Assignment Prompt & Instructions
Mm week 2
**files (2)**
– ## InterventionEvidenceMatrixTableweek12.pdf
– ## AdaptedAHRQGapAnalysisOverviewandAssignmentTemplateforUnit4Fillable1b2.pdf
**## InterventionEvidenceMatrixTableweek12.pdf**
Michelle Murray
Class-NU810
In-text citation for
the resource – in the
References list below
this table include a
full citation.
You are required to
upload the full-text
file for each article
represented in the
matrix table into the
assignment drop box.
What is the purpose
of the resource to
support the
strategy/interventio
n?
1. Is the resource a
research or non-
research study (Hint:
JH EBP Rating Scale
notes which are
research or non-
research at the side of
the scale)?
2. What is the study
design (i.e.,
Systematic Review of
RCTs, Prospective
Cohort, etc.)?
3. If not a research
study, what type of
literature is
represented in the
resource (i.e., peer-
review like narrative
review, case reports,
clinical guidelines in
published journals or
non-peer review like
editorials, policy
briefs, opinion
pieces)?
What are the findings
(i.e., quantitative or
qualitative data) and the
recommendations in this
resource that are
relevant to your
proposed DNE project?
How does this resource support your
proposed project?
Articles/resources in the table need to support the strategy or intervention you have chosen for your project implementation.
Michelle Murray
Class-NU810
1 Sherrington et al.
(2020)
To identify the effects
of exercise on the
prevalence of falls
among older adults
and the exercise
components that can
best be used to
prevent falls.
Research study
Systematic review and
meta-analysis of
randomized controlled
trials
Balance and functional
exercises at regular
frequency proved to be of
great help in reducing
falls. Standing balance,
lower limb strengthening,
and repeated movement
training programs were
most effective.
Recommendation:
exercising must be
directed and continued.
Advocates to include balance and strength
training programs to adult day care routines
to prevent falls.
2 Dyer et al. (2023) To test the
effectiveness of
exercise interventions
in settings providing
care to elderly
individuals and their
impact on their fall
prevention.
Research study
Systematic review and
trial endpoint meta-
analysis
When scaled to the ability
of the participant,
exercise programs
decreased the occurrence
of falls and enhanced
functional mobility. The
results were better with
monitored delivery.
Suggestion: exercise
intensity should be
customized to physical
capacity.
Favors personalized workout regimens
among participants of adult day care whose
mobility is different.
3 Lee et al. (2013) The hypothesis that a
multifactorial fall
prevention program
will reduce the
incidence of falls in
older adults at risk of
falls.
Research study
Randomized controlled
trial
Exercise, education, and
risk screening reduced the
number of falls and
improved the physical
performance of
participants compared to
control participants.
Conclusion: integrating
Encourages the use of exercise, education,
and fall-risk assessment in adult day care.
Michelle Murray
Class-NU810
interventions is preferable
to a single strategy.
4 Sibley et al. (2024) To determine
condition that
enhances execution
of community fall-
prevention exercise
programs
Research study
Scoping review study
Employee participation,
basic practice, and
incorporated approach in
routine care increased
compliance with fall
prevention initiatives.
Recommendation:
training of staff is
necessary.
Contributes to personnel education and day-
to-day monitoring as an element of the adult
day care fall prevention policy.
5
Hopewell et al.
(2018)
To compare
multifactorial and
exercise interventions
as fall prevention
strategies in elderly
people.
Research study
Cochrane systematic
review
When assessed and
individualized,
multifactorial
interventions reduced fall
rate. Recommendation:
environmental review +
medication review +
exercise.
Provides an adult day care intervention that
includes screening, exercise, and
environmental safety checks.
**Add additional rows as needed.**
References
Hopewell, S., Adedire, O., Copsey, B., et al. (2018). Multifactorial interventions for preventing falls. Cochrane Database of Systematic Reviews,
CD012424. https://pmc.ncbi.nlm.nih.gov/articles/PMC6513234/pdf/CD012221.pdf
Dyer, S. M., Suen, J., Kwok, W. S., Dawson, R., McLennan, C., Cameron, I. D., … & Sherrington, C. (2023). Exercise for falls prevention in aged
care: systematic review and trial endpoint meta-analyses. Age and ageing, 52(12), afad217.https://academic.oup.com/ageing/article-
pdf/52/12/afad217/54492705/afad217.pdf
[https://pmc.ncbi.nlm.nih.gov/articles/PMC6513234/pdf/CD012221.pdf](https://pmc.ncbi.nlm.nih.gov/articles/PMC6513234/pdf/CD012221.pdf)
[https://academic.oup.com/ageing/article-pdf/52/12/afad217/54492705/afad217.pdf](https://academic.oup.com/ageing/article-pdf/52/12/afad217/54492705/afad217.pdf)
[https://academic.oup.com/ageing/article-pdf/52/12/afad217/54492705/afad217.pdf](https://academic.oup.com/ageing/article-pdf/52/12/afad217/54492705/afad217.pdf)
Michelle Murray
Class-NU810
Lee, H. C., Chang, K. C., Tsauo, J. Y., Hung, J. W., Huang, Y. C., & Lin, S. I. (2013). Effects of a multifactorial fall prevention program on fall
incidence and physical function in community-dwelling older adults with risk of falls. Archives of physical medicine and rehabilitation,
94(4), 606-615.https://www.archives-pmr.org/article/S0003-9993(12)01201-4/pdf
Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., … & Lamb, S. E. (2020). Exercise for preventing falls
in older people living in the community. Cochrane database of systematic reviews,
(1).https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012424.pub2/pdf/full
Sibley, K. M., Tittlemier, B., Olarinde, F., Leadbetter, B. K., & Bouchard, D. R. (2024). Factors influencing older adult community fall prevention
exercise implementation: a scoping review. Age and ageing, 53(8), afae186. https://academic.oup.com/ageing/article-
pdf/53/8/afae186/58885899/afae186.pdf
[https://www.archives-pmr.org/article/S0003-9993(12)01201-4/pdf](https://www.archives-pmr.org/article/S0003-9993(12)01201-4/pdf)
[https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012424.pub2/pdf/full](https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012424.pub2/pdf/full)
[https://academic.oup.com/ageing/article-pdf/53/8/afae186/58885899/afae186.pdf](https://academic.oup.com/ageing/article-pdf/53/8/afae186/58885899/afae186.pdf)
[https://academic.oup.com/ageing/article-pdf/53/8/afae186/58885899/afae186.pdf](https://academic.oup.com/ageing/article-pdf/53/8/afae186/58885899/afae186.pdf)
**## AdaptedAHRQGapAnalysisOverviewandAssignmentTemplateforUnit4Fillable1b2.pdf**
INSTRUCTIONS
Gap Analysis Tool Adapted from AHRQ
What is this tool? The purpose of the gap analysis is to provide project teams with a format in which to
do the following:
• Compare the best practices with the processes currently in place in your organization.
• Determine the “gaps” between your organization’s practices and the identified best
practices.
• Select the best practices you will implement in your organization.
Who are the target audiences? The project liaison (you will serve as the liaison for this assignment) will
be the primary individual to prepare this written gap analysis, but the entire improvement project team
should be engaged in performing the gap analysis.
How can the tool help you? Upon completion of the gap analysis, project teams will have the
following:
• An understanding of the differences between current practices and best practice.
• An assessment of the barriers that need to be addressed before successful implementation
of best practices.
How does this tool relate to others? Information from AHRQ’s Self-Assessment (Tool A.3) about
the readiness of the hospital/practice setting to perform quality improvement for the Quality Indicators
or Best/Evidence-based practices can be considered in the gap analysis as possible strengths or
weaknesses (i.e., barriers) to be managed when implementing improvements. The best practice
elements defined in the Selected Best Practices and Suggestions for Improvement (Tool D.4) are prefilled
in the gap analysis tool. This provides the elements for the Implementation Plan (Tool D.6).
Instructions
1. List the identified practice problem in Column 1.
2. In Column 2, provide a description of identified best practices (3 best practices required) to address
the problem
4. In Column 3, identify barriers that may hinder successful implementation of each best
practice strategy. Consider systems, procedures, policies, people (i.e. stakeholders), equipment, etc.
5. In Column 4, discuss your thoughts on whether your organization will implement that best practice
strategy. If not, explain why.
6. Repeat steps 1-4 for each best practice.
[https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/a3_combo_selfassessment.pdf](https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/a3_combo_selfassessment.pdf)
[https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4_combo_bestpracticescover.pdf](https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4_combo_bestpracticescover.pdf)
[https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d6_combo_implementationplan.pdf](https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d6_combo_implementationplan.pdf)
Gap Analysis Tool (as adapted from AHRQ’s Tool D-5)
Improvement Project: _____________________ Quality Indicator/Practice Metric: ____________________________
Individual Completing This Form: ______________________________
Column 1 Column 2 Column 3 Column 4
How Your Practices Differ
From Best Practice (describe
the practice problem you
have identified for this
improvement process)
Best Practice Strategies (what a
review of the literature indicates is a
best practice approach that you
could implement to address the
problem)
Barriers to Best Practice
Implementation (this
could be actual or
anticipated/potential
barriers)
Will Implement Best
Practice (considering
the barriers you
identified – discuss
whether you believe
the identified best
practices could/would
be implemented)
Best Practice #1: [insert description of best practice here]
Column 1 Column 2 Column 3 Column 4
How Your Practices Differ
From Best Practice (describe
the practice problem you
have identified for this
improvement process)
Best Practice Strategies (what a
review of the literature indicates is a
best practice approach that you
could implement to address the
problem)
Barriers to Best Practice
Implementation (this
could be actual or
anticipated/potential
barriers)
Will Implement Best
Practice (considering
the barriers you
identified – discuss
whether you believe
the identified best
practices could/would
be implemented)
Best Practice #2: [insert description of best practice here]
Column 1 Column 2 Column 3 Column 4
How Your Practices Differ
From Best Practice (describe
the practice problem you
have identified for this
improvement process)
Best Practice Strategies (what a
review of the literature indicates is a
best practice approach that you
could implement to address the
problem)
Barriers to Best Practice
Implementation (this
could be actual or
anticipated/potential
barriers)
Will Implement Best
Practice (considering
the barriers you
identified – discuss
whether you believe
the identified best
practices could/would
be implemented)
Best Practice #3: [insert description of best practice here]
01. Improvement Project: Fall Assessment Tool
02. Quality IndicatorPractice Metric:
03. Individual Completing This Form: Michelle Murray
04. Column 1:
The facility lacks a validated tool of assessing fall risks. Informal observation and inconsistent documentation are used to determine risk.
During admission or regularly, screening is not done that leads to the identification of high-risk individuals sluggishly and reactive measures instead of preventive measures.
.
05. Column 2: Morse Fall Scale and CDC STEADI toolkit are tools with evidence-based applicability in offering standardized fall risk screening. STEADI model incorporates the yearly screening, drug review, gait and balance evaluations, and referral to the respective interventions . Research indicates that the use of standardized tools has a great impact on the reduction of falls in nurse-led programs
06. Column 3: Lack of staff training
little time to make evaluations.
Resistance to change of workflow.
Insufficiency of policy that requires screening.
07. Column 4: Yes. The facility can implement STEADI where some nurse champions will spearhead training and screening process as a part of the regular intake assessment.
08. Best Practice Strategies what a review of the literature indicates is a best practice approach that you could implement to address the problem: Fall Risk Screening- Standardized (STEADI or Morse Fall Scale)
09. Column 1_2: Prevention measures are taken following a fall. It lacks a risk-based individualized prevention plan, particularly in regard to risk level, medication profile, or mobility status.
10. Column 2_2: One-on-one treatments, including the use of strength and balance exercises, medication monitoring, environmental adjustments, and eye checkups are effective to prevent falls. The STEADI model focuses on customized interventions, as opposed to universal prevention.
11. Column 3_2: little interdisciplinary cooperation.
Restrained access to physical therapy.
Staffing shortages
Budget constraints
12. Column 4_2: Yes, by gradual introduction. Referrals will be made through nurses, with the high-risk patients taken priority first.
13. Best Practice Strategies what a review of the literature indicates is a best practice approach that you could implement to address the problem_2: Personalized Fall Prevention Care Plans.
14. Column 1_3: The training of the staff and the formal fall tracking system is not standardized. There is no trend and prevention improvement analysis of falls.
15. Column 2_3: Frequent nurse training sessions and fall-incidence monitoring systems enhance the staffs knowledge and minimize the falls. Constant quality improvement and accountability is made possible by data monitoring.
16. Column 3_3: Limited time for training
Technology limitations
Absence of administrative assistance.
17. Column 4_3: Yes. Monthly trainings and a basic electronic fall log will be presented to trace trends and provide directions on the quality improvement.
18. Best Practice Strategies what a review of the literature indicates is a best practice approach that you could implement to address the problem_3: Continued Education of Staff and Fall Statistics.
19. Text1:
20. Text2:
21. Text3:
22. Text4:
23. Text5:
24. Text6:
25. Text7:
26. Text8:
27. Text9:
28. Text10:
29. Text11:
30. Text12:
31. Text13:
32. Text14:
33. Text15:
34. Text16:
35. Text17:
36. Text18:
37. Text19:
38. Text20:
39. Text21:
40. Text22:
41. Text23:
42. Text24:
**## AdaptedAHRQGapAnalysisOverviewandAssignmentTemplateforUnit4Fillable1b2.pdf**
INSTRUCTIONS
Gap Analysis Tool Adapted from AHRQ
What is this tool? The purpose of the gap analysis is to provide project teams with a format in which to
do the following:
• Compare the best practices with the processes currently in place in your organization.
• Determine the “gaps” between your organization’s practices and the identified best
practices.
• Select the best practices you will implement in your organization.
Who are the target audiences? The project liaison (you will serve as the liaison for this assignment) will
be the primary individual to prepare this written gap analysis, but the entire improvement project team
should be engaged in performing the gap analysis.
How can the tool help you? Upon completion of the gap analysis, project teams will have the
following:
• An understanding of the differences between current practices and best practice.
• An assessment of the barriers that need to be addressed before successful implementation
of best practices.
How does this tool relate to others? Information from AHRQ’s Self-Assessment (Tool A.3) about
the readiness of the hospital/practice setting to perform quality improvement for the Quality Indicators
or Best/Evidence-based practices can be considered in the gap analysis as possible strengths or
weaknesses (i.e., barriers) to be managed when implementing improvements. The best practice
elements defined in the Selected Best Practices and Suggestions for Improvement (Tool D.4) are prefilled
in the gap analysis tool. This provides the elements for the Implementation Plan (Tool D.6).
Instructions
1. List the identified practice problem in Column 1.
2. In Column 2, provide a description of identified best practices (3 best practices required) to address
the problem
4. In Column 3, identify barriers that may hinder successful implementation of each best
practice strategy. Consider systems, procedures, policies, people (i.e. stakeholders), equipment, etc.
5. In Column 4, discuss your thoughts on whether your organization will implement that best practice
strategy. If not, explain why.
6. Repeat steps 1-4 for each best practice.
[https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/a3_combo_selfassessment.pdf](https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/a3_combo_selfassessment.pdf)
[https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4_combo_bestpracticescover.pdf](https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4_combo_bestpracticescover.pdf)
[https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d6_combo_implementationplan.pdf](https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d6_combo_implementationplan.pdf)
Gap Analysis Tool (as adapted from AHRQ’s Tool D-5)
Improvement Project: _____________________ Quality Indicator/Practice Metric: ____________________________
Individual Completing This Form: ______________________________
Column 1 Column 2 Column 3 Column 4
How Your Practices Differ
From Best Practice (describe
the practice problem you
have identified for this
improvement process)
Best Practice Strategies (what a
review of the literature indicates is a
best practice approach that you
could implement to address the
problem)
Barriers to Best Practice
Implementation (this
could be actual or
anticipated/potential
barriers)
Will Implement Best
Practice (considering
the barriers you
identified – discuss
whether you believe
the identified best
practices could/would
be implemented)
Best Practice #1: [insert description of best practice here]
Column 1 Column 2 Column 3 Column 4
How Your Practices Differ
From Best Practice (describe
the practice problem you
have identified for this
improvement process)
Best Practice Strategies (what a
review of the literature indicates is a
best practice approach that you
could implement to address the
problem)
Barriers to Best Practice
Implementation (this
could be actual or
anticipated/potential
barriers)
Will Implement Best
Practice (considering
the barriers you
identified – discuss
whether you believe
the identified best
practices could/would
be implemented)
Best Practice #2: [insert description of best practice here]
Column 1 Column 2 Column 3 Column 4
How Your Practices Differ
From Best Practice (describe
the practice problem you
have identified for this
improvement process)
Best Practice Strategies (what a
review of the literature indicates is a
best practice approach that you
could implement to address the
problem)
Barriers to Best Practice
Implementation (this
could be actual or
anticipated/potential
barriers)
Will Implement Best
Practice (considering
the barriers you
identified – discuss
whether you believe
the identified best
practices could/would
be implemented)
Best Practice #3: [insert description of best practice here]
01. Improvement Project: Fall Assessment Tool
02. Quality IndicatorPractice Metric:
03. Individual Completing This Form: Michelle Murray
04. Column 1:
The facility lacks a validated tool of assessing fall risks. Informal observation and inconsistent documentation are used to determine risk.
During admission or regularly, screening is not done that leads to the identification of high-risk individuals sluggishly and reactive measures instead of preventive measures.
.
05. Column 2: Morse Fall Scale and CDC STEADI toolkit are tools with evidence-based applicability in offering standardized fall risk screening. STEADI model incorporates the yearly screening, drug review, gait and balance evaluations, and referral to the respective interventions . Research indicates that the use of standardized tools has a great impact on the reduction of falls in nurse-led programs
06. Column 3: Lack of staff training
little time to make evaluations.
Resistance to change of workflow.
Insufficiency of policy that requires screening.
07. Column 4: Yes. The facility can implement STEADI where some nurse champions will spearhead training and screening process as a part of the regular intake assessment.
08. Best Practice Strategies what a review of the literature indicates is a best practice approach that you could implement to address the problem: Fall Risk Screening- Standardized (STEADI or Morse Fall Scale)
09. Column 1_2: Prevention measures are taken following a fall. It lacks a risk-based individualized prevention plan, particularly in regard to risk level, medication profile, or mobility status.
10. Column 2_2: One-on-one treatments, including the use of strength and balance exercises, medication monitoring, environmental adjustments, and eye checkups are effective to prevent falls. The STEADI model focuses on customized interventions, as opposed to universal prevention.
11. Column 3_2: little interdisciplinary cooperation.
Restrained access to physical therapy.
Staffing shortages
Budget constraints
12. Column 4_2: Yes, by gradual introduction. Referrals will be made through nurses, with the high-risk patients taken priority first.
13. Best Practice Strategies what a review of the literature indicates is a best practice approach that you could implement to address the problem_2: Personalized Fall Prevention Care Plans.
14. Column 1_3: The training of the staff and the formal fall tracking system is not standardized. There is no trend and prevention improvement analysis of falls.
15. Column 2_3: Frequent nurse training sessions and fall-incidence monitoring systems enhance the staffs knowledge and minimize the falls. Constant quality improvement and accountability is made possible by data monitoring.
16. Column 3_3: Limited time for training
Technology limitations
Absence of administrative assistance.
17. Column 4_3: Yes. Monthly trainings and a basic electronic fall log will be presented to trace trends and provide directions on the quality improvement.
18. Best Practice Strategies what a review of the literature indicates is a best practice approach that you could implement to address the problem_3: Continued Education of Staff and Fall Statistics.
19. Text1:
20. Text2:
21. Text3:
22. Text4:
23. Text5:
24. Text6:
25. Text7:
26. Text8:
27. Text9:
28. Text10:
29. Text11:
30. Text12:
31. Text13:
32. Text14:
33. Text15:
34. Text16:
35. Text17:
36. Text18:
37. Text19:
38. Text20:
39. Text21:
40. Text22:
41. Text23:
42. Text24:
**## InterventionEvidenceMatrixTableweek12.pdf**
Michelle Murray
Class-NU810
In-text citation for
the resource – in the
References list below
this table include a
full citation.
You are required to
upload the full-text
file for each article
represented in the
matrix table into the
assignment drop box.
What is the purpose
of the resource to
support the
strategy/interventio
n?
1. Is the resource a
research or non-
research study (Hint:
JH EBP Rating Scale
notes which are
research or non-
research at the side of
the scale)?
2. What is the study
design (i.e.,
Systematic Review of
RCTs, Prospective
Cohort, etc.)?
3. If not a research
study, what type of
literature is
represented in the
resource (i.e., peer-
review like narrative
review, case reports,
clinical guidelines in
published journals or
non-peer review like
editorials, policy
briefs, opinion
pieces)?
What are the findings
(i.e., quantitative or
qualitative data) and the
recommendations in this
resource that are
relevant to your
proposed DNE project?
How does this resource support your
proposed project?
Articles/resources in the table need to support the strategy or intervention you have chosen for your project implementation.
Michelle Murray
Class-NU810
1 Sherrington et al.
(2020)
To identify the effects
of exercise on the
prevalence of falls
among older adults
and the exercise
components that can
best be used to
prevent falls.
Research study
Systematic review and
meta-analysis of
randomized controlled
trials
Balance and functional
exercises at regular
frequency proved to be of
great help in reducing
falls. Standing balance,
lower limb strengthening,
and repeated movement
training programs were
most effective.
Recommendation:
exercising must be
directed and continued.
Advocates to include balance and strength
training programs to adult day care routines
to prevent falls.
2 Dyer et al. (2023) To test the
effectiveness of
exercise interventions
in settings providing
care to elderly
individuals and their
impact on their fall
prevention.
Research study
Systematic review and
trial endpoint meta-
analysis
When scaled to the ability
of the participant,
exercise programs
decreased the occurrence
of falls and enhanced
functional mobility. The
results were better with
monitored delivery.
Suggestion: exercise
intensity should be
customized to physical
capacity.
Favors personalized workout regimens
among participants of adult day care whose
mobility is different.
3 Lee et al. (2013) The hypothesis that a
multifactorial fall
prevention program
will reduce the
incidence of falls in
older adults at risk of
falls.
Research study
Randomized controlled
trial
Exercise, education, and
risk screening reduced the
number of falls and
improved the physical
performance of
participants compared to
control participants.
Conclusion: integrating
Encourages the use of exercise, education,
and fall-risk assessment in adult day care.
Michelle Murray
Class-NU810
interventions is preferable
to a single strategy.
4 Sibley et al. (2024) To determine
condition that
enhances execution
of community fall-
prevention exercise
programs
Research study
Scoping review study
Employee participation,
basic practice, and
incorporated approach in
routine care increased
compliance with fall
prevention initiatives.
Recommendation:
training of staff is
necessary.
Contributes to personnel education and day-
to-day monitoring as an element of the adult
day care fall prevention policy.
5
Hopewell et al.
(2018)
To compare
multifactorial and
exercise interventions
as fall prevention
strategies in elderly
people.
Research study
Cochrane systematic
review
When assessed and
individualized,
multifactorial
interventions reduced fall
rate. Recommendation:
environmental review +
medication review +
exercise.
Provides an adult day care intervention that
includes screening, exercise, and
environmental safety checks.
**Add additional rows as needed.**
References
Hopewell, S., Adedire, O., Copsey, B., et al. (2018). Multifactorial interventions for preventing falls. Cochrane Database of Systematic Reviews,
CD012424. https://pmc.ncbi.nlm.nih.gov/articles/PMC6513234/pdf/CD012221.pdf
Dyer, S. M., Suen, J., Kwok, W. S., Dawson, R., McLennan, C., Cameron, I. D., … & Sherrington, C. (2023). Exercise for falls prevention in aged
care: systematic review and trial endpoint meta-analyses. Age and ageing, 52(12), afad217.https://academic.oup.com/ageing/article-
pdf/52/12/afad217/54492705/afad217.pdf
[https://pmc.ncbi.nlm.nih.gov/articles/PMC6513234/pdf/CD012221.pdf](https://pmc.ncbi.nlm.nih.gov/articles/PMC6513234/pdf/CD012221.pdf)
[https://academic.oup.com/ageing/article-pdf/52/12/afad217/54492705/afad217.pdf](https://academic.oup.com/ageing/article-pdf/52/12/afad217/54492705/afad217.pdf)
[https://academic.oup.com/ageing/article-pdf/52/12/afad217/54492705/afad217.pdf](https://academic.oup.com/ageing/article-pdf/52/12/afad217/54492705/afad217.pdf)
Michelle Murray
Class-NU810
Lee, H. C., Chang, K. C., Tsauo, J. Y., Hung, J. W., Huang, Y. C., & Lin, S. I. (2013). Effects of a multifactorial fall prevention program on fall
incidence and physical function in community-dwelling older adults with risk of falls. Archives of physical medicine and rehabilitation,
94(4), 606-615.https://www.archives-pmr.org/article/S0003-9993(12)01201-4/pdf
Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., … & Lamb, S. E. (2020). Exercise for preventing falls
in older people living in the community. Cochrane database of systematic reviews,
(1).https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012424.pub2/pdf/full
Sibley, K. M., Tittlemier, B., Olarinde, F., Leadbetter, B. K., & Bouchard, D. R. (2024). Factors influencing older adult community fall prevention
exercise implementation: a scoping review. Age and ageing, 53(8), afae186. https://academic.oup.com/ageing/article-
pdf/53/8/afae186/58885899/afae186.pdf
[https://www.archives-pmr.org/article/S0003-9993(12)01201-4/pdf](https://www.archives-pmr.org/article/S0003-9993(12)01201-4/pdf)
[https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012424.pub2/pdf/full](https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012424.pub2/pdf/full)
[https://academic.oup.com/ageing/article-pdf/53/8/afae186/58885899/afae186.pdf](https://academic.oup.com/ageing/article-pdf/53/8/afae186/58885899/afae186.pdf)
[https://academic.oup.com/ageing/article-pdf/53/8/afae186/58885899/afae186.pdf](https://academic.oup.com/ageing/article-pdf/53/8/afae186/58885899/afae186.pdf)
**## AdaptedAHRQGapAnalysisOverviewandAssignmentTemplateforUnit4Fillable1b2.pdf**
INSTRUCTIONS
Gap Analysis Tool Adapted from AHRQ
What is this tool? The purpose of the gap analysis is to provide project teams with a format in which to
do the following:
• Compare the best practices with the processes currently in place in your organization.
• Determine the “gaps” between your organization’s practices and the identified best
practices.
• Select the best practices you will implement in your organization.
Who are the target audiences? The project liaison (you will serve as the liaison for this assignment) will
be the primary individual to prepare this written gap analysis, but the entire improvement project team
should be engaged in performing the gap analysis.
How can the tool help you? Upon completion of the gap analysis, project teams will have the
following:
• An understanding of the differences between current practices and best practice.
• An assessment of the barriers that need to be addressed before successful implementation
of best practices.
How does this tool relate to others? Information from AHRQ’s Self-Assessment (Tool A.3) about
the readiness of the hospital/practice setting to perform quality improvement for the Quality Indicators
or Best/Evidence-based practices can be considered in the gap analysis as possible strengths or
weaknesses (i.e., barriers) to be managed when implementing improvements. The best practice
elements defined in the Selected Best Practices and Suggestions for Improvement (Tool D.4) are prefilled
in the gap analysis tool. This provides the elements for the Implementation Plan (Tool D.6).
Instructions
1. List the identified practice problem in Column 1.
2. In Column 2, provide a description of identified best practices (3 best practices required) to address
the problem
4. In Column 3, identify barriers that may hinder successful implementation of each best
practice strategy. Consider systems, procedures, policies, people (i.e. stakeholders), equipment, etc.
5. In Column 4, discuss your thoughts on whether your organization will implement that best practice
strategy. If not, explain why.
6. Repeat steps 1-4 for each best practice.
[https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/a3_combo_selfassessment.pdf](https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/a3_combo_selfassessment.pdf)
[https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4_combo_bestpracticescover.pdf](https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4_combo_bestpracticescover.pdf)
[https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d6_combo_implementationplan.pdf](https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d6_combo_implementationplan.pdf)
Gap Analysis Tool (as adapted from AHRQ’s Tool D-5)
Improvement Project: _____________________ Quality Indicator/Practice Metric: ____________________________
Individual Completing This Form: ______________________________
Column 1 Column 2 Column 3 Column 4
How Your Practices Differ
From Best Practice (describe
the practice problem you
have identified for this
improvement process)
Best Practice Strategies (what a
review of the literature indicates is a
best practice approach that you
could implement to address the
problem)
Barriers to Best Practice
Implementation (this
could be actual or
anticipated/potential
barriers)
Will Implement Best
Practice (considering
the barriers you
identified – discuss
whether you believe
the identified best
practices could/would
be implemented)
Best Practice #1: [insert description of best practice here]
Column 1 Column 2 Column 3 Column 4
How Your Practices Differ
From Best Practice (describe
the practice problem you
have identified for this
improvement process)
Best Practice Strategies (what a
review of the literature indicates is a
best practice approach that you
could implement to address the
problem)
Barriers to Best Practice
Implementation (this
could be actual or
anticipated/potential
barriers)
Will Implement Best
Practice (considering
the barriers you
identified – discuss
whether you believe
the identified best
practices could/would
be implemented)
Best Practice #2: [insert description of best practice here]
Column 1 Column 2 Column 3 Column 4
How Your Practices Differ
From Best Practice (describe
the practice problem you
have identified for this
improvement process)
Best Practice Strategies (what a
review of the literature indicates is a
best practice approach that you
could implement to address the
problem)
Barriers to Best Practice
Implementation (this
could be actual or
anticipated/potential
barriers)
Will Implement Best
Practice (considering
the barriers you
identified – discuss
whether you believe
the identified best
practices could/would
be implemented)
Best Practice #3: [insert description of best practice here]
01. Improvement Project: Fall Assessment Tool
02. Quality IndicatorPractice Metric:
03. Individual Completing This Form: Michelle Murray
04. Column 1:
The facility lacks a validated tool of assessing fall risks. Informal observation and inconsistent documentation are used to determine risk.
During admission or regularly, screening is not done that leads to the identification of high-risk individuals sluggishly and reactive measures instead of preventive measures.
.
05. Column 2: Morse Fall Scale and CDC STEADI toolkit are tools with evidence-based applicability in offering standardized fall risk screening. STEADI model incorporates the yearly screening, drug review, gait and balance evaluations, and referral to the respective interventions . Research indicates that the use of standardized tools has a great impact on the reduction of falls in nurse-led programs
06. Column 3: Lack of staff training
little time to make evaluations.
Resistance to change of workflow.
Insufficiency of policy that requires screening.
07. Column 4: Yes. The facility can implement STEADI where some nurse champions will spearhead training and screening process as a part of the regular intake assessment.
08. Best Practice Strategies what a review of the literature indicates is a best practice approach that you could implement to address the problem: Fall Risk Screening- Standardized (STEADI or Morse Fall Scale)
09. Column 1_2: Prevention measures are taken following a fall. It lacks a risk-based individualized prevention plan, particularly in regard to risk level, medication profile, or mobility status.
10. Column 2_2: One-on-one treatments, including the use of strength and balance exercises, medication monitoring, environmental adjustments, and eye checkups are effective to prevent falls. The STEADI model focuses on customized interventions, as opposed to universal prevention.
11. Column 3_2: little interdisciplinary cooperation.
Restrained access to physical therapy.
Staffing shortages
Budget constraints
12. Column 4_2: Yes, by gradual introduction. Referrals will be made through nurses, with the high-risk patients taken priority first.
13. Best Practice Strategies what a review of the literature indicates is a best practice approach that you could implement to address the problem_2: Personalized Fall Prevention Care Plans.
14. Column 1_3: The training of the staff and the formal fall tracking system is not standardized. There is no trend and prevention improvement analysis of falls.
15. Column 2_3: Frequent nurse training sessions and fall-incidence monitoring systems enhance the staffs knowledge and minimize the falls. Constant quality improvement and accountability is made possible by data monitoring.
16. Column 3_3: Limited time for training
Technology limitations
Absence of administrative assistance.
17. Column 4_3: Yes. Monthly trainings and a basic electronic fall log will be presented to trace trends and provide directions on the quality improvement.
18. Best Practice Strategies what a review of the literature indicates is a best practice approach that you could implement to address the problem_3: Continued Education of Staff and Fall Statistics.
19. Text1:
20. Text2:
21. Text3:
22. Text4:
23. Text5:
24. Text6:
25. Text7:
26. Text8:
27. Text9:
28. Text10:
29. Text11:
30. Text12:
31. Text13:
32. Text14:
33. Text15:
34. Text16:
35. Text17:
36. Text18:
37. Text19:
38. Text20:
39. Text21:
40. Text22:
41. Text23:
42. Text24:
**## InterventionEvidenceMatrixTableweek12.pdf**
Michelle Murray
Class-NU810
In-text citation for
the resource – in the
References list below
this table include a
full citation.
You are required to
upload the full-text
file for each article
represented in the
matrix table into the
assignment drop box.
What is the purpose
of the resource to
support the
strategy/interventio
n?
1. Is the resource a
research or non-
research study (Hint:
JH EBP Rating Scale
notes which are
research or non-
research at the side of
the scale)?
2. What is the study
design (i.e.,
Systematic Review of
RCTs, Prospective
Cohort, etc.)?
3. If not a research
study, what type of
literature is
represented in the
resource (i.e., peer-
review like narrative
review, case reports,
clinical guidelines in
published journals or
non-peer review like
editorials, policy
briefs, opinion
pieces)?
What are the findings
(i.e., quantitative or
qualitative data) and the
recommendations in this
resource that are
relevant to your
proposed DNE project?
How does this resource support your
proposed project?
Articles/resources in the table need to support the strategy or intervention you have chosen for your project implementation.
Michelle Murray
Class-NU810
1 Sherrington et al.
(2020)
To identify the effects
of exercise on the
prevalence of falls
among older adults
and the exercise
components that can
best be used to
prevent falls.
Research study
Systematic review and
meta-analysis of
randomized controlled
trials
Balance and functional
exercises at regular
frequency proved to be of
great help in reducing
falls. Standing balance,
lower limb strengthening,
and repeated movement
training programs were
most effective.
Recommendation:
exercising must be
directed and continued.
Advocates to include balance and strength
training programs to adult day care routines
to prevent falls.
2 Dyer et al. (2023) To test the
effectiveness of
exercise interventions
in settings providing
care to elderly
individuals and their
impact on their fall
prevention.
Research study
Systematic review and
trial endpoint meta-
analysis
When scaled to the ability
of the participant,
exercise programs
decreased the occurrence
of falls and enhanced
functional mobility. The
results were better with
monitored delivery.
Suggestion: exercise
intensity should be
customized to physical
capacity.
Favors personalized workout regimens
among participants of adult day care whose
mobility is different.
3 Lee et al. (2013) The hypothesis that a
multifactorial fall
prevention program
will reduce the
incidence of falls in
older adults at risk of
falls.
Research study
Randomized controlled
trial
Exercise, education, and
risk screening reduced the
number of falls and
improved the physical
performance of
participants compared to
control participants.
Conclusion: integrating
Encourages the use of exercise, education,
and fall-risk assessment in adult day care.
Michelle Murray
Class-NU810
interventions is preferable
to a single strategy.
4 Sibley et al. (2024) To determine
condition that
enhances execution
of community fall-
prevention exercise
programs
Research study
Scoping review study
Employee participation,
basic practice, and
incorporated approach in
routine care increased
compliance with fall
prevention initiatives.
Recommendation:
training of staff is
necessary.
Contributes to personnel education and day-
to-day monitoring as an element of the adult
day care fall prevention policy.
5
Hopewell et al.
(2018)
To compare
multifactorial and
exercise interventions
as fall prevention
strategies in elderly
people.
Research study
Cochrane systematic
review
When assessed and
individualized,
multifactorial
interventions reduced fall
rate. Recommendation:
environmental review +
medication review +
exercise.
Provides an adult day care intervention that
includes screening, exercise, and
environmental safety checks.
**Add additional rows as needed.**
References
Hopewell, S., Adedire, O., Copsey, B., et al. (2018). Multifactorial interventions for preventing falls. Cochrane Database of Systematic Reviews,
CD012424. https://pmc.ncbi.nlm.nih.gov/articles/PMC6513234/pdf/CD012221.pdf
Dyer, S. M., Suen, J., Kwok, W. S., Dawson, R., McLennan, C., Cameron, I. D., … & Sherrington, C. (2023). Exercise for falls prevention in aged
care: systematic review and trial endpoint meta-analyses. Age and ageing, 52(12), afad217.https://academic.oup.com/ageing/article-
pdf/52/12/afad217/54492705/afad217.pdf
[https://pmc.ncbi.nlm.nih.gov/articles/PMC6513234/pdf/CD012221.pdf](https://pmc.ncbi.nlm.nih.gov/articles/PMC6513234/pdf/CD012221.pdf)
[https://academic.oup.com/ageing/article-pdf/52/12/afad217/54492705/afad217.pdf](https://academic.oup.com/ageing/article-pdf/52/12/afad217/54492705/afad217.pdf)
[https://academic.oup.com/ageing/article-pdf/52/12/afad217/54492705/afad217.pdf](https://academic.oup.com/ageing/article-pdf/52/12/afad217/54492705/afad217.pdf)
Michelle Murray
Class-NU810
Lee, H. C., Chang, K. C., Tsauo, J. Y., Hung, J. W., Huang, Y. C., & Lin, S. I. (2013). Effects of a multifactorial fall prevention program on fall
incidence and physical function in community-dwelling older adults with risk of falls. Archives of physical medicine and rehabilitation,
94(4), 606-615.https://www.archives-pmr.org/article/S0003-9993(12)01201-4/pdf
Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., … & Lamb, S. E. (2020). Exercise for preventing falls
in older people living in the community. Cochrane database of systematic reviews,
(1).https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012424.pub2/pdf/full
Sibley, K. M., Tittlemier, B., Olarinde, F., Leadbetter, B. K., & Bouchard, D. R. (2024). Factors influencing older adult community fall prevention
exercise implementation: a scoping review. Age and ageing, 53(8), afae186. https://academic.oup.com/ageing/article-
pdf/53/8/afae186/58885899/afae186.pdf
[https://www.archives-pmr.org/article/S0003-9993(12)01201-4/pdf](https://www.archives-pmr.org/article/S0003-9993(12)01201-4/pdf)
[https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012424.pub2/pdf/full](https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012424.pub2/pdf/full)
[https://academic.oup.com/ageing/article-pdf/53/8/afae186/58885899/afae186.pdf](https://academic.oup.com/ageing/article-pdf/53/8/afae186/58885899/afae186.pdf)
[https://academic.oup.com/ageing/article-pdf/53/8/afae186/58885899/afae186.pdf](https://academic.oup.com/ageing/article-pdf/53/8/afae186/58885899/afae186.pdf)
**## AdaptedAHRQGapAnalysisOverviewandAssignmentTemplateforUnit4Fillable1b2.pdf**
INSTRUCTIONS
Gap Analysis Tool Adapted from AHRQ
What is this tool? The purpose of the gap analysis is to provide project teams with a format in which to
do the following:
• Compare the best practices with the processes currently in place in your organization.
• Determine the “gaps” between your organization’s practices and the identified best
practices.
• Select the best practices you will implement in your organization.
Who are the target audiences? The project liaison (you will serve as the liaison for this assignment) will
be the primary individual to prepare this written gap analysis, but the entire improvement project team
should be engaged in performing the gap analysis.
How can the tool help you? Upon completion of the gap analysis, project teams will have the
following:
• An understanding of the differences between current practices and best practice.
• An assessment of the barriers that need to be addressed before successful implementation
of best practices.
How does this tool relate to others? Information from AHRQ’s Self-Assessment (Tool A.3) about
the readiness of the hospital/practice setting to perform quality improvement for the Quality Indicators
or Best/Evidence-based practices can be considered in the gap analysis as possible strengths or
weaknesses (i.e., barriers) to be managed when implementing improvements. The best practice
elements defined in the Selected Best Practices and Suggestions for Improvement (Tool D.4) are prefilled
in the gap analysis tool. This provides the elements for the Implementation Plan (Tool D.6).
Instructions
1. List the identified practice problem in Column 1.
2. In Column 2, provide a description of identified best practices (3 best practices required) to address
the problem
4. In Column 3, identify barriers that may hinder successful implementation of each best
practice strategy. Consider systems, procedures, policies, people (i.e. stakeholders), equipment, etc.
5. In Column 4, discuss your thoughts on whether your organization will implement that best practice
strategy. If not, explain why.
6. Repeat steps 1-4 for each best practice.
[https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/a3_combo_selfassessment.pdf](https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/a3_combo_selfassessment.pdf)
[https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4_combo_bestpracticescover.pdf](https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4_combo_bestpracticescover.pdf)
[https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d6_combo_implementationplan.pdf](https://www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d6_combo_implementationplan.pdf)
Gap Analysis Tool (as adapted from AHRQ’s Tool D-5)
Improvement Project: _____________________ Quality Indicator/Practice Metric: ____________________________
Individual Completing This Form: ______________________________
Column 1 Column 2 Column 3 Column 4
How Your Practices Differ
From Best Practice (describe
the practice problem you
have identified for this
improvement process)
Best Practice Strategies (what a
review of the literature indicates is a
best practice approach that you
could implement to address the
problem)
Barriers to Best Practice
Implementation (this
could be actual or
anticipated/potential
barriers)
Will Implement Best
Practice (considering
the barriers you
identified – discuss
whether you believe
the identified best
practices could/would
be implemented)
Best Practice #1: [insert description of best practice here]
Column 1 Column 2 Column 3 Column 4
How Your Practices Differ
From Best Practice (describe
the practice problem you
have identified for this
improvement process)
Best Practice Strategies (what a
review of the literature indicates is a
best practice approach that you
could implement to address the
problem)
Barriers to Best Practice
Implementation (this
could be actual or
anticipated/potential
barriers)
Will Implement Best
Practice (considering
the barriers you
identified – discuss
whether you believe
the identified best
practices could/would
be implemented)
Best Practice #2: [insert description of best practice here]
Column 1 Column 2 Column 3 Column 4
How Your Practices Differ
From Best Practice (describe
the practice problem you
have identified for this
improvement process)
Best Practice Strategies (what a
review of the literature indicates is a
best practice approach that you
could implement to address the
problem)
Barriers to Best Practice
Implementation (this
could be actual or
anticipated/potential
barriers)
Will Implement Best
Practice (considering
the barriers you
identified – discuss
whether you believe
the identified best
practices could/would
be implemented)
Best Practice #3: [insert description of best practice here]
01. Improvement Project: Fall Assessment Tool
02. Quality IndicatorPractice Metric:
03. Individual Completing This Form: Michelle Murray
04. Column 1:
The facility lacks a validated tool of assessing fall risks. Informal observation and inconsistent documentation are used to determine risk.
During admission or regularly, screening is not done that leads to the identification of high-risk individuals sluggishly and reactive measures instead of preventive measures.
.
05. Column 2: Morse Fall Scale and CDC STEADI toolkit are tools with evidence-based applicability in offering standardized fall risk screening. STEADI model incorporates the yearly screening, drug review, gait and balance evaluations, and referral to the respective interventions . Research indicates that the use of standardized tools has a great impact on the reduction of falls in nurse-led programs
06. Column 3: Lack of staff training
little time to make evaluations.
Resistance to change of workflow.
Insufficiency of policy that requires screening.
07. Column 4: Yes. The facility can implement STEADI where some nurse champions will spearhead training and screening process as a part of the regular intake assessment.
08. Best Practice Strategies what a review of the literature indicates is a best practice approach that you could implement to address the problem: Fall Risk Screening- Standardized (STEADI or Morse Fall Scale)
09. Column 1_2: Prevention measures are taken following a fall. It lacks a risk-based individualized prevention plan, particularly in regard to risk level, medication profile, or mobility status.
10. Column 2_2: One-on-one treatments, including the use of strength and balance exercises, medication monitoring, environmental adjustments, and eye checkups are effective to prevent falls. The STEADI model focuses on customized interventions, as opposed to universal prevention.
11. Column 3_2: little interdisciplinary cooperation.
Restrained access to physical therapy.
Staffing shortages
Budget constraints
12. Column 4_2: Yes, by gradual introduction. Referrals will be made through nurses, with the high-risk patients taken priority first.
13. Best Practice Strategies what a review of the literature indicates is a best practice approach that you could implement to address the problem_2: Personalized Fall Prevention Care Plans.
14. Column 1_3: The training of the staff and the formal fall tracking system is not standardized. There is no trend and prevention improvement analysis of falls.
15. Column 2_3: Frequent nurse training sessions and fall-incidence monitoring systems enhance the staffs knowledge and minimize the falls. Constant quality improvement and accountability is made possible by data monitoring.
16. Column 3_3: Limited time for training
Technology limitations
Absence of administrative assistance.
17. Column 4_3: Yes. Monthly trainings and a basic electronic fall log will be presented to trace trends and provide directions on the quality improvement.
18. Best Practice Strategies what a review of the literature indicates is a best practice approach that you could implement to address the problem_3: Continued Education of Staff and Fall Statistics.
19. Text1:
20. Text2:
21. Text3:
22. Text4:
23. Text5:
24. Text6:
25. Text7:
26. Text8:
27. Text9:
28. Text10:
29. Text11:
30. Text12:
31. Text13:
32. Text14:
33. Text15:
34. Text16:
35. Text17:
36. Text18:
37. Text19:
38. Text20:
39. Text21:
40. Text22:
41. Text23:
42. Text24: