Implementing an evidenced-based toolkit for fall prevention in community-dwelling Hispanic elderly




Hourigan, Claudia

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Background: One in four elderly falls, frequently resulting in unintentional injuries and death, causing a health concern and a financial burden. This project identified a home health agency (HHA) with a vulnerable population and unmet fall goals. It recognized nurses had fall knowledge deficits, no single fall identification instrument, and lacked evidence-based practice (EBP) resources. Objective: Project aims included: implementing an EBP fall prevention Stop Elderly Accidents, Death, and Injury (STEADI) protocol and minimizing elderly injuries and death in a South Texas HHA. Pre- and post-intervention comparisons were analyzed for employee STEADI tool kit knowledge and patient screening effectiveness in decreasing community-dwelling Hispanic elderly (CDHE) fall rates. Methods: The project employed a Quasi-Experimental with a Quality Improvement Initiative. On day one, the nurses (n=8) STEADI trained. Over three months, they applied the STEADI tool kit on CDHE (n=48). Evaluation and Measurement: Pre-STEADI fall data was the baseline. Quantitative pre-and post-STEADI educational tests, fall data chart review, and feedback surveys were collected and analyzed over three months. Paired sample t-Test compared pre- and post-STEADI scores to reveal a significant difference. Results: All HHA nurses (100%) were STEADI-trained and subsequently screened the CDHE (100%). Post-STEADI, an increase in the nurses' knowledge (36.25, 95% CI) and skills (147.5%, p =.007) occurred, and the CDHE fall rates were reduced (71%, p =.019). Conclusion: Adopting policies and procedures, including STEADI in HHA care, to sustain fall monitoring and screening is recommended as STEADI enhanced nurse organizational support, communication, training, and prudence and decreased CDHE falls.


A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Nursing Practice.


elderly falls, Hispanic, home health care, prevention, risk, screening