arthritis, dementia, and cardiovascular disease, which puts them at risk of falling. Independence among the participants is differentiated but they usually need help with their activities of daily living. As the health requirements of this group are complex, a comprehensive fall risk assessment and prevention course should be applied to enhance the overall level of safety and health outcomes.

Problem Identification

Older falls in adult day care programs are known to be a huge and common problem. The lack of a unified and evidence-based fall risk assessment and prevention program is one of the key factors. The Centers for Disease Control and Prevention (CDC) explains that around a quarter of adults aged 65 and above suffer a fall annually with most of them incurring injuries like fractures, head trauma, and hospitalization (Wilkerson, 2022). Falls in the adult day care setting is possibly underreported and not always mitigated because routine screening and recommended prevention efforts are not routine. The conditions observed in the setting also suggest that the risk of falls and individual intervention are not conducted regularly, which results in the lack of prevention opportunities.

Problem Statement

Falls in older adults living in adult day care facilities are a critical problem, but due to lack of standardized and evidence-based fall risk assessment and prevention program, it leads to insufficient identification of risk factors and subsequent timely preventive measures. This disparity in care is one of the factors that has led to the rising number of falls and associated injuries among this susceptible population.

Aim Statement

This project will seek to carry out a nurse-led fall risk assessment and prevention initiative in an adult day care facility among adults aged 65 years and above. The program aims at the 30% reduction of falls in half a year of the program. The main elements of the intervention are the development of the individual fall risk assessment and prevention plans, the staff training, and continuous monitoring and evaluation. The outcome measures of the program will include the number of falls and the health outcomes of participants.

Framework Selection

The Health Belief Model (HBM) will be used as the theoretical framework of this project. Some of the common theoretical models that are used to explain and predict health behaviors are the HBM in which people base their beliefs and perceptions on (Vincenzo et al., 2022). It is especially suited to the health promotion programs, to which fall prevention belongs, and behavior change and heightened awareness are the keys to success.

The key constructs of the health belief model are:

Perceived Susceptibility: Respondents will be required to be aware of their individual risks of falling.

Perceived Severity: The participants have to learn about severe physical and functional impacts that could occur as a result of falls.

Perceived Benefits: This needs to be believed by the participants that the preventive measures, including the balance training or assistive devices, will lower the risk of falls.

Perceived Barriers: The program should recognize and deal with barriers like the fear of falling, unwillingness to use assistive devices or issues related to stigma.

Prompts of Action: Prompts will be provided to continue fall prevention behaviors by use of cues such as nurse-led assessment, education sessions, and regular follow-ups.

Framework Implementation.

Health Belief Model offers a great basis in dealing with the issue of fall prevention in the adult day care facility in both identifying the risks and behavior modification (Giovanni et al., 2022). Individualized fall risk assessment will enhance the perceived risk and severity of the participants as personal risk factors will be communicated effectively. Perceived advantages of preventive behaviors will be emphasized through education and interventions, like strength and balance training or medication education. The perceived barriers will be overcome with the help of the staff, motivation, and specific interventions that do not violate the wishes of the participants. Prompts to act will be incorporated in the form of planned reviews, alerts and regular staff interaction to remind the staff of fall prevention measures.

Conclusion

The problem of falls in older adults in the environment of adult day cares is a severe challenge to the safety and quality of life and requires an organized and evidence-based prevention method. A nurse-based program of assessing and preventing falls, based on the Health Belief Model, is an efficient way of preventing the number of falls among this high-risk group of patients. The proposed program can change the situation by targeting personal risk factors, increasing awareness, and encouraging more proactive behaviors to enhance the safety outcomes and health outcomes of older adults that receive care at adult day care institutions.

References

Giovannini, S., Brau, F., Galluzzo, V., Santagada, D. A., Loreti, C., Biscotti, L., ... & Bernabei, R. (2022). Falls among older adults: screening, identification, rehabilitation, and management. Applied Sciences, 12(15), 7934. https://www.mdpi.com/2076-3417/12/15/7934

Vincenzo, J. L., Patton, S. K., Lefler, L. L., McElfish, P. A., Wei, J., & Curran, G. M. (2022). A qualitative study of older adults' facilitators, barriers, and cues to action to engage in falls prevention using health belief model constructs. Archives of gerontology and geriatrics, 99, 104610. https://pmc.ncbi.nlm.nih.gov/articles/PMC9344858/pdf/nihms-1766757.pdf

Wilkerson, J. L. (2022). Has Productivity Improved in the Treatment of Traumatic Brain Injury from Falls Among Older Adults?. University of Arkansas for Medical Sciences. https://search.proquest.com/openview/3fff7b259e21aec9c9a256cf3e04b957/1.pdf?pq-origsite=gscholar&cbl=18750&diss=y

JHEBPModelforNursingHierarchyEvidenceGuide.pdf

Johns Hopkins Evidence-Based Practice Model for Nursing and Healthcare Professionals Hierarchy of Evidence Guide Appendix D

Note: Refer to the appropriate Evidence Appraisal Tool (Research [Appendix E] or Nonresearch [Appendix F]) to determine quality ratings.

Evidence Level Types of Evidence

R es

ea rc

h E

vi de

nc e

(A pp

en di

x E

)

Level I • Experimental study, randomized controlled trial (RCT) • Explanatory mixed methods design that includes only a Level I quaNtitative study • Systematic review of RCTs, with or without meta-analysis

Level II • Quasi-experimental study • Explanatory mixed methods design that includes only a Level II quaNtitative study • Systematic review of a combination of RCTs and quasi-experimental studies, or quasi-experimental studies only, with or without meta-analysis

Level III

• Nonexperimental study • Systematic review of a combination of RCTs, quasi-experimental and nonexperimental studies, or nonexperimental studies only, with or without meta-analysis. • Exploratory, convergent, or multiphasic mixed methods studies • Explanatory mixed methods design that includes only a Level III quaNtitative study • QuaLitative study • Systematic review of quaLitative studies with or without meta-synthesis

N on

re se

ar ch

E vi

de nc

e

(A pp

en di

x F)

Level IV Opinion of respected authorities and/or nationally recognized expert committees or consensus panels based on scientific evidence. Includes:

• Clinical practice guidelines • Consensus panels/position statements

Level V

Based on experiential and non-research evidence. Includes: • Scoping reviews • Integrative reviews • Literature reviews • Quality improvement, program or financial evaluation • Case reports • Opinion of nationally recognized expert(s) based on experiential evidence

NU760Unit3SynthesisMatrixTable.docx

INSERT YOUR NAME HERE

	In-text citation for the resource – in the References list below this table include a full citation. You are required to upload the full-text file for each article represented in the matrix table into the assignment drop box.	What is the purpose of the resource to support the prompt for the unit?	1. Is the resource a research or non-research study (Hint: JH EBP Rating Scale notes which are research or non-research at the side of the scale) ? 2. What is the study design (i.e., Systematic Review of RCTs, Prospective Cohort, etc.) ? 3. If not a research study, what type of literature is represented in the resource (i.e., peer-review like narrative review, case reports, clinical guidelines in published journals or non-peer review like editorials, policy briefs, opinion pieces) ?	What are the findings and the recommendations in this resource that are relevant to your proposed graduate scholarship project?	How does this resource support your proposed project?
Articles/resources #1-2 in the table need to demonstrate the observation of the problem you identified for which you are designing a project to address. ***Input your Problem Statement here from your unit #2 assignment here :
1
2

Articles/resources #3 -6 in the table need to demonstrate support for the intervention you have selected to address the identified problem. ***Input your Intervention here from your unit #2 assignment here :
3
4
5
6

References

ImplementingaNurse2.docx

2

Implementing a Nurse-Led Fall Risk Assessment and Prevention Program

Students name

Institution affiliation

Course

Instructors name

Date

Implementing a Nurse-Led Fall Risk Assessment and Prevention Program

Older adults have falls as a significant issue of public health in the United States, especially in the adult day care facilities where the older adults spend a considerable amount of time. The impact of falls may be severe, such as injury, loss of independence, long-term disability, and death. The paper will discuss the problem of fall prevention in an adult day care setting, provide a clear problem statement and aim of the paper, and outline a suitable theoretical framework that will be used to implement a nurse-led fall risk assessment and prevention program.

Practice Setting

The targeted project will occur in an adult day care center where the target population will be the elderly population who are mostly frail, living with chronic age-related ailments, and having different levels of mobility restrictions. Social interaction, health care, and organized activities are some of the services, which are important in adult day care facilities and give the family caregivers a break. Although those are advantages, the safety of participants is still a problem. A high number of people in this environment have several risk factors of falls, such as cognitive impairment, vision loss, muscle weakness, and balance problems caused by medications, and tend to argue in favor of fall-related injuries.

Population of the Practice Setting.

The target population comprises of the adults aged 65 years and above who visit the adult day care facility. Most of the participants have a variety of chronic illnesses including arthritis, dementia, and cardiovascular disease, which puts them at risk of falling. Independence among the participants is differentiated but they usually need help with their activities of daily living. As the health requirements of this group are complex, a comprehensive fall risk assessment and prevention course should be applied to enhance the overall level of safety and health outcomes.

Problem Identification

Older falls in adult day care programs are known to be a huge and common problem. The lack of a unified and evidence-based fall risk assessment and prevention program is one of the key factors. The Centers for Disease Control and Prevention (CDC) explains that around a quarter of adults aged 65 and above suffer a fall annually with most of them incurring injuries like fractures, head trauma, and hospitalization (Wilkerson, 2022). Falls in the adult day care setting is possibly underreported and not always mitigated because routine screening and recommended prevention efforts are not routine. The conditions observed in the setting also suggest that the risk of falls and individual intervention are not conducted regularly, which results in the lack of prevention opportunities.

Problem Statement

Falls in older adults living in adult day care facilities are a critical problem, but due to lack of standardized and evidence-based fall risk assessment and prevention program, it leads to insufficient identification of risk factors and subsequent timely preventive measures. This disparity in care is one of the factors that has led to the rising number of falls and associated injuries among this susceptible population.

Aim Statement

This project will seek to carry out a nurse-led fall risk assessment and prevention initiative in an adult day care facility among adults aged 65 years and above. The program aims at the 30% reduction of falls in half a year of the program. The main elements of the intervention are the development of the individual fall risk assessment and prevention plans, the staff training, and continuous monitoring and evaluation. The outcome measures of the program will include the number of falls and the health outcomes of participants.

Framework Selection

The Health Belief Model (HBM) will be used as the theoretical framework of this project. Some of the common theoretical models that are used to explain and predict health behaviors are the HBM in which people base their beliefs and perceptions on (Vincenzo et al., 2022). It is especially suited to the health promotion programs, to which fall prevention belongs, and behavior change and heightened awareness are the keys to success.

The key constructs of the health belief model are:

Perceived Susceptibility: Respondents will be required to be aware of their individual risks of falling.

Perceived Severity: The participants have to learn about severe physical and functional impacts that could occur as a result of falls.

Perceived Benefits: This needs to be believed by the participants that the preventive measures, including the balance training or assistive devices, will lower the risk of falls.

Perceived Barriers: The program should recognize and deal with barriers like the fear of falling, unwillingness to use assistive devices or issues related to stigma.

Prompts of Action: Prompts will be provided to continue fall prevention behaviors by use of cues such as nurse-led assessment, education sessions, and regular follow-ups.

Framework Implementation.

Health Belief Model offers a great basis in dealing with the issue of fall prevention in the adult day care facility in both identifying the risks and behavior modification (Giovanni et al., 2022). Individualized fall risk assessment will enhance the perceived risk and severity of the participants as personal risk factors will be communicated effectively. Perceived advantages of preventive behaviors will be emphasized through education and interventions, like strength and balance training or medication education. The perceived barriers will be overcome with the help of the staff, motivation, and specific interventions that do not violate the wishes of the participants. Prompts to act will be incorporated in the form of planned reviews, alerts and regular staff interaction to remind the staff of fall prevention measures.

Conclusion

The problem of falls in older adults in the environment of adult day cares is a severe challenge to the safety and quality of life and requires an organized and evidence-based prevention method. A nurse-based program of assessing and preventing falls, based on the Health Belief Model, is an efficient way of preventing the number of falls among this high-risk group of patients. The proposed program can change the situation by targeting personal risk factors, increasing awareness, and encouraging more proactive behaviors to enhance the safety outcomes and health outcomes of older adults that receive care at adult day care institutions.

References

Giovannini, S., Brau, F., Galluzzo, V., Santagada, D. A., Loreti, C., Biscotti, L., ... & Bernabei, R. (2022). Falls among older adults: screening, identification, rehabilitation, and management. Applied Sciences, 12(15), 7934. https://www.mdpi.com/2076-3417/12/15/7934

Vincenzo, J. L., Patton, S. K., Lefler, L. L., McElfish, P. A., Wei, J., & Curran, G. M. (2022). A qualitative study of older adults' facilitators, barriers, and cues to action to engage in falls prevention using health belief model constructs. Archives of gerontology and geriatrics, 99, 104610. https://pmc.ncbi.nlm.nih.gov/articles/PMC9344858/pdf/nihms-1766757.pdf

Wilkerson, J. L. (2022). Has Productivity Improved in the Treatment of Traumatic Brain Injury from Falls Among Older Adults?. University of Arkansas for Medical Sciences. https://search.proquest.com/openview/3fff7b259e21aec9c9a256cf3e04b957/1.pdf?pq-origsite=gscholar&cbl=18750&diss=y

JHEBPModelforNursingHierarchyEvidenceGuide.pdf

NU760Unit3SynthesisMatrixTable.docx

ImplementingaNurse2.docx

JHEBPModelforNursingHierarchyEvidenceGuide.pdf

NU760Unit3SynthesisMatrixTable.docx

ImplementingaNurse2.docx

JHEBPModelforNursingHierarchyEvidenceGuide.pdf