Implementation of STEADI Toolkit of CDC for Preventing Falls Among Community Dwelling Older Adults

The study was focused on implementing an evidence-based fall prevention strategy for home healthcare clients receiving care from the healthcare workers of a home health agency in the Dallas–Fort Worth metroplex. The quantitative study design was planned to implement the evidence-based change project as part of the practicum requirement of the DNP program. After identifying the current practice of fall prevention strategy through detailed charts and extensive literature review, the Stopping Elderly Accidents, Death, and Injuries (STEADI) initiative of the Centers for Disease Control and Prevention (CDC) was identified for implementation. The STEADI toolkit consists of multiple fall prevention assessment tools that are proven for reliability and validity. The STEADI guideline toolkit includes STEADI fall risk screening algorithm; Stay independent checklist; Timed Up and Go (TUG) test; 30-second chair stand test; four-stage balance test; and Chair rise exercise guideline. The TUG test assesses for patient’s mobility. The 30-second chair stand test assesses the patients muscle strength and endurance. The four-stage balance test evaluates the static balance of an individual. Appropriate guidance, supervision, and support were given to the staff by the project leader throughout the implementation period to ensure accuracy and sustainability. The staff assessed the patients using all the STEADI tools during weekly home visits. The staff also implemented appropriate interventions as per the STEADI algorithm. A statistical analysis of the chart review results was conducted after implementation using Wilcoxon signed rank test, Mann-Whiney U test, and McNemar test of Symmetry for appropriate variables. The results did not demonstrate a statistical significance in the reduction of the number of fall and fall-related injuries due to the small sample size (P=0.070). There was a statistically significant improvement in the mobility, muscle strength, and static balance of patients, evidenced by the analysis of the results of the STEADI toolkit (P<0.001). The literature review concludes that the enhancement of the mobility, balance, and muscle strength will reduce the risk of fall. The project was concluded with evidence of the successful reduction of fall risk. The project site decided to incorporate the implementation as a practice guideline.