Increasing Self-Efficacy in Fall Prevention Behavior Among Long-Term Care Residents

Abstract

Purpose. The purpose of this quality improvement (QI) project was to increase the self-efficacy and intent to incorporate fall prevention behaviors of long-term skilled nursing facility (SNF) residents, who are at risk for unintentional falls.Background. Unintentional falls are a significant cause of injury, hospitalization, and death worldwide. It is estimated that 50% of SNF residents in the United States (US) fall each year and 33% fall more than once in 12 months. The Centers for Disease Control and Prevention (CDC) developed the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) toolkit to assess risk and prevent falls among community-dwelling older adults. The resources and strategies outlined in the STEADI toolkit can be expanded to other settings, including SNFs. Methods. Residents who had resided at the SNF project site for a minimum of 90 days were eligible for participation. A total of 12 long-term care residents participated in this project and received an individual face-to-face education session that focused on fall prevention behaviors as outlined in the CDC STEADI toolkit. Pretest and posttest surveys were administered at the time of the intervention and a follow-up survey was administered two weeks following the intervention. Survey questions included a fall risk assessment from the STEADI toolkit and Likert scale statements to measure participant self-efficacy levels. Results. Survey responses showed improvement in self-efficacy levels following the intervention. There was a statistically significant improvement in self-reported confidence to prevent future falls between the pre- and posttests (p=0.046). Between the intervention and follow-up survey, 92% of participants reported implementing fall prevention behaviors for several days or more. Conclusions. Project results support the need to further explore the impact the CDC STEADI toolkit has on the fall prevention behaviors of long-term care residents. Future QI work should integrate this evidence-based education intervention into fall prevention programs at SNFs.