LACE readmission scores and STEADI fall screens sort twelve composite discharges into three tiers, with one documented override, in this finished NU470 Unit 4 exercise. Searches like "nu 470 unit 4 assignment example", "nu470 unit 4 sample" and "nu470 unit 4 example" land here.
Twelve Discharges, Three Tiers and One Override: A Risk Stratification Exercise Using LACE and STEADI
[Student Name]
Purdue University Global
NU470: Regenerative and Restorative Care Spheres - A Wellness and Prevention Focus
Unit 4 Assignment
[Instructor Name]
[Date]
Composite patients written as a model exercise. Scores are illustrative.
Tier Rules, Stated First
Top tier, care management: LACE of 10 or more, or a STEADI score of 4 or more combined with living alone. Middle tier, rising risk: LACE 5 to 9. Lower tier, self-management support: LACE below 5 and STEADI below 4. LACE adds points for how long the patient stayed, whether the admission was emergent, the burden of other illnesses and recent emergency visits (van Walraven et al., 2010); STEADI's screening questions flag older adults at risk of falling (Centers for Disease Control and Prevention, n.d.).
The Caseload (Age, Diagnosis, Living Situation, LACE Components L-A-C-E and Total, STEADI, Tier)
1. 81, heart failure, lives with wife; 4-3-5-3, 15; STEADI 5; top.
2. 76, COPD exacerbation, alone; 4-3-3-2, 12; STEADI 6; top.
3. 72, pneumonia, with son; 4-3-2-1, 10; STEADI 3; top.
4. 66, cellulitis, with spouse; 3-3-1-1, 8; STEADI 2; middle.
5. 70, urinary infection, alone; 3-3-1-0, 7; STEADI 8; moved up to top by override.
6. 63, diabetes, hyperglycemia; 2-3-2-0, 7; STEADI 1; middle.
7. 74, atrial fibrillation, with spouse; 3-3-1-0, 7; STEADI 3; middle.
8. 69, gastrointestinal bleed, with daughter; 3-3-1-0, 7; STEADI 2; middle.
9. 60, elective cardiac catheterization, with spouse; 1-0-1-0, 2; STEADI 0; lower.
10. 58, elective knee replacement, with spouse; 3-0-0-0, 3; STEADI 2; lower.
11. 55, elective gallbladder removal, with partner; 1-0-0-0, 1; STEADI 0; lower.
12. 62, elective hernia repair, alone; 1-0-0-0, 1; STEADI 1; lower.
The Override
Patient 5 has a LACE of 7, which places her in the middle tier. She lives alone, scored 8 on STEADI and has no car, factors the readmission score cannot see, so she moves up a tier for a home visit in the first week. Recorded as: "Tier raised from middle to top on nursing judgment: lives alone, high fall risk screen, no transportation."
First Nursing Action per Tier
Top: home visit within seven days, medication reconciliation and a fall risk check. Middle: a phone call within 72 hours, a medication review and referral to a balance class where falls are a concern. Lower: written discharge teaching and a follow-up appointment.
Why the Middle Tier Matters Most
The top tier gets attention by default. The middle tier is where a phone call, a medication review or a balance class can still change what happens next, before rising risk becomes a readmission.
Limits
LACE was developed and validated in Ontario hospitals (van Walraven et al., 2010); local recalibration against this hospital's readmission data is recommended before the thresholds are relied on.
References
Centers for Disease Control and Prevention. (n.d.). STEADI: Stopping elderly accidents, deaths and injuries. Centers for Disease Control and Prevention.
van Walraven, C., Dhalla, I. A., Bell, C., Etchells, E., Stiell, I. G., Zarnke, K., Austin, P. C., & Forster, A. J. (2010). Derivation and validation of an index to predict early death or unplanned readmission after discharge from hospital to the community. Canadian Medical Association Journal, 182(6), 551-557. https://doi.org/10.1503/cmaj.091117
How this NU470 Unit 4 example is structured
Scores come first and judgment second, and the exercise keeps the two visibly apart. The table reports each tool as published, with LACE's length of stay, acuity, comorbidity and emergency visit components shown separately so an error can be traced. Tier rules are stated before any patient is placed: LACE of 10 or more, or a STEADI score of 4 or more combined with living alone, sends a patient up. The override paragraph then argues from factors the scores cannot see, isolation and transport, and records the decision the way a chart note would. The narrative spends its most careful paragraph on the middle tier rather than the top, contending that rising-risk patients are where a phone call, a medication review or a balance class changes what happens next. Limits close the paper: LACE was validated in Ontario hospitals, and local recalibration is flagged.
Get an NU470 Unit 4 example written to your instructions
Caseload size and tool choice differ; some sections supply patients and a named score, others leave both to the writer. Send the Unit 4 prompt and rubric plus any caseload provided, and a model stratification scored on your tools is written within 24-48h, at no cost for a first request. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU470 Unit 4 questions, answered
Which risk tool should the exercise use?
The one your prompt names, if any. LACE is common for readmission, STEADI for falls, and others exist for pressure injury or frailty. Choose a tool that predicts the event the exercise asks about, cite where it was validated, and report its components. Using two tools for two different next events, as the sample does, is often welcomed.
Is it acceptable to override a score?
Yes, when the reason is stated and documented. Scores miss factors such as living alone, transport or a caregiver's health, and clinical judgment is expected to add them. What markers look for is transparency: the original score, the adjusted tier, and a sentence explaining the change. An override with no reason reads as ignoring the tool.
Are the twelve patients drawn from a real hospital?
No. The caseload is composite, and every score was assigned to illustrate the method. If your section asks you to stratify patients from a placement, follow your program's privacy procedures for any details used; the assessments and any sign-offs belong to your clinical work, and the sample only shows how the written exercise is presented.