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Falls are prevalent among those aged 65 years and older and may result in minor to debilitating injuries in this vulnerable population. Frailty, unsteady gait, and medication side effects all contribute to fall risk as well as dementia, a type of cognitive impairment that disrupts memory and judgment leading to

Falls are prevalent among those aged 65 years and older and may result in minor to debilitating injuries in this vulnerable population. Frailty, unsteady gait, and medication side effects all contribute to fall risk as well as dementia, a type of cognitive impairment that disrupts memory and judgment leading to an underestimation of fall risk. Fall prevention evidence suggests that interventions aimed at decreasing fall rates begin with a fall risk assessment and tailored fall prevention measures that promote safety.

To examine the effectiveness of a fall prevention program in dementia care, an evidence-based pilot was conducted in a long-term care facility focused on dementia care. A convenience sample of 16 nurses received a fall prevention education intervention. A fall prevention knowledge instrument measured pre and post-fall prevention knowledge. There was a significant increase in fall risk knowledge from the pre-test (p < .001). The participants then conducted a fall risk assessment of 50 dementia patients using the Morse Fall Scale.

Of the 50 dementia patients, 28 were identified as high risk for falls. The nurses then instituted tailored fall risk prevention measures for those high risk for falls. As a result of the pilot, 40 fall events were noted within a three-month time period, reflecting a significant reduction in falls (p < .001) from the previous year. The institution of a fall prevention program in dementia care incorporating nursing education, a fall risk scale, and measures to promote safety can reduce fall risk in dementia patients.

ContributorsEbea, Kate Ndudi (Author) / Tharalson, Erin (Thesis advisor)
Created2020-05-06
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Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually, transitional care should be time-sensitive, patient-centered services intended to ensure continuity of care and an efficient transition between health care

Ineffective transitional care programs for ensuring the continuation of care from acute settings to the home settings post discharge can result in rehospitalization of elderly patients with chronic diseases. Usually, transitional care should be time-sensitive, patient-centered services intended to ensure continuity of care and an efficient transition between health care settings or home. A patient centered transitional care program was implemented at an outpatient primary care facility to reduce readmission rates. Institutional Review Board approval was obtained.

Twenty adult patients with chronic diseases discharged from an acute setting were identified. A follow up phone call and/or a home visit within 24-72 hours post discharge was employed. The Care Transitions Measure (CTM®) and Medication Discrepancy Tool (MDT®) were utilized to identify quality of care of transition and medication discrepancies. A chart audit collected data on the age of participant, diagnosis for initial hospitalization, CTM score, home visit, and ED visits or re-hospitalizations after 30 days of discharge. The outcome indicated that transitional care within primary care utilizing evidence-based practices is beneficial in reducing readmission rates. A logistic regression showed model significance, p = .002, suggesting that the CTM score was effective for both telephone support (TS) and home visit (HV).

A correlation analysis showed that as age of participants increased, the CTM score decreased, indicating that older adults required more support. A significance p <.001, of a proportional test indicated that readmission rates after the intervention was lower. It is evident that providing a timely and effective transitional care intervention in a primary care setting can reduce hospital readmissions, improve symptom management and quality of life of adult patients with chronic diseases.

ContributorsAnnor, Wilhelmina Sagoe (Author) / Baker, Laurie (Thesis advisor)
Created2020-05-05
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Importance: Idiopathic Pulmonary Fibrosis (IPF) is a worldwide deadly disease with a mortality rate of nearly 100% without lung transplantation (IPF Foundation, 2020). The exact cause of this disease is unclear. Evidence has shown that IPF patients have a high risk of having abnormal acid reflux. Chronic acid reflux can

Importance: Idiopathic Pulmonary Fibrosis (IPF) is a worldwide deadly disease with a mortality rate of nearly 100% without lung transplantation (IPF Foundation, 2020). The exact cause of this disease is unclear. Evidence has shown that IPF patients have a high risk of having abnormal acid reflux. Chronic acid reflux can worsen IPF prognosis. Objective: To assess the effectiveness of an online educational intervention in enhancing clinician’s belief, confidence and readiness in implementing an acid reflux screening protocol in IPF patients. Methods: Physicians and nurse practitioners in primary care and pulmonary specialties within the United States were asked to complete online pre- and post-surveys after reviewing a webpage presenting up-to-date research evidence showing the relationship between IPF and gastroesophageal reflux disease (GERD). Main Outcomes and Measures: Questionnaires adapted from the Evidence-Based Practice Beliefs and Implementation Scales by Melnyk were utilized to evaluate changes in belief, confidence and readiness to implement evidence-based practice recommendations. Results: Percentage of participants who strongly believed in acid reflux screening in IPF increased from 60% pre-survey to 80% post survey (M=4.75, SD=0.58). The percentage of participants who thought they were ready to implement this screening protocol decreased from 60% pre-survey to 50% post survey (M=4.44, SD=0.63). More participants felt strongly confident during the post-survey. The pre-survey had 130 views with a completion rate of 12.3%. Conclusion and Relevance: An online educational tool such as a webpage was an effective way to enhance clinician’s belief and confidence in acid reflux screening in IPF. Keywords: idiopathic pulmonary fibrosis, gastroesophageal reflux disease, abnormal acid reflux screening, evidence-based practice
Created2021-04-27