Proposed Practice Change Presentation: Falls-Risk Assessment in Community Nursing (Level 6 Sample)

For information and reference only – not to be submitted as your own work.

This sample supports final-year (Level 6) BSc Adult Nursing students preparing an individual online presentation of 13 to 15 minutes on a proposed practice change. The brief asks you to act as a newly qualified nurse and emerging leader, rationalise the need for change, lead implementation, monitor success and reflect critically on your own leadership. The example change is an improved approach to falls-risk assessment in community nursing for older adults, aligned to NMC Future Nurse Platform 6, Improving safety and quality of care. No university, trust or ward is named. Browse comparable briefs in our UK questions archive (a matching question page will be linked when live), and read the companion planning guide for Level 6 practice-change presentations.

Slide-by-slide outline

The brief allows six to seven slides including the title slide, with citations on every slide. Spend most of the talking time on leadership, not on the clinical detail of the change.

That plan gives about 13 minutes of speech, leaving a small buffer. At a steady pace of roughly 140 words a minute, the transcript should run to around 1,800 to 2,000 words.

Transcript extract: Slide 2, rationale for change

Good morning. I am presenting a change I would lead as a newly qualified nurse in community nursing: improving how we identify and assess falls risk in older adults at home.

Falls are a major cause of harm in later life, and NICE (2025) has updated its national guideline to cover assessment and prevention for people aged 65 and over, and for people aged 50 to 64 with a higher-risk condition. The international consensus is consistent. Montero-Odasso et al. (2022) recommend opportunistic case-finding in community-dwelling older adults, followed by a comprehensive multifactorial assessment for those at higher risk.

Here is the first critical point. NICE (2025) recommends against using falls risk prediction tools to predict who will fall. A common local response is to add a score to the record. My proposal does not rely on a score. It strengthens the question that triggers assessment, asking about falls at routine contacts, and ensures that people who meet NICE criteria are offered a comprehensive assessment or referral.

From my placement observations, which I have anonymised, falls history was asked about inconsistently and assessment elements such as medication review, lying and standing blood pressure and footwear were recorded unevenly. I recognise that this is a limited sample and not an audit, so the first step of my plan is to confirm the gap with local data.

Transcript extract: Slide 4, leading the change

As a newly qualified nurse I will not hold formal authority, so influence matters. I use Kotter’s (1996) eight-step model as a planning framework: creating urgency, building a guiding coalition, forming a vision, communicating it, removing barriers, generating short-term wins, consolidating gains and anchoring change in the culture.

In practice, my coalition would include a senior community nurse, a physiotherapist, a pharmacist and a healthcare assistant, because each holds a part of the assessment. I would seek the team leader’s sponsorship before presenting any proposal, since a change led only by the newest registrant will not last.

I also need to be critical of the model. Kotter’s steps are linear, whereas community teams work in unpredictable, interrupted ways. I would therefore treat the model as a checklist for thinking, not a script.

My leadership approach draws on compassionate leadership. West (2021) describes four behaviours: attending, understanding, empathising and helping. For my team, that means listening to the workload pressures that make an extra question feel burdensome, then helping to remove barriers rather than just urging compliance. Supportive leadership of this kind helps sustain a positive culture, which is a core expectation of the NQN role.

Transcript extract: Slide 5, monitoring success

To know whether the change works, I would use three kinds of measure. A process measure: the proportion of eligible contacts where a falls question is asked and recorded. An outcome measure: the number of people who meet the NICE (2025) criteria and receive a comprehensive assessment or referral within an agreed time. A balancing measure: whether visit length or staff stress increases, because a safety change that harms workload would not be sustainable.

I would test the change on a small scale first, with one nurse and a handful of patients for a fortnight, then adapt it before widening use. Data would be reviewed with the team monthly and shared openly so that results are owned by everyone. If the process measure improves but referrals do not, that tells me the barrier lies beyond the visit, perhaps in access to the falls service, and I would escalate this with my manager.

Transcript extract: Slide 6, critical reflection

Reflecting on my own skills, my strengths are communication with patients and a systematic approach to assessment. My development areas are influencing senior colleagues and handling resistance. I would address these through supervised practice, preceptorship, and structured feedback from my line manager.

There are limits to my proposal. First, evidence for my local gap is anecdotal until audited. Second, PDSA cycles are widely used in the NHS, yet a systematic review found the method is often applied inconsistently (Taylor et al., 2014), so I would define each cycle’s question, prediction and measure in advance. Third, sustaining change is harder than starting it; early enthusiasm may fade after the first quarter.

This work is aligned to Platform 6 of the NMC (2018) standards, improving safety and quality of care, and to The Code’s theme of preserving safety. I would confirm with my team that the change is acceptable, keep all patient information confidential, and escalate any concerns through the proper channels.

Why this scores well

• It questions the obvious solution (a risk score) using current national guidance.
• Leadership theory is applied and critiqued, not just named.
• The student acknowledges evidence limits and personal development needs.
• The talk links back to Platform 6 and the Code.
• Citations support each claim on screen.

Check every guideline version and date before you present, as national guidance is updated regularly. Use Harvard referencing, and keep any wording on your slides short so that the transcript carries the detail.

Need help planning your own presentation? See our adult nursing assignment help or our PowerPoint presentation support.

About the expert

Guidance on this sample reflects the profile of Sophie Adams, who holds an MSc in Adult Nursing from Kingston University London, works as a professional nurse in a UK city hospital, and has been associated with the service for seven years.

References

• Kotter, J.P. (1996) Leading change. Boston: Harvard Business School Press.
• Montero-Odasso, M. et al. (2022) ‘World guidelines for falls prevention and management for older adults: a global initiative’, Age and Ageing, 51(9), afac205.
• National Institute for Health and Care Excellence (2025) Falls: assessment and prevention in older people and in people 50 and over at higher risk. NICE guideline NG249. Available at: https://www.nice.org.uk/guidance/ng249
• Nursing and Midwifery Council (2018) Future nurse: Standards of proficiency for registered nurses. London: NMC. Available at: https://www.nmc.org.uk/standards/standards-for-nurses/standards-of-proficiency-for-registered-nurses/
• Nursing and Midwifery Council (2018) The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates. London: NMC. Available at: https://www.nmc.org.uk/standards/code/
• Taylor, M.J., McNicholas, C., Nicolay, C., Darzi, A., Bell, D. and Reed, J.E. (2014) ‘Systematic review of the application of the plan-do-study-act method to improve quality in healthcare’, BMJ Quality & Safety, 23(4), pp. 290-298.
• West, M.A. (2021) Compassionate leadership: Sustaining wisdom, humanity and presence in health and social care.