1. Preventing falls in community- dwelling older adults. NURS 7360 Evidence-based Practice I Eyong Atem

2. Definition According to Meiner, 2011, a fall can be defined as “anything that causes a person to unintentionally move from one level plane to another.”

3. Introduction Fall is a common clinical problem affecting nearly one third of the community-dwelling older adults and more than half of institutionalized older persons in the United States The risk of falling increases with age. (Tremblay & Barber, 2005)

4. Introduction Cont. Falls represents a considerable problem in elderly both in hospital and the community.

5. Statistics. According to CDC in 2010 2.3 million falls occurred amongst older adults.

6. Statistics of fall age 65 and above

7. Evidence-based practice Every year 1 in 3 older adult falls, falls causes severe disability among survivors” Failure to exercise regularly results in poor muscle tone, decreased strength, and loss of bone mass and flexibility

8. Evidence-based model Evidence-based Practice (EBP) is a pattern and life long problem-solving concept to clinical decisions about patient care (Melynk & Fineout-Overholt, 2010 ) The ACE star model is an Evidence-based practice model that furnished a comprehensive structure on how to formulate EBP processes and concepts.

9. Evidence- base model cont. The five-point star demonstrates what is known as knowledge transformation. Discovery Summary Translation Integration Evaluation

10. Pico Question In community-dwelling adults 65 or older what are the evidences that effective physical exercises that increase muscle tone, bone density and strength can help prevent falls as compare to little or no exercise.

11. Older adults performing strength exercises agingcare.com

12. PICO Continue P –Community-dwelling Older adults 65 or older: The population of focus is adults 65 or older living in the community that are ambulatory and are high risk for fall I –Physical exercise such as tai chi that help increase strength. C –little or no exercise O –The desired outcome is strength training can loss of bone mass and increase balance thus preventing falls (T) – Not applicable. This area is not applicable; this is because fall prevention in the elderly is a clinical area that needs continuous attention

13. Many benefits of exercise Physical exercise has many health benefits and preventing falls is one of them

14. References Center for disease control and prevention. (2012) Falls among older adults: An overview. Retrieved from website: http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html Exercise for the elderly retrieved from www.agingcare.com Meiner, S, E (2011). Gerontologic nursing. (4 ed.). St Louis MO: Mosby Inc. Melnyk, B. M. & Fineout-Overholt, E (2010). Evidence-based practice in nursing & healthcare, a guide to best practice. ( 2.ed., pp 307-309). Steven, K. R (2004) ACE star model of EBP: Knowledge transformation. academic center for evidence-based practice. The university of Texas health science center at san Antonio. www. acesstar.uthscsa.edu. Tremblay, K., & Barber, C. E. (2005, may). Preventing falls in the elderly. Retrieved from http://www.ext.colostate.edu/pubs/consumer/10242.html