First Advisor

Alma Jackson


Rueckert-Hartman College for Health Professions

Degree Name

Doctor of Nursing Practice


Loretto Heights School of Nursing

Document Type

Thesis - Open Access

Number of Pages

57 pages


Executive Summary

Fall reduction among Elderly residents in skilled nursing facility


Falls among elderly or older adults is a serious issue in skilled nursing facilities. According to the Centers for Disease Control and Prevention (2012), about 1800 residents living in nursing homes die annually from falls and fall-related injuries. Those who survive sustain injuries that might cause permanent disability. Some of the facilities use bed alarms as a preventive measure. Despite the use of these bed alarms, the fall rates in these skilled facilities still remains high. The problem statement describing this capstone project is: In (P) nursing staff in skilled nursing facility, (I) staff education and implementation of hourly rounds and use of bed alarm, (C) when compared to the use of bed alarm only (O) decrease in the incidence of falls?


The purpose of this capstone project is to assess whether hourly rounding by staff and the use of bed alarm will decrease the incidence of falls in skilled nursing facility.


The goal of this project is to serve residents in the skilled nursing facility by providing an intervention rooted in evidence based practice aimed at decreasing the incidence of falls and promoting quality of life.


The project objectives included: to reduce the fall rate by 50% in six months; to reduce the fall rate by 75% in one year; and to increase the supervision of residents by nursing staff.


This project utilized Zaccagnini and Whites (2011) Doctor of Nursing Practice Process Model. The project identified through a needs assessment and comprehensive literature review that despite the use of bed alarms in skilled nursing facilities, the rate of falls was still high. This information provided the framework which developed the goals and objectives, guided the theoretical foundation, and initiated specific plans for the work, evaluation, and implementation after Institutional Review Board approval was obtained from the facility and Regis University.

Outcomes and Results

The implementation of hourly rounding using the 4 P’s reduced the fall rate in the facility by 13.3% and the use of bed alarm by 9.5%. It was concluded that there was a decrease in the incidence of falls following the implementation of bed alarm and hourly rounding using the 4 P’s.

Date of Award

Spring 2016

Location (Creation)

Colorado (state); Denver (county); Denver (inhabited place)

Rights Statement

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