Click here to review the scenario and determine what type of question the scenario suggests: intervention, etiology, diagnosis, prognosis or prediction,

Scenario 2 You have recently joined the Community Assistance Program (CAP), a group of volunteers with your community’s fire department in the 40’s and older “retirement community” where you live. The purpose of this group is to help the loved ones while the paramedics are caring for the ill person. Even though you are a nurse practitioner working part time in private internal medicine practice, those skills are not needed in this group. Your role is to drive the loved one to the hospital if they are too nervous to drive or help in any other way. Recently you met with the health professions subgroup of CAP, composed of retired nurses (RNs), physical therapists (PTs), and one occupational therapist (OT), to discuss what more could be done to help your community. The subject came up regarding the number of paramedic calls that were due to someone falling in the home. One member had reviewed the log and determined that over one third of the calls were due to falls. Often these calls are to the same home because no intervention typically results unless the patient is transported to the hospital due to injury. Then, often nothing further is done. Because of this, your discussion turns to what can be done to prevent these falls with the limited resources available. The PT’s recognize the importance of fall risk assessment, but other than impacting those who actually called 911 due to a fall, identifying those in need of prevention would be difficult to determine. You asked about exercise programs and if any evidence existed that suggested regular exercise would result in preventing falls. The PTs agreed is must, but they were unaware of any actual evidence from research studies. The group decides to approach this from an evidence-based perspective. You start to work on the PICOT question. Although you have no funds for the project, many resources are already available. Your community includes 4000 homes and is divided into five sub-communities and all have beautiful facilities, such as club houses with rooms suitable for exercise, restaurants, large swimming pools, and paved walking paths. While anyone over 40 years of age can purchase a home in the community, most residents are over age 65, with many in their 80’s and 90’s. Most live independently and care for their own homes. The conversation about impacting this problem has made everyone in the health professions subgroup excited. The consensus seems to be that others can be recruited to help to make a difference with regard to decreasing falls in the home. First, you must find the evidence.

Page 1 of 1 Evidence, Effectiveness, and Clinical Quality

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