Phase III: Program Design: Students will design a primary prevention health care program with the goal of decreasing exposure of the target population to the risk considering how the program will function within the current health care environment.
Program Design Criteria:
1. Program title
2. Target population
3. Priority risk that will be targeted for reduction by this program
4. List two formal Goals for the program & three Objectives for each goal (goals should have a time frame. Objectives should be issue or participant centered, have a time frame and be measurable. See Bloom’s taxonomy for measurable verbs.
5. Relate the vision of the program as it will be (core components) including:
a. Location of the program
b. Key players to maintain the program and implement it
c. Day to day functions, activities etc. How it works.
d. Accessibility, availability, affordability of the program
6. Budget and funding
7. Evaluating the program’s outcome based on the set goals and objectives.
Be creative! Think out of the box! Use your community members and other stakeholders!
You will need to make sure that the goals and objectives you discuss are measurable and participant-focused. Here is a link to how to develop SMART goals from the University of California. I also included a link to Bloom’s taxonomy for measurable verbs to use as well.
https://www.ucop.edu/local-human-resources/_files/performance-appraisal/How%20to%20write%20SMART%20Goals%20v2.pdf
https://edspace.american.edu/ctrl/blooms_taxonomy/
While this says for HR purposes it is the same step-by-step process you should use to develop the goals and then the subsequent objectives for your primary prevention program. Make sure you don’t go too broad with your goals and objectives. One way is to look back at the risk factors you listed and choose one as the basis of your program that you feel is the priority risk and provide the rationale for your selection. Write goals and objectives that can bring measurable changes in the outcomes of the population you chose. They don’t have to be huge changes, the point is to be measurable and each has a time frame. Sometimes small changes make the biggest difference in overall outcomes.
The core components of the program should be in these goals and objectives as well. Where is the location of your program? Who are the key players to maintain the program and implement it? What are the day-to-day functions, or activities you will implement? Remember to focus on primary prevention (reduce the risk/prevent the onset of the issue). This is to be your own original program not one that exists already. The funds for the program can come from wherever you want: a grant, the city or county, or a donor … Make sure the budget is detailed.
For reference, I will include Phase one and two to know what we spoke about:
Phase one:
Epidemiological Research on Falls among Elders in New York Nursing Homes
1. Epidemiological Perspective
Occurrence (Prevalence and Incidence)
Falls remain one of the most common causes of injuries among the adult population, particularly older adults (Vaishya & Vaish, 2020). Research reveals that the rate of falls in nursing homes is high across New York, with several research works citing the figure to be between 50-75% of the nursing home residents falling annually.
Severity (Mortality Incidence)
Falls are the leading cause of injury-related death among the elderly (Haagsma et al., 2020). The mortality rates associated with falls in nursing homes are very high, and many of the victims had pre-existing conditions.
· Demographics
Gender: Females are more likely to fall in nursing homes than males due to the longer span of their age and higher prevalence of conditions like osteoporosis (Niznik et al., 2021).
Education and Income: This could be due to disparities in health literacy and access to preventive care among individuals with limited formal education and income.
Geographical Areas: Nursing homes in the urban setting have higher incidences of fallers, more than likely because of the higher concurrency of residents and variations in staffing patterns.
· Epidemiological Model Explanation
Falls in the context of the Web of Causation Model refer to the occurrence of the fall being due to a number of factors, such as the patient’s general state of health, mobility, medication impact, and physical barriers within the nursing home.
2. Ecological Perspective
Political Factors
Health policies, such as staffing ratios in nursing homes and state funding for elder care services, determine the extent of fall prevention care programs offered.
Economic Factors
Economic challenges have repercussions on the quality of care and the facilities in nursing homes, as well as, consequently, the rate of falls.
Social and Cultural Factors
Preventative measures taken due to cultural attitudes towards the elderly and perceived importance given to their care affect fall incidence reportage.
Environmental Factors
Unsuitable architectural design, such as poor lighting and slippery floors, is one of the leading causes of falls among the elderly.
References
Vaishya, R., & Vaish, A. (2020). Falls in older adults are serious. Indian Journal of Orthopaedics, 54(1), 69–74. https://doi.org/10.1007/s43465-019-00037-x.
Haagsma, J. A., Olij, B. F., Majdan, M., van Beeck, E. F., Vos, T., Castle, C. D., Dingels, Z. V., Fox, J. T., Hamilton, E. B., Liu, Z., Roberts, N. L. S., Sylte, D. O., Aremu, O., Bärnighausen, T. W., Borzì, A. M., Briggs, A. M., Carrero, J. J., Cooper, C., El-Khatib, Z., & Ellingsen, C. L. (2020). Falls in older aged adults in 22 European countries: incidence, mortality and burden of disease from 1990 to 2017. Injury Prevention, 26(Supp 1), i67–i74. https://doi.org/10.1136/injuryprev-2019-043347.
Niznik, J. D., Li, X., Gilliam, M. A., Hanson, L. C., Aspinall, S. L., Colon-Emeric, C., & Thorpe, C. T. (2021). Are Nursing Home Residents With Dementia Appropriately Treated for Fracture Prevention? Journal of the American Medical Directors Association, 22(1), 28-35.e3. https://doi.org/10.1016/j.jamda.2020.11.019.
Phase 2:
Research studies have estimated that the nursing home fall rate in New York is between 50% and 75% of residents who fall each year (New York State Department of Health, n.d.).
Cluster 1: Risk – Environmental Factors
· Poor architectural design, including inadequate lighting and slippery floors.
· Insufficient handrails and assistive devices throughout the facility.
· Higher resident density in urban nursing homes.
· Weather-related conditions, such as snow, rain, and wind.
· Hallways and rooms cluttered with furniture or personal items can obstruct movement.
Impact:
· These environmental hazards create unsafe conditions, making it difficult for elderly residents to navigate without falling.
· Poor maintenance can exacerbate risks, especially during adverse weather conditions, leading to slippery outdoor areas.
Cluster 2: Risk – Physiological Factors
· Age-related health issues, including osteoporosis, balance impairments, and muscle weakness.
· Cognitive decline, particularly in residents with dementia, increases fall risk.
· Side effects of medications, such as dizziness and confusion, further compromise mobility and stability.
· Declining eyesight in elderly residents can reduce their ability to detect obstacles.
Impact:
· Physiological vulnerabilities make elderly residents more prone to falls, especially when combined with environmental hazards.
· Pre-existing health conditions can amplify the severity of injuries sustained during falls.
Cluster 3: Risk – Cultural/Social Factors
· Disparities in health literacy and access to preventive care based on education and income levels.
· Cultural attitudes toward elderly care.
· Social isolation within nursing homes.
· Diverse linguistic backgrounds may not fully understand safety instructions.
Impact:
· Cultural and social factors can hinder the implementation of effective fall prevention strategies.
· Residents from lower-income backgrounds may not receive adequate support or resources for fall prevention.
Prioritization of Risks
· Environmental Hazards: Unsafe physical surroundings in nursing homes.
· Physiological Vulnerabilities: Age-related health issues that increase fall risk.
Cultural and Social Disparities: Inequities in access to care and fall prevention resources.
The topic name is Falls among Elders