Implementing Evidence-based Fall Prevention Bundle to Reduce Preventable Falls in a Long-term Memory Care Unit: A Quality Improvement Project
Nature and scope of the project
Falls in older adults are prevalent and can result in an injury affecting their quality of life. Whether a fall is fatal or not, it has a high financial impact. Older adults with cognitive impairment fall more frequently than cognitively fit persons. An evidence-based intervention will be implemented to achieve better outcomes for a problem. This quality improvement project aims to develop, implement, and evaluate an evidence-based fall prevention bundle to reduce preventable falls in a long-term memory care unit.
Synthesis and analysis of supporting literature
Research databases such as PubMed, Scopus, Joanna Briggs, and CINAHL were used to search for evidence. The keywords used were accidental falls, dementia or cognitive impairment, and nursing home. The John Hopkins Nursing Evidence-based Practice Research Evidence Appraisal Tool was used to rate the level and quality of articles. Based on the evidence reviewed, the interventions that will be implemented are screening, physical exercises, vitamin D supplementation, purposeful hourly rounding, and post-fall huddles.
Project implementation
Kurt Lewin’s force field analysis will guide the project’s implementation. The project participants will be the nurses, certified nursing assistants, restorative aides, life enrichment personnel, and physicians for all shifts at a long-term memory care unit. The participants will implement the evidence-based fall prevention bundle based on their scope of practice. The expected duration of their participation will be 12 weeks.
Evaluation criteria
The number of falls will be measured by frequency. The timed up-and-go (TUG) scores will assess the resident’s balance. The compliance of the participants will also be measured.
Outcomes
After the project is implemented, the number of falls three months pre-implementation, during, and three months post-implementation will be collected and analyzed. The residents' TUG scores and the participants' compliance will also be collected and analyzed.
Recommendations
The recommendations from this project will help the long-term memory care unit improve the care they provide for the residents, specifically in reducing preventable falls.
Implementing Evidence-based Fall Prevention Bundle to Reduce Preventable Falls in a Long-term Memory Care Unit: A Quality Improvement Project