Falling Star Program: A Visual Cue Intervention to Reduce Falls in Long-Term Care

Author

• Maggie Shanahan, Valparaiso University

Date of Award

5-5-2026

Degree Type

Evidence-Based Project Report

Degree Name

Doctor of Nursing Practice (DNP)

Department

Nursing

First Advisor

Rebecca L. Peterson

Abstract

Falls among older adults in skilled nursing and long-term care settings remain a leading cause of injury, functional decline, and increased healthcare utilization, contributing significantly to morbidity and mortality in this population (Centers for Disease Control and Prevention [CDC], 2023; Agency for Healthcare Research and Quality [AHRQ], 2022). The primary purpose of this project aimed to implement and evaluate a structured visual cue–based fall prevention intervention to reduce fall rates among high-risk residents in a long-term care facility in Northwest Indiana. The project included 23 participants aged 65 years and older who were identified as high risk for falls. Using a within-group pre-intervention and post-intervention design, fall rates were compared over a 30-day baseline period and a 12-week intervention period. The intervention, known as the falling star program, included placement of yellow star visual cues on resident doorframes and mobility devices, staff education sessions, reinforcement during shift huddles, and weekly audits to promote consistent implementation and interdisciplinary communication. Fall outcome data were collected through review of incident reports and facility safety logs. Fall rates were calculated as falls per 1,000 resident-days. A Poisson regression model with a log offset for resident-days was used to compare fall rates between baseline and post-intervention periods. Following implementation, fall rates decreased from 26.1 to 11.9 falls per 1,000 resident-days, representing a 54.4% reduction. The reduction in fall rates was statistically significant (p = .013). Findings from this project suggest that a standardized visual cue intervention combined with staff education and consistent monitoring may reduce fall incidence among high-risk older adults in long-term care settings and improve patient safety outcomes.

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Recommended Citation

Shanahan, Maggie, "Falling Star Program: A Visual Cue Intervention to Reduce Falls in Long-Term Care" (2026). Evidence-Based Practice Project Reports. 219.
https://scholar.valpo.edu/ebpr/219