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Falls Prevention in the Elderly and Risk Assessment Tools

Due to the fact that the risk of falls among elderly patients in emergency departments is high enough, it is necessary to find a way to reduce the number of victims. As a potential solution, the use of appropriate tools can be considered as a technique of effective intervention. As a rationale, the Ace Star model will be implemented as a mechanism to explain the relevance of this study. The use of a specific fall assessment tool in the emergency department may help reduce the number of falls among elderly patients.

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Change Model Overview

The Ace Star model is a special scientific technique for assessing this or that intervention in terms of its effectiveness. The main provisions of this scheme include the description of the problem, evidence, translation, introduction into practice, and evaluation. Junior medical staff should use this model to develop a strategy for implementing a certain idea step-by-step and, at the same time, to protect themselves from any ill-conceived actions.

Scope of the EBP

The problem that this study addresses is a large number of falls among elderly patients in emergency departments. This problem is urgent since, according to Hirase, Inokuchi, Matsusaka, Nakahara, and Okita (2014), “approximately 30% of individuals aged 65 years or older fall at least once per year, and about half of them do so recurrently” (p. 159). The impact of this problem on the healthcare system as a whole is also significant because the high number of readmission caused by falls inevitably leads to poor patient outcomes and worsens the performance of medical institutions. Therefore, appropriate measures should be taken to improve the current situation.


As the stakeholders who will participate in the study, both junior medical personnel and doctors will be involved. Two nurses are needed to record the data obtained during observation and interviews with patients using appropriate fall prevention tools. Also, the help of one equipment control specialist is necessary to monitor the stable operation of the mechanisms used. Two doctors from the emergency department will evaluate the results.

Responsibility of Team Members

The selected members of the group play an important role in achieving the set goal. Junior medical specialists not only serve as data collectors but also help elderly patients to cope with certain fall prevention tools. An expert in the control of the equipment operation can react quickly in case of system failures and eliminate any possible violations. The role of doctors is also significant since they are competent persons in order to draw appropriate conclusions regarding the success of the intervention.


In addition to the found justification of the problem’s urgency, additional facts regarding the issue under consideration can also be mentioned. For instance, Luk, Chan, and Chan (2015) note that “older patients or residents should be assessed individually” in order to achieve optimal research results. This fact is significant since, despite previous attempts to solve the problem of a large number of falls among older adults, many studies were group ones. Also, as one of this study’s strengths, the risk of unplanned readmission may be reduced, which, as Leppin et al. (2014) remark, is one of physicians’ work priority directions. Therefore, this intervention is relevant.

Evidence Summary

In order to implement all the stages of the study, it is necessary to resort to the help of a special fall assessment tool. According to Hirase et al. (2014), this design may include “questions about fall history, walking ability, muscle power, medical disorders, medication, vision and hearing, and fear of falling” (p. 160). Also, Luk et al. (2015) argue that additional measures should be taken, for example, staff education so that all the stakeholders could be aware of the importance of the work performed and could have sufficient qualifications. Since one of the goals is to reduce the number of readmissions among older adults, Leppin et al. (2014) recommend paying attention to individual work with patients for more positive results. All these findings can be useful in order to use them in this study.

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Recommendations for Change Based on Evidence

In order to achieve positive patient outcomes and introduce appropriate patient care practices successfully, the findings described should be used in the study. Individual work is to be one of the priority areas to exclude potential limitations caused by group therapies. The interest of all stakeholders is essential, and all relevant materials should be provided to the study participants so that they could have all the necessary resources.


Action Plan

In order to realize the tasks set, preliminary, it is necessary to prepare a target group of participants over 65 years old to test the effectiveness of a corresponding fall prevention tool. In addition to practical procedures, patient interviews will also be conducted to receive their opinions on the specifics of this program and its effectiveness. The approximate period of the study is one month. At the end of this time, both the practical results and respondents’ opinions will be evaluated for compiling the comprehensive picture of the intervention. The results will be given in the form of statistical analysis.

Process, Outcomes Evaluation, and Reporting

The desired outcomes include a decrease in the number of readmissions among elderly patients by reducing the number of their falls in emergency departments. The evaluation will be based on participants’ opinions and practical tests, and actual health indicators will be measured. In case of obvious positive changes, the results will be reported to stakeholders at the general meeting devoted to the completion of the study.

Next Steps

To implement the reviewed plan on a larger scale, information about the study may be sent to other departments and clinics since the results can be applied to other healthcare facilities. In order for the introduction to be permanent, it is necessary to tell the heads of structural medical units about the research problem and the study’s positive results. In this case, the algorithm described may be realized in various healthcare institutions.

Findings Dissemination

In order to communicate the findings within the organization, a meeting of stakeholders and other team members may be held. Outside the clinic, colleagues can receive relevant results through email. Also, the research outcomes can be printed in scientific journals for wider dissemination of the data obtained. Online medical portals may also be a good platform to communicate the results and tell doctors and nurses about the project implemented.


The introduction of a relevant fall assessment tool in the emergency department may be useful to reduce falls among older adults. The Ace Star model is used to develop the study and provide consistent work. The problem under consideration is frequent falls among elderly patients in medical institutions. Because of a large number of patient readmission, both the outcomes of treatment and the reputation of medical clinics worsen. As the literature analysis shows, this problem is significant and requires intervention. The plan that includes the review of existing practices, the integration of stakeholders, and the involvement of study participants includes one-month work with patients. The analysis of the data obtained will be statistical, and the evaluation will be based on the actual patients’ health indicators at the time of the study completion. In order to maintain the change plan, all valuable information may be disseminated both within one medical organization and outside it.


Hirase, T., Inokuchi, S., Matsusaka, N., Nakahara, K., & Okita, M. (2014). A modified fall risk assessment tool that is specific to physical function predicts falls in community-dwelling elderly people. Journal of Geriatric Physical Therapy, 37(4), 159-165. Web.

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Leppin, A. L., Gionfriddo, M. R., Kessler, M., Brito, J. P., Mair, F. S., Gallacher, K.,…Montori, V. M. (2014). Preventing 30-day hospital readmissions: A systematic review and meta-analysis of randomized trials. JAMA Internal Medicine, 174(7), 1095-1107. Web.

Luk, J. K., Chan, T. Y., & Chan, D. K. (2015). Falls prevention in the elderly: Translating evidence into practice. Hong Kong Medical Journal, 21(2), 165-71. Web.

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