Date of Award
Final DNP Paper
Doctor of Nursing Practice (DNP) in Family Nurse Practitioner
Lynnette Lewis Djonret-Hall, DNP, RN
Martha Young Richey, DNP, RN
Background: Falling is defined as an accidental encounter with the ground or other surfaces. Individuals with dementia are at a greater risk for falls due to conditions such as neurological impairments in perception or cognition. Presently, 50 million people live with dementia worldwide, which is projected to increase to 152 million by 2050 because of a rise in life expectancy and an aging population. The incidence of falls has rapidly become a major public health problem around the world. Approximately 30% of people older than 65 years of age fall each year, and patients with dementia cost the nation $236 billion in 2016. However, what is available for patients at risk for falls is limited to standard interventions throughout health care systems, such as the use of safety alarms and hourly rounding. Innovative strategies such as early recognition of the disease process of cognitive impairment can decrease the occurrence of falls. Also, an abundance of the literature states approximately 78% of falls experienced are from patients who are predicted to be more prone to falls and incidents.
Purpose: The purpose of this Doctor of Nursing Practice (DNP) project is to assess the effectiveness of a specific patient-centered quality improvement study in a hospitalized setting as a potential strategy to reduce the number of patient falls.
Design Method: A quasi-experimental design using hospital staff’s pre- and post-education test scores along with pre- and post-intervention fall data collection methods.
Results: This project used a paired t-test to compare overall pre and post-test results related to knowledge gained from the educational intervention. The paired t-test looked at the pre-and post-education scores per participant. The mean participating staff test score prior to receiving education equaled 70.33 %. The mean participating staff test score after receiving education equaled 84.50%.The p value test results of the pre and post educational test scores was less than .001 (std +/- 7 test points) suggesting the Null hypothesis was rejected and showed the difference between the mean test scores were statistically highly significant. The pre-intervention mean score was 1.5 falls per month and a post-intervention mean score was 1.8 falls per month.These statistical findings may have been skewed due to potential unidentified outliers.
Conclusion: Fall rates moderately increased overall within the pilot facility between September 2020 to May 2021. However, the fall prevention initiative did increase the staff’s knowledge on recognizing early signs of cognitive decline like dementia.
Keywords: falls, dementia, cognitive impairment, fall risk
Smalls, Milledge, "Fall Prevention: The First Line of Defense. Integration of Innovated Strategies to Decrease Falls for the Hospitalized Patient" (2021). Doctor of Nursing Practice Projects. 34.