Date of Degree
Fall 2025
Document Type
DNP Scholarly Project
Academic Department
School of Nursing
Degree Type
Doctoral
Degree Name
Doctor of Nursing Practice
First Advisor
Corinne Cochran, DNP, RN, NNP-BC
Abstract
Problem: Falls continue to be one of the leading causes of injury and mortality among older adults and remain a significant driver of healthcare utilization and cost. Within the home health setting, inconsistent practices in fall risk assessment and intervention have contributed to care gaps and increased patient vulnerability. The absence of a standardized, evidence-based process created the need for a structured quality improvement initiative to strengthen patient safety.
Aim of the Project: The purpose of this quality improvement project was to integrate the CDC’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) toolkit into home health visits to enhance the consistency of fall risk screening, guide targeted interventions, and ultimately reduce fall events.
Review of the Evidence: A review of the literature supports the use of structured fall risk screening and multifactorial interventions to reduce adverse outcomes among community-dwelling older adults. The STEADI toolkit offers validated instruments and a framework for informed clinical decision-making, thereby enhancing provider adherence to best practices. Evidence suggests that the consistent use of such standardized tools strengthens the early detection of risk factors and informs timely, individualized prevention strategies.
Project Design: The project was guided by a quality improvement framework using the Plan-Do-Study-Act (PDSA) cycle to implement and refine processes incrementally. The OhioHealth Change Management (OHCM) model supported staff engagement, promoted adaptability, and enhanced the sustainability of practice changes.
Intervention: The intervention incorporated STEADI screening and interventions into routine home health workflows. Staff participated in education sessions focused on assessment, documentation, and patient education. Data sources included electronic health record audits, incident reports, and staff feedback surveys.
Significant Findings/Outcomes: The implementation of the STEADI toolkit improved completion rates of fall risk assessments and standardized the delivery of fall prevention strategies. Over time, staff efficiency improved, with reduced assessment duration and more consistent documentation. The agency reported a 100% decline in fall events, reflecting both improved clinical processes and enhanced patient outcomes.
Implications for Nursing: This project highlights the value of implementing evidence-based resources such as the STEADI toolkit into everyday clinical practice. Standardization not only promotes patient safety and quality of care but also supports staff confidence in fall prevention practices. For long-term sustainability, integration into electronic health records, ongoing education, and organizational support are recommended.
Recommended Citation
Barbosa - Barreiro, Margarida, "Fall Prevention in Home Care: The Introduction of the STEADI Initiative as Evidence-based Tool" (2025). Doctor of Nursing Practice (DNP) Scholarly Project. 46.
https://fuse.franklin.edu/dnp-project/46
Rights
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