DPI Project Milestone 10 Strategic Points Project Proposal

·         Hospital falls are among the most commonly reported adverse hospital events with more than one million occurring annually (Leone & Adams, 2016).

·         Stroke patients were the largest diagnostic group accounting for all unassisted falls (Leone & Adams, 2016).

·         Most of these incidents were related to stroke patients attempting to toilet themselves when they fell.

·         There are some challenges for stroke patients to have awareness of their surroundings and ability effect by stroke.

b.      Theoretical Foundations (models and theories to be foundation for study):

·         The RE-AIM model (Reach, Efficacy, Adoption, Implementation, Maintenance) was used to identify strategies for an effective program (Day et al., 2011).

c.       Review of Literature Topics With Key Organizing Concepts or Topics for Each One

·         Research study found bladder training and prompted voiding share the two characteristics of cognitive behavioral modification and active client participation (Roe, Milne, Ostaszkiewicz & Wallace, 2007).

·         Timed voiding program has proved successful in decreasing unassisted bathroom-related falls in the stroke population (Mehdi, Birms & Bhalla, 2013).

d.      Summary

• Gap/Problem: There is a need to implement evidence-based methods of improving hospital falls in stroke patients through preventive fall program.
• Prior studies: Prior studies show that timed voiding program has improved unassisted bathroom-related falls in the stroke population.
• Quantitative application: Sources of data provide a method of evaluating and analyzing a new intervention and its effectiveness.

e.       Significance:

·         Improving rate of hospital falls;

·.

(P) – Population: post ischemic stroke patients.

(I) – Intervention: Implementing a Bladder Training and Timed-voiding program to decrease unassisted bathroom-related falls in post ischemic stroke population.

(C) – Comparison: Use multiple data collection and analysis from EHR and FIM score to compare before and after the new fall prevention program.

(O) – Outcome: Decreased unassisted bathroom-related falls in post ischemic stroke population.

(T) – Time: Quasi-experimental review of electronic medical records for all stroke patients who fell in six months period prior to the program need to be conducted. Then compare with Fall debrief survey score for post program will be measure in 6 weeks period.

·         Independent Variable: Bladder training and timed-voiding program.

·         Dependent Variable: The effectiveness of decreasing unassisted bathroom-related falls post ischemic stroke population.