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NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Student Name

Capella University

NURS-FPX 6030 MSN Practicum and Capstone

Prof. Name


Problem Statement

The Increasing Incidence of Falls Among the Geriatric Community

The rising occurrence of falls among the geriatric population is a significant public health concern, resulting in both physical injuries and psychological distress, thereby decreasing overall quality of life. There is a need to reconsider current standard care approaches. Thus, our research centers around the PICOT question: “In geriatric patients residing in community settings with a history of falls and multiple comorbidities, does a tailored community-based fall prevention program reduce falls over eight months compared to standard care?” This central inquiry aims to explore more effective, individualized interventions for the elderly population.

Needs Assessment

Addressing Geriatric Falls: A Multifaceted Approach

The pressing need this project aims to address includes health promotion, quality improvement, and prevention, with a specific focus on geriatric falls within community settings. This need is crucial as falls among the elderly not only result in physical injuries but also impact mental well-being, leading to reduced mobility, social isolation, and diminished overall quality of life. Notably, adults aged 65 and older experience the highest number of fatal falls globally, highlighting the urgency of this issue (WHO, 2021). Moreover, data from the CDC indicates that 25% of seniors fall each year, with a doubled likelihood of recurring falls post-initial fall (CDC, 2021). Thus, implementing a community-based fall prevention program tailored to individual needs is imperative to mitigate fall risks and enhance overall well-being among the elderly population.

Population and Settings

Targeting Vulnerable Geriatric Patients in Community Settings

Our project focuses on geriatric patients in community settings with a history of falls and managing multiple comorbidities. This population is particularly vulnerable due to the intersection of natural aging frailties, previous fall risks, and managing concurrent health conditions. Community settings lack specialized infrastructure or protocols found in healthcare facilities, exposing the elderly to common hazards and limiting immediate access to professional medical assistance post-fall. Introducing a community-based fall prevention program aims to create a safer environment for the elderly where they reside, thereby enhancing their overall well-being.

Intervention Overview

Tailored Interventions for Effective Fall Prevention

To address the pressing issue of falls among the geriatric population in community settings, our intervention proposes personalized exercise routines, targeted strength training programs, and structured balance training sessions. These interventions focus on enhancing physical capacity and improving balance, key factors in fall prevention. Implementing these interventions within community settings is strategic, considering the lack of specialized fall prevention programs in such environments. However, challenges in implementation include access to specialized trainers, consistent monitoring, and robust engagement strategies to ensure elderly participation.

Comparison of Approaches

Exploring Interprofessional Alternatives

Considering the proposed interventions, three interprofessional alternatives emerge. Firstly, comprehensive medication reviews by pharmacists can address potential drug-induced dizziness or balance issues, emphasizing collaborative care (Eckert et al., 2023). Secondly, physical therapy sessions led by specialized therapists can target specific balance and strength deficiencies unique to each elderly individual (Tapley et al., 2021). Thirdly, occupational therapists can conduct home hazard assessments, recommending modifications to reduce fall risks in domestic settings (Ziebart et al., 2021). While these alternatives highlight an interprofessional approach, challenges include additional costs and potential patient resistance.

Initial Outcome Draft

Aiming for Significant Reduction in Fall Incidents

The primary outcome of our intervention is to achieve a noticeable reduction of at least 20% in fall incidents among the geriatric population within community settings over eight months. This outcome emphasizes our commitment to quality improvement and injury prevention while providing a clear benchmark for success. Evaluation criteria include monthly fall tallies, participant feedback sessions, and comparison of current fall rates against baseline data.

Time Estimate

Developing and Implementing the Intervention

Our community-based fall prevention program is projected to develop over two months, encompassing initial groundwork and resource acquisition. Implementation will span eight months, involving onboarding elderly participants, routine check-ins, and progress monitoring. Challenges may arise from low patient adherence and unforeseen events, necessitating contingency plans and open communication channels.

Literature Review

Supporting Evidence for Tailored Interventions

Scholarly literature emphasizes the necessity of addressing fall prevention among the geriatric population within community settings. Studies highlight the high incidence of falls among the elderly and underscore the effectiveness of tailored interventions, such as personalized exercise routines and home modifications, in reducing fall rates.

Evaluation and Synthesis of Relevant Health Policy

Aligning with Existing Policy Frameworks

Health policies like the Older Americans Act and the Falls Free National Action Plan provide a supportive framework for our project’s implementation within community settings. However, gaps remain, particularly in policies addressing personalized, community-based fall prevention programs. Aligning our project with existing policy frameworks is essential to ensure quality and procedural standards are met.


Addressing Falls Among the Geriatric Population: A Comprehensive Approach

The assessment highlights the importance of addressing falls among the elderly, especially within community settings, and the opportunities for intervention. Key policies, such as the Older Americans Act and the Falls Free National Action Plan, provide a foundation for our project. Integrating these insights ensures our project is practical and fills existing policy voids, ultimately aiming to mitigate fall risks for the geriatric population.

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)


Brewer-Smyth, K. (2022). Primary and secondary prevention, health equity, and trauma-informed institutional and public policies to promote healing and resilience. Adverse Childhood Experiences, 429–454.

Campos, L., Prochazka, A. V., Anderson, M. C., Kaizer, A. M., Foster, C. A., & Hullar, T. E. (2023). Consistent hearing aid use is associated with lower fall prevalence and risk in older adults with hearing loss. Journal of the American Geriatrics Society.

CDC. (2021). Facts about falls.

de Lima, M. do C. C., Dallaire, M., Tremblay, C., Nicole, A., Fortin, É., Maluf, I. C., Nepton, J., Severn, A.-F., Tremblay, P., Côté, S., Bouchard, J., & da Silva, R. A. (2022). Physical and functional clinical profile of older adults in specialized geriatric rehabilitation care services in Saguenay-québec: A retrospective study at La Baie hospital. International Journal of Environmental Research and Public Health, 19(16), 9994.

Eckert, B. S., Wolf, R., & Ehrlich, A. R. (2023). A comprehensive guide to safety and aging: Minimizing risk, maximizing security. CRC Press.

Gahimer, J. E., & Bates, F. J. (2021). A toolbox for implementing community-based physical activity programs for older adults and adults with disabilities. Topics in Geriatric Rehabilitation, 37(3), 134–144.

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Herrler, A., Kukla, H., Vennedey, V., & Stock, S. (2021). What matters to people aged 80 and over regarding ambulatory care? A systematic review and meta-synthesis of qualitative studies. European Journal of Ageing.

Izquierdo, M., Merchant, R. A., Morley, J. E., Anker, S. D., Aprahamian, I., Arai, H., Aubertin-Leheudre, M., Bernabei, R., Cadore, E. L., Cesari, M., Chen, L.-K. ., de Souto Barreto, P., Duque, G., Ferrucci, L., Fielding, R. A., García-Hermoso, A., Gutiérrez-Robledo, L. M., Harridge, S. D. R., Kirk, B., & Kritchevsky, S. (2021). International exercise recommendations in older adults (ICFSR): Expert consensus guidelines. The Journal of Nutrition, Health & Aging, 25(7), 824–853.

Marfeo, E. (2020). The Supporting Older Americans Act of 2020: How policy connects with occupational therapy principles and practice. American Journal of Occupational Therapy, 74(5), 7405090010p1.

Papalia, G. F., Papalia, R., Diaz Balzani, L. A., Torre, G., Zampogna, B., Vasta, S., Fossati, C., Alifano, A. M., & Denaro, V. (2020). The effects of physical exercise on balance and prevention of falls in older people: A systematic review and meta-analysis. Journal of Clinical Medicine, 9(8), 2595.

Romero-García, M., López-Rodríguez, G., Henao-Morán, S., González-Unzaga, M., & Galván, M. (2020). Effect of a multicomponent exercise program (VIVIFRAIL) on functional capacity in elderly ambulatory: A non-randomized clinical trial in Mexican women with dynapenia. The Journal of Nutrition, Health & Aging, 25(2), 148–154.

Tapley, H., Houser, J., Idlewine, T., Kiesel, J., Stevens, D., & Tapley, S. (2021). The annual physical therapy visit: Opportunities for service learning in professional education. Journal of Community Engagement and Higher Education, 13(3).

NURS FPX 6030 Assessment 2 Problem Statement (PICOT)

Tzeng, H.-M., Okpalauwaekwe, U., & Lyons, E. J. (2020). Barriers and facilitators to older adults participating in fall-prevention strategies after transitioning home from acute hospitalization: A scoping review. Clinical Interventions in Aging, Volume 15, 971–989.

Vandervelde, S., Vlaeyen, E., Dierckx de Casterlé, B., Flamaing, J., Valy, S., Meurrens, J., Poels, J., Himpe, M., Belaen, G., & Milisen, K. (2023). Strategies to implement multifactorial falls prevention interventions in community-dwelling older persons: A systematic review. Implementation Science, 18(4).

World Health Organization. (2021). Falls. World Health Organization.

Ziebart, C., Dewan, N., Tuazon, J., & MacDermid, J. (2021). Development of the home fall hazard checklist. Rehabilitation Research and Practice, 2021, 1–7.