Use of a multifactorial fall protocol in primary care to reduce falls in community dwelling older adults




Smith, Deborah Ann


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Background: Falls among older community dwelling adults 65 years and older claim at least one life every twenty minutes in the United States. Falls occur in 28% of community dwelling older adults and result in seven million injuries per year and costs projected to rise above $100 billion within this decade. Primary care practice should implement fall risk screening with multifactorial fall assessments and interventions to avert unnecessary injuries and enhance quality of life. Purpose: The purpose of this quality improvement (QI) project was to improve management of falls through implementation of an evidence-based multifactorial fall risk protocol in a primary care clinic aimed at decreasing fall rates among community dwelling adults 65 years and older. Method: This QI project used a one-group pretest posttest and retrospective chart review comparison and correlation design to implement the STEADI fall protocol in a primary care clinic. Staff and providers were educated regarding fall risk assessment and preventative interventions guided by the STEADI algorithm. Aims included increasing provider and staff knowledge and decreasing community dwelling patient fall rates. Results: The STEADI fall prevention protocol was used in over 90% of patients 65 years and older. Fall assessments increased by 48% from prior review, and an increase in appropriate referrals as an intervention was associated with high fall risk patients (r = .209, p < .01). Fall rates decreased by 13.4% from pre-implementation (28.8%) to post-implementation (15.4%). Implications: Use of the STEADI fall risk protocol in this primary care clinic improved provider and staff assessment and management of fall risk and decreased fall rates for patients aged 65 and older.



older community dwelling adults, multifactorial fall assessment, STEADI fall algorithm, fall risk, fall rate