Abstract

Problem: Falls among adults aged 65 years and older are a leading cause of injury, emergency department visits, hospitalizations, and healthcare costs. Early identification of individuals at risk is essential to preventing falls and related complications.

Intervention: Guided by the Iowa Model of Evidence-Based Practice, a fall risk program was implemented in a rural Midwestern emergency department. Following a 30-day staff education period, the Center for Disease Control and Prevention (CDC) STEADI (Stopping Elderly Accidents, Deaths, and Injuries) algorithm and the Clinical Frailty Scale (CFS) were implemented in adults aged 65 years and older during a 30-day pilot.

Measures: Outcomes included staff knowledge and confidence assessed through pre- and post- intervention surveys and electronic health record data evaluating completion of fall and frailty assessments.

Results: Staff knowledge and confidence improved following the educational intervention. Self-confidence scores increased significantly from pre-intervention (M = 16.22, SD = 1.48) to post-intervention (M = 19.22, SD = 1.20), t(8) = −4.8, p = .001. During implementation, 91 eligible older adults were evaluated; 36 were identified as at risk for falls, but only eight (8.8%) received the complete CDC STEADI algorithm intervention and CFS assessment. Documentation of individual CDC STEADI interventions was inconsistent, indicating partial implementation of the protocol.

Conclusion: Implementation of standardized fall and frailty screening supported age-friendly care and identified opportunities to improve integration of evidence-based assessments into emergency department workflows. Future efforts should focus on optimizing electronic health record (EHR) workflows and increasing adherence to standardized screening protocols.

Description

NRS 890 Doctoral Scholarly Project IV

Author Details

Hannah L. Brudigam Jensen, DNP-FNP; Gina Crudden DNP, APRN-CNS, ACCNS-AG, CMSRN, FCNS

Sigma Membership

Non-member

Type

DNP Capstone Project

Format Type

Text-based Document

Study Design/Type

Quality Improvement

Research Approach

Pilot/Exploratory Study

Keywords:

STEADI, Clinical Frailty Scale, Frail Elderly, Frailty, Fall Prevention, Accidental Fall Prevention, Risk Assessment, Age-Friendly Health Systems, Medical Care for Older People, Older Adults, Older People, Geriatrics, Evidence-Based Nursing

Advisor

Gina Crudden

Degree

DNP

Degree Grantor

Nebraska Methodist College

Degree Year

2026

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Self-submission

Date of Issue

2026-10-14

Full Text of Presentation

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