NURS FPX 9000 Assessment 1 Project, Preceptor, and Practicum Interest Form (PPPIF)

Project, Preceptor, and Practicum Interest Form (PPPIF)

Site Description

The suggested location of the project is an inpatient rehabilitation hospital that is a part of the largest system of specialized rehabilitation hospitals in the country. The inpatient rehabilitation hospitals are acute care facilities that offer intensive therapeutic interventions to stroke, neurological, spinal cord, and orthopedic procedure patients (Chief nursing officer, personal communication, June 7, 2025).

The characteristics of the facilities include the provision of three hours of therapy sessions daily, five days a week, and 24/7 nursing service and regular visits by physicians (Chief nursing officer, personal communication, June 7, 2025). The organization has more than 165 hospitals in 38 states and in Puerto Rico, and it serves about 225,000 patients per year (Chief nursing officer, personal communication, June 7, 2025). 

Identified Problem or Gap

The identified problem in the inpatient rehabilitation hospital is the high level of risk of falls in patients with Parkinson’s disease, which causes safety and clinical outcomes challenges. The patients with Parkinsonism have a double rate of falls compared to age-matched older adults, and over half of all suffer recurring falls (Camicioli et al., 2023). The most frequent cause of emergency hospitalization in the demographics of Parkinson’s disease is falls, accounting for 23.7 percent of all emergency hospitalizations, and falls related to hospitalization among people with Parkinson’s disease are associated with higher rates of injuries and longer average hospital stay compared to those who do not have Parkinson’s disease (Centers for Disease Control and Prevention, 2020).

According to national standards, epidemiologic research findings suggest that 3-5 falls per 1,000 bed-days represent hospital fall rates, and the Agency of Healthcare Research and Quality estimates the number of falls to be 700,000 to 1 million hospitalized patients per year (AHRQ, 2024), and the current data of the rehabilitation hospital indicates 4.2 falls per 1,000 patient days, which is out of the limits of national benchmarks (Chief nursing officer, personal communication, January 15, Even though there is availability of research-supported frameworks of fall prevention, the current clinical practice release of methodical fall prevention measures is low because of ambiguous roles among care teams and complexity of implementation.

Certain research-based evidence supports the implementation of the CDC stopping elderly accidents, deaths, and injuries (STEADI) protocol in hospital settings, statistically showing a decrease in length of stay and an enhancement in the rates of discharge-to-home, which implies that the best practice protocols to prevent falls in the inpatient rehabilitation setting must be specifically tailored to the patient group of Parkinson’s disease (CDC, 2024). The practice location needs the urgency of the evidence-based implementation of intervention within a 12-week period to resolve the problem of patient safety and achieve the maximum clinical outcomes among the vulnerable population.

Quality Improvement Intervention

Implementation of the CDC STEADI fall prevention model is a quality improvement intervention based on research, which addresses the multifaceted nature of fall risks in patients with Parkinson’s disease by applying a systematic method of screening, assessment, and intervention. The STEADI program equips medical workers with tools and materials to facilitate fall risk screening and holistic fall risk assessment and interventions, with the use of a single approach that is executed in line with the American and British Geriatrics Society Clinical Practice Guideline regarding fall prevention (Rein et al., 2024). The three core components of the STEADI, screening patients at risk of falls, assessing modifiable risk factors, and preventing the fall risk through effective methods, have the potential to impact the reduction of falls, improve health outcomes, and reduce healthcare expenditures (CDC, 2024).

STEADI implementation in outpatient rehabilitation settings demonstrated successful implementation in the healthcare organizations, with a 76.4% screening coverage of qualified patients and 44.1% of the participants classified as high-risk of falls (Vincenzo et al., 2024). The recent controlled quality improvement trials have created the frameworks for determining the efficacy of STEADI with the help of telehealth-based applications, providing the frameworks for the evaluation of the process and outcome measures, such as the reduction of falls and cost-effectiveness (Rein et al., 2024). The holistic approach considers a wide array of modifiable risk factors, such as pharmaceutical management, mobility and balance assessment, home safety inspection, and vision test, and is thus suitable for the needs of patients with Parkinson’s disease who are exposed to the risk of falls because of movement and non-movement symptoms (Centers for Disease Control and Prevention, 2024). 

Additional Information for Mentor or Site-Based Learning

Some other data points that would support mentorship and site-based learning involve the detailed information about the proposed implementation schedule, resource distribution, and organizational preparation, as well as assessment of the implementation of the STEADI protocol. The mentor and site-based learning team would find it helpful to learn about the already used practice of fall prevention in the facility, the level of staff training on fall risk assessment, and accessible technological infrastructure to facilitate the systematic screening and recording of the results (Wi et al., 2024).

Data on the presence of institutional support of quality improvement programs, such as administrative support, provision of specific personnel time to conduct training and implementation, and defined quality measures of fall prevention, would improve project planning and implementation. The team members must be notified of the possible implementation obstacles, including interruptions in the workflow, staff reluctance to protocol change, or institutional priorities that could hinder the project’s success (Vincenzo et al., 2023). The history of past quality improvement efforts in the site, results, and lessons learned would present a good background for the drawing up of suitable implementation plans. Data regarding current collaboration with community fall prevention programs, rehabilitation services, and discharge planning processes would be useful in defining the prospects of intervention implementation and care continuity coordination.

Population Description

The target population will be made up of the nursing staff who have direct patient care with those diagnosed with Parkinson’s disease in inpatient rehabilitation hospitals. The registered nurses, licensed practical nurses, and nursing assistants are part of the nursing workforce that provides 24/7 services to patients at different levels of Parkinson’s disease development. The nursing staff is usually well-educated with different education levels, which may include diploma and associate degrees courses, to the bachelor’s and master’s degree preparation with different levels of experience in neurological rehabilitation and fall prevention protocols. The patients who came to the setting have complex clinical presentations that include patients with mild motor symptoms at early stages or advanced ones who have significant mobility loss, cognitive alterations, and complex medication schedules (Camicioli et al., 2023).

Multifaceted needs of the patient, such as motor symptom control, balance impairments, gait deviations, medication administration, and safety observation, have to be met by the nursing staff during rehabilitation. These nurses operate in interdisciplinary teams with physical therapists, occupational therapists, speech-language pathologists, and doctors in order to introduce holistic care programs. The responsibilities of the nurses in the population include constant patient surveillance, administration of complex regimens of medications such as dopaminergic and anticholinergics, and introduction of safety measures to prevent falls and injuries (Rein et al., 2024). The nursing personnel are spread over various shifts and units in the rehabilitation hospital, and this necessitates standard training and protocol application to ensure similar fall prevention measures in all the units and the 10-21-day average length of stay in Parkinson disease patients.

1. Please provide a list of dates and blocks of time when you and your preceptor are available. Your mentor will use this to send out a Zoom meeting link. 

For complete detail about this class visit: NURS FPX9000 Doctor of Nursing Practice 1