Usual Care Versus Best Practice: A Program Evaluation on Fall Risk Assessment

Abstract

In the United States, falls are a significant cause of morbidity, mortality, and loss of independence in the older adult population. One third of adults, age 65 years and older, fall each year (Centers for Disease Control and Prevention, 2013b). The fear of falling can also lead to decreased activity level, further increasing fall risk (Kempen et al., 2009). Furthermore falls have a major financial impact, costing the United States over 30 billion dollars each year (Centers for Disease Control and Prevention, 2013a). In North Carolina, falls were the most common diagnosis for hospital admission among the elderly (NC Department of Health and Human Services, 2012). To address the prevention of falls in the community, community-based agencies have implemented fall risk assessment tools (Tinetti, 2008). / / This honors project was conducted at a home health agency in a city in eastern North Carolina in collaboration with a home health nurse. The purpose was to examine the usual practice of fall risk assessment among home health clients and compare this with best practice fall risk assessment. This project will take place over seven weeks, and will include routine home visits to home health clients with a home health nurse. The project has three objectives: 1) to interview 4-5 key informants to determine their perspective on falls among older adults and the usefulness of the fall risk assessment by Feb. 14, 2014, 2) to identify the steps in implementation of fall risk assessment with home health clients by Feb. 26, 2014, and 3) the home health nurses and I will determine how usual practice compares with best practices by February 26, 2014. By utilizing the fall risk assessment tool with my preceptor I will be providing screening for my clients to determine which clients are considered a high risk for falls. I intend to provide health teaching to my clients on ways to prevent falls within their homes, and written recommendations will be submitted to the agency nursing director at a staff meeting by February 26, 2014 /