Capstone Project Change Proposal Presentation for Faculty
Review and Feedback
Assessment Description
Create a 10-15 slide Power Point presentation of your evidence-
based intervention and change proposal to be disseminated to an
interprofessional audience of leaders and stakeholders. Include
the intervention, evidence-based literature, objectives, resources
needed, anticipated measurable outcomes, and how the
intervention would be evaluated. Submit the presentation in the
digital classroom for feedback from the instructor.
PICOT Question (See other file uploaded)
Interventions
Falling incidences can cause several complications, including
health care costs, severe health issues, immobility, etc. With the
severity of this issue, appropriate interventions should take
place. In this context, proper monitoring is one of the
significant interventions to prevent this incidence (Huang et al.,
2020). Hence, incorporating educated and efficient technicians
while providing patient care can be an essential step. Yet, due
to decreased mobility or functionality, older people often
require help in doing basic activities, in this aspect, providing
help to the patients while changing to hospital-approved gowns
(Liu-Ambrose et al., 2019). In addition, one significant and
effective intervention is providing quick education to the
patient regarding fall prevention strategies (Radecki, Reynolds
& Kara, 2018). Another critical aspect is providing a safe
environment for clinical care. Outpatient clinics should improve
their workflow and environmental condition, such as removing
hazardous materials, and keeping the floor clean and dry, so
that the clinic can provide a safe area for older patients. These
interventions can help prevent falls (Guirguis-Blake et al.,
2018).

Benchmark - Capstone Change Project Objectives
1. Prevent elderly falls in an outpatient radiology clinic.
Rationale: Falls occur as age advances due to individual risk
factors or environmental factors. For example, gait or balance
deficits, chronic conditions, medications, and footwear the
patient is wearing. Assisting these patient populations can
prevent falls in the department.
2. Educate patients and people in the community on how to
prevent falls.
Rationale: Educate patients regarding physical changes and
chronic health conditions that cause or probability of falls.
3. Provide a safe environment for clinical care in the
outpatient clinical setting.
Rationale: Design the clinical area accessible to patients in
wheelchairs, with assistive devices, and with mobility deficits.
Have handrails on walls and hallways for support, clean, non-
skid floors, and lighted pathways in hallways, rooms, and
bathrooms.
4. A patient care technician (PCT) is available in the
outpatient clinical area for patients.
Rationale: Having a PCT in the clinical area, especially around
the dressing rooms, would benefit the patients needing help
when changing to hospital-approved gowns and monitoring
patients for risk of falls.
5. Invest in a push-button alarm system in the dressing room
area of the outpatient radiology clinic.
Rationale: The availability of a push-button alarm would aid
patients if they need assistance while changing to hospital
approved gown. A push-button alarm will allow patients to
notify nurses or PCT when help is needed.
Capstone Change Project Resources
Implementing my change project would need resources to be
readily available. After meeting and discussing with my
preceptor, Randy Toquero, we have identified and agreed on
four of the important resources that would be needed in order to

implement the change project effectively. Below is the list of
resources needed for my project change:
1. I will have to work within the existing clinic workflow to
incorporate the fall prevention program questionnaire.
Questions would include age, history of falls, and mobility – if
the patient is able to walk with a steady gait, or with assistance.
Also included is if the patient has any patient care equipment
such as a cane, rolling walker, or wheelchair.
2. Request internal stakeholders – supervisor and manager
for approval of extra staff to help or assist the patients needing
help, especially patients needing to change to MRI-safe hospital
gowns.
3. Offer education to employees of outpatient radiology
clinics and patients scheduled for radiology diagnostic testing
about fall prevention.
4. I will need to have approval from internal stakeholders on
what kind of push-button alarm system to use.
Monitoring and assessing patients help in eliminating falls.
Constant awareness of the staff in the outpatient radiology
clinic about falls such as placing patients near staff stations for
high-risk fall patients. Bringing the team together for fall
awareness with effective communication will help prevent falls.
Fall prevention education gives a clear perspective to the entire
team.
Measurable Outcomes:
1. Develop a falls guideline questionnaire or screening
questions for ages 60 and above.
Rationale: An assessment tool to help detect the at-risk for fall
patients. Help educate patients on key factors and external or
environmental factors that cause falls. Approaches to prevent
falls and decrease injury.
2. Placement of pushbutton alarms in high-risk areas of
falls such as bathrooms and dressing rooms will prevent or
decrease the incidence of falls.
Rationale: Having a tool near you for safety like a pushbutton

alarm will alert healthcare workers of patient needs. The
pushbutton alarm is a safety net that would prevent the
incidence of falls and other injuries.
3. Having an extra staff like a patient care technician (PCT)
would be a positive effect on elderly patients.
Rationale: The availability of a PCT would be a big help for
elderly patients that come to the outpatient radiology clinic
alone. There is a percentage of older adults with no companion
or family members with them that come for radiology diagnostic
testing. Having a PCT or extra staff would be beneficial for
these patients for safety and decrease the incidence of falls.
Capstone Change Project Evaluation Plan
Address the following in your summary:
What data was collected?
Qualitative data collection will be used. Interviewing patients
for history of falls, mobility, gait, and balance. While patients
are in the outpatient radiology clinic staff observation will also
be used for assessment and monitoring if a patient is at high
risk for falls. Interviewing and observing patients will assist in
the determination of patients who are a fall risk.
What tool will be used to collect the data?
Questionnaires, oral histories taken from patients, and
observation while in the outpatient radiology clinic. The
questions asked of patients will reveal if they are prone to falls.
Patients sharing their histories will give the investigator or staff
if a patient has a history of falls.
Who will be responsible for collecting data?
My preceptor and I started the initial education of the staff in
the radiology clinic. Most of the staff will be involved in the
collection of data or information. The bulk of the interview and
questionnaires will be implemented at the front desk when
patients check in during their diagnostic testing. Follow-up of
fall education and reinforcement happens when a patient is with
a nurse prior to any diagnostic testing. Diagnostic technicians
will make sure that patients are safe from falls during testing.

All employee members of the outpatient radiology clinic are
responsible for observing for the best outcome – No Falls.
How will this data be communicated to the team?
Good communication is essential for business success. As lead
of the change project, I prefer to communicate information to
the team face to face. I believe doing face-to-face
communication builds a positive rapport with each team
member. Developing a positive relationship between employers
and employees increases workplace productivity. However, as
every workplace is different outpatient radiology clinic is no
exception. Presently, I am using multiple forms of
communication to include all people involved in the change
project. The communication strategies I use consist of setting
up meetings with managers and supervisors. Constant emails for
updates and follow-ups to definitely and quickly relay the
message. Patients are part of my change project, to educate
them about fall prevention I printed some pamphlets to start fall
awareness in the lobby and waiting areas. Lastly, face-to-face or
one on one allows me to check on the progress of desk and
scheduling staff for questions being asked. It also allows me to
discuss and tweak issues. Most of all face to face and one to one
gives me the chance to say thank you for allowing me to
implement my project change.
Change Summary
Evidence-based Topic:
Identify practices and interventions for reducing falls of elderly
patients in the Outpatient Radiology Clinic.
The capstone change proposal concerns fall prevention for
elderly patients in an outpatient radiology clinic. The change of
practice serves both the community and leadership categories.
Falls are common and happen anywhere. Falls result in injury
and fear to patients. It also causes healthcare organizations a
considerable amount of detrimental expenses. Most falls,
whether inpatient or outpatient, are unwitnessed. The
department’s practices are a factor in preventing falls. The
outpatient radiology clinic is typically not monitored. Since it is

an outpatient clinic, it is assumed that patients are walkie-
talkies. However, the outpatient radiology clinic I work has
multiple incidents of unwitnessed falls with injuries. The
numerous falls have prompted my decision to make a project
change proposal where I work. There is insufficient evidence
underpinning the effectiveness of interventions to guide clinical
staff regarding reducing falls in the elderly. (Vass et al., 2009).
The proposed project change is community-based since the
patients are within the community. The leadership part of the
scope is to get support from the managers about the change
proposal on unit practices to prevent falls in the department.
Proposed interventions would be:
• Monitoring elderly patients on their mobility and agility
• If patients need help changing from street clothes to
hospital-approved gowns, a patient care technician (PCT) is
available for service.
• The placement of push-button alarms must be accessible to
patients in the outpatient radiology clinic, especially when they
are in the dressing room while changing.
• The need to educate patients on the dangers of falls,
especially in unmonitored settings, would prevent falls.
Reference
Vass CD, Sahota O, Drummond A, Kendrick D, Gladman J,
Sach T, Avis M, Grainge M. REFINE (Reducing Falls in In-
patient Elderly)--a randomised controlled trial. Trials. 2009 Sep
10;10:83. doi: 10.1186/1745-6215-10-83. PMID: 19744323;
PMCID: PMC2753618. Retrieved from https://pubmed-ncbi-
nlm-nih-gov.lopes.idm.oclc.org/19744323/
While APA style is not required for the body of this assignment,
solid academic writing is expected, and documentation of
sources should be presented using APA formatting guidelines.

PICOT Question Paper
Mananita Gerochi-Caparas
Grand Canyon University
NRS-493-O503 Professional Capstone and Practicum
Davida Murphy Smith
September 18, 2022
PICOT Question Paper
PICOT Question
In elderly adult patients in the outpatient radiology clinic (P)
what is the effect of placing push button alarms while changing
in the dressing room (I) compared with no alarm system (C)
reducing the incidence of falls (O) within four weeks (T)?
PICOT Problem
Falls are the most common and severe risk factors among
elderly patients in any healthcare setting. It has been found that
disability and morbidity are the leading factors resulting in falls
among the elderly. Falls may develop severe injuries and a
significant risk of death within the organization (Ang, Low &
How, 2020). Some additional causal factors, such as chronic
conditions, medications, hazards within the environmental
setting (radiology setting), and other age factors, like low
balance, may have significant risks to the fall. Changing clothes
is a primary or daily personal duty that may also develop risks
among the elderly towards falls. While seeking the services or
screening for multiple tests in a radiology clinic, there is a need
for undressing and putting on a gown (Berková & Berka, 2018).
Therefore, it is vital to understand that there is a need for
assistance when an elderly patient tries to change their clothes,
as poor balance while changing clothes may result in falls.
Since changing clothes is a private act, healthcare staff cannot
provide necessary services or support.
Nursing Intervention

An adequate nursing intervention would be providing support
services to the elderly when they are in the dressing room of the
clinical radiology setting. Therefore, patients are equipped with
the push button alarms in clinical settings, where they would
receive adequate support services while they are in the dressing
room while changing (Santiago et al., 2017). Pressing the button
will alert or inform the nurses to provide and connect to
patients to understand their requirements. It has been found that
such a portable alarm unit is efficient for the care providers as
they would be able to identify the needs and provide the needful
support to the patients (Wang, Ellul & Azzopardi, 2020). While
changing clothes in the clinical setting, there could be a need
for assistance in balancing and wearing oversized dresses or
gowns. Therefore, the push button alarm is identified as an
evidence-based intervention in healthcare to improve the overall
health outcome.
Clinical Problem and Patient Outcome
The push button alarm would help and empower the elderly to
have immediate and emergent accessibility to the help of nurses
or technicians while performing any tasks or after any accident.
Prompt attention and care should be provided to the elderly
after the incident of falls. Therefore, the usage of push-button
alarms would develop a significant enhancement in addressing
the overall needs of patients. The clinical problems of falls
would reduce with the effective implementation of push button
alarms as it would also help provide emergency care services.
Therefore, the push-button alarm system's performance would
help develop a quicker way of delivering care services. More
immediate intervention and identification of clinical issues or
risks would help improve the overall patient outcome.

References
Ang, G. C., Low, S. L., & How, C. H. (2020). Approach to falls
among the elderly in the community. Singapore medical journal,
61(3), 116–121. https://doi.org/10.11622/smedj.2020029
Berková, M., & Berka, Z. (2018). Falls: a significant cause of
morbidity and mortality in elderly people. Pády: významná
příčina morbidity a mortality seniorů. Vnitrni lekarstvi, 64(11),
1076–1083.
Santiago, J., Cotto, E., Jaimes, L. G., & Vergara-Laurens, I.
(2017, January). Fall detection system for the elderly. In 2017
IEEE 7th Annual Computing and Communication Workshop and
Conference (CCWC) (pp. 1-4). IEEE.
Wang, X., Ellul, J., & Azzopardi, G. (2020). Elderly fall
detection systems: A literature survey. Frontiers in Robotics and
AI, 7, 71. https://doi.org/10.3389/frobt.2020.00071