Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2018


Doctor of Nursing Practice (DNP)

Primary Advisor

Cathie E. Guzzetta, PhD, RN, FAAN; Jennifer R. Castello, MS, AGNP-BC; Qiuping Zhou, PhD, RN


Background: Falls threaten the safety of older adults in long term care (LTC).

Objectives: To assess environmental, clinical and pharmacological causes of falls as well as compare Fall Risk Assessment Score, Brief Interview of Mental Status (BIMS) score, Activities of Daily Living (ADL) scores, age and gender of residents with one fall, recurrent falls, and no falls.

Methods: Using a descriptive-comparative design, we included a convenience sample of 290 adults ≥50 years old at our LTC facility. Fall and recurrent fall groups were matched to those with no falls. We assessed environmental, clinical and pharmacological variables, Fall Risk Assessment Scores, BIMS scores, ADL scores, age, and gender among those with one fall, recurrent falls, and no falls.

Results: Among 290 residents, patients who fell had significantly more modifiable environmental (p<.05), clinical (p<.05), and pharmacological (p<.05) causes of falls. Fall risk scores were significantly higher for the initial falls (p=.02) group and the recurrent falls group (p<.001) compared to no fall. BIMS scores were significantly lower for the initial fall group compared to the no fall group (p=.03). For ADL bed mobility (p<.001), transfer (p=.01), eating (p<.001), and toilet use (p<.001), significantly more residents in the no falls group required extensive assistance compared to the recurrent falls group. There was no significant difference in age or gender among fall groups.

Conclusions: Many of the significant variables found in the initial fall and recurrent fall groups are modifiable. LTC residents would benefit most from an ongoing multidisciplinary approach to falls risk reduction.

Open Access




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