Date of Conferral

2021

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Joan E. Hahn

Abstract

AbstractFalls among residents of long-term care facilities (LTCFs) pose significant threats to their health and quality of life, as falls often lead to life-threatening injuries such as traumatic brain injury and hip fractures. The etiology of the falls is multifactorial and complex; thus, interventions to reduce the falls typically combine two or more evidence-based interventions. The objective of this doctorate project was to develop an evidenced-based clinical practice guideline (CPG) outlining a multifaceted, evidenced-based bundled set of interventions for a fall prevention program to reduce falls for elderly patients living in the LTCFs. Lewin’s 3-step model of change was used to inform this project’s planning and evaluation of the CPG. Peer-reviewed journal articles and published clinical practice guidelines were the sources of evidence for the CPG development. Inclusion selection criteria considered evidence rated at Levels I to IV based on the AGREE II tool method and published later than 2011, preferably in the latest 5 years. Staff (N = 23) inclusive of members of the project team of stakeholders representing registered nurses, licensed practical nurses, and certified nursing assistants assessed the CPG for its quality and usability. This CPG had an overall quality rating of 5.4 (based on a Likert scale ranging from 1 as lowest to 7 as highest) and a mean domain score of 75.3%. The findings showed support for this CPG using the Morse falls tool as a suitable risk assessment tool along with bundled interventions. The CPG was strongly recommended by staff for implementation. This CPG has potential for promoting positive social change when used to evaluate the fall policies and promote use of evidenced-based CPGs to reduce the incidence of falls among residents of LCTFs.

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