Using an Online Learning Module in a Nursing Program to Improve Knowledge and Skills to Prevent Falls in the Community Dwelling Older Adult Population

Nationally, 28.4% of older adults fall each year. Falls and resulting injury result in decreased mobility, functional impairment, loss of independence, and increased mortality. Utilization of evidence based protocols by providers to identify older adults at risk of falling is limited and rates of participation by older adults in prevention activities is low. Because of nursing’s increasing role in caring for older adults, development of fall prevention education for nursing students would result in increased awareness of the need for fall prevention in community dwelling older adults and increased access of older adults to falls risk assessment. There is a need to extend research to inform teaching and learning strategies for fall prevention. After pretesting, a convenience sample of 52 BSN students and 20 graduate nursing students completed an online education program and performed a falls risk assessment on an older adult before completing a posttest and self-efficacy survey. Data were analyzed using multivariate statistical tests. A qualitative approach was used to investigate a subset of student’s views about relationships between acquiring knowledge, self-efficacy, and skill mastery and their perceptions of barriers and facilitators to incorporating falls risk assessment into practice. Data were analyzed using the constant comparative method to review, code, and categorize data. Results revealed a rise in knowledge and student self-reporting of self-efficacy with falls risk assessment skills. Themes that emerged from semi-structured interviews included nurses are too busy to perform fall risk assessments, the older adult is a barrier, the importance of increasing awareness of falls prevention among nurses, opportunities to address health beliefs of older adults, and need for policies or guidelines. In conclusion, an online program enhanced with opportunity for hands on practice provides an effective environment for learning to use falls risk tools and should be incorporated into nursing education in order to increase older adults’ access to fall risk assessment. Dedication I dedicate my dissertation work to my family: past, present, and future. Although my parents never obtained an advanced degree, they understood the value of education and passed on a love of learning and a push for tenacity. I hope to continue the legacy. Acknowledgements I would like to express my appreciation to my advisor, Dr. Ches Jones, for the guidance provided to me through completion of this degree. I feel fortunate to have had the opportunity to work with him. I would also like to thank my committee members, Drs. Nan Smith-Blair, Leah Jean Henry, and Bart Hammig for the guidance, mentorship, challenging suggestions, and collegiality provided to me over the years. A great deal of gratitude is also reserved for Drs. Kristen Jozkowski, Kathleen Barta, Marianne Neighbors, and Wen-Juo Lo for the contributions each made to my education at the University of Arkansas. I would like to acknowledge Drs. Audrey Weymiller and Charleen McNeill for reviewing my data. I reserve a special thank you for my students for providing inspiration and giving meaning to the John Cotton Dana quote: “Who dares to teach must never cease to learn. ” Finally, I would like to acknowledge the innumerable sacrifices made by my husband, Robert, and granddaughter, Elizah, as they supported my pursuit of this final degree. Table of