Utilizing Change Theory to Implement a Quality Improvement, Evidence based Fall Prevention Model in Long-term Care

Abstract

In order to maintain safety and increase the quality of life for Long Term Care (LTC) residents, fall prevention is a primary concern. Although there is conflicting evidence regarding the effectiveness of fall prevention strategies in LTC, there are evidence-based strategies that can be implemented to decrease fall rates. In order for these strategies to be effective, a behavioral change must occur from an organizational standpoint that includes key stakeholders such as administration, staff, residents, and their families. The authors sought to test the hypothesis, if a Change Theory Fall Model (CTFM) was implemented at the LTC facility, then behavioral changes will occur among key stakeholders to decrease fall rates in residents. The CTFM is an evidence-based fall prevention model developed by an Advanced Practice Nurse (APN) that incorporated Kotter and Cohen’s Change Theory (2002). The CTFM was tested for its effectiveness in a non-profit, 119-bed nursing home, located in northern Alabama during January through December, 2011. Fall outcome measures for 2010 were compared with 2011. Although results did not reveal a decrease in fall rates for the specified time period, stakeholders did learn about Evidence Based Practice (EBP). Factors influencing fall rate outcomes included a high staff turn-over rate. Evaluation of the CTFM remains ongoing, and reeducation and data collection remain critical elements for success.