Reducing falls in the elderly population

October 10, 2020

Description

Develop a 1375 word written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal. Use the websites that are listed in the Literature Evaluation Tool 8 sources are listed

1. Background

2. Clinical problem statement.

3. Purpose of the change proposal in relation to providing patient care in the changing health care system.

4. PICOT question.

5. Literature search strategy employed.

6. Evaluation of the literature.

7. Applicable change or nursing theory utilized.

8. Proposed implementation plan with outcome measures.

9. Discussion of how evidence-based practice was used in creating the intervention plan.

10. Plan for evaluating the proposed nursing intervention.

11. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.

12. Appendix section, if tables, graphs, surveys, educational materials, etc. are created.

Literature Evaluation Table

Student Name: Nora Freeman

Change Topic (2-3 sentences):The leading cause of injuries in older adults is falling.Falls can lead to loss of independence, early admission into long-term care facilities, disability, and even death. In fact, falls are the leading cause of fatal injuries in older adults.

The leading cause of injuries in older adults is falling.Falls can lead to loss of independence, early admission into long-term care facilities, disability, and even death. In fact, falls are the leading cause of fatal injuries in older adults.

Criteria	Article 1	Article 2	Article 3	Article 4
Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article	Stevens, J. A., & Lee, R. American journal of preventive medicine, 55(3), 290-297. https://www.sciencedirect.com/science/article/abs/pii/S0749379718317598	Marvin, V., Ward, E., Poots, A. J., Heard, K., Rajagopalan, A., &Jubraj, B.European journal of hospital pharmacy, 24(1), 10-15. https://ejhp.bmj.com/content/24/1/10.short	Sherrington, C., Michaleff, Z. A., Fairhall, N., Paul, S. S., Tiedemann, A., Whitney, J., … & Lord, S. R. British journal of sports medicine, 51(24), 1750-1758. https://bjsm.bmj.com/content/51/24/1750.short	Griffin, B., Kessler, A., Luckraft, K., Monroe, H., Richardson, A., Smisek, A., &Wohletz, H. (2020). Decreasing Falls in the Elderly Population Living in Long Term Care Facilities. https://digitalcommons.csbsju.edu/ur_cscday/106
Article Title and Year Published	The potential to reduce falls and avert costs by clinically managing fall risk. Published in 2018.	Deprescribing medicines in the acute setting to reduce the risk of falls. Published in 2017	Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Published in 2017	Decreasing Falls in the Elderly Population Living in Long Term Care Facilities. Published in 2020
Research Questions (Qualitative)/Hypothesis (Quantitative)	To estimate the prevalence of seven fall risk factors and the effectiveness of seven evidence based fall interventions.	To Identify all admissions aged over 70 years following a fall, on poly pharmacy or problematic medicines.	To explore whether characteristics of the trial design, sample or intervention are associated with greater fall prevention effects	To determine whether long term care facility will demonstrate compliance of the intervention by completing at least 75% of the resident’s checklist.
Purposes/Aim of Study	To come up with the best intervention plans promotes reduction in falls within the elderly population.	To quantify the nature and extent of deprescribing for patients that experience falls.	To test whether exercise prevents falls in older adults	To promote long-term care that will decrease the prevalence of fall rates by 10% during a one month timeframe.
Design (Type of Quantitative, or Type of Qualitative)	Meta-analysis Research Design.	Correlational Research Design	Meta-analysis	Descriptive Research Design
Setting/Sample	Systematic Sampling.	Stratified sampling	Random Sampling	Systematic Sampling
Methods: Intervention/Instruments	Seven fall interventions such as Tai Chi, Otago, medication management, vitamin D supplementation, expedited first eye cataract surgery, single-vision distance lenses for outdoor activities, and home modifications led by an occupational therapist.	Coded data Emergency department discharge summaries (DSUMs) for the period 02 February 2015 to 31March 2015 were examined to identify patients who were aged70 years or older who were known to have had a fall and werein hospital as a result overnight.	Use of a single intervention to see to what extent it reduced the fall rates.	Use of long term care as an intervention to reduce the number of falls.
Analysis	Data conducted was subjected to analysis through SPSS(Statistical Package for Social Sciences.)	ANOVA analysis	Meta- Regression.	Regression Analysis\Correlational Analysis
Key Findings	Implementing a single intervention could prevent between 9,563 and 45,164 medically treated falls and avert $94–$442 million in direct medical costs annually	Deprescribing drugs plays a great role in preventing falls.	Exercise as a singleintervention can prevent falls in community-dwellingolder people.	The expected results would be a 58.6% decrease in falls during the experimental month. Since September 2019, the care center has experienced an average of 19.16 falls per month. After the intervention, there should be roughly 7.94 falls in that month. The initial goal was a 10% decrease in falls.
Recommendations	The article recommends that interventions take place early to reduce the number of accidents.	Our recommendation is to involve pharmacists in identifying patients at risk, beginning the process of comprehensive medication review from the point of verifying the drug history (in line with Royal Pharmaceutical Society standards34) and prompting the prescriber at all stages of the patient journey through thehospital and at transfer.	The article recommends that we should incorporate exercise as an intervention to reduce falls among the elderly.	We recommend that experiments should be done in such cases as descriptive literature may give the wrong approximation about long term care.
Explanation of How the Article Supports EBP/Capstone Project	The article greatly supports the EBP\|Capstoneproject through giving seven interventions that can prevent patient falls which is a problem that the Capstone project aims to reduce but remains acute.	The article supports the capstone project that aims to reduce patient falls by making them exercise rather than prescribing drugs to them.	The article supports the Capstone project by vouching for exercise as an intervention that helps in the prevention of falls among the elderly.	The article supports the Capstone project by providing long term care as an intervention to prevent falls among elder adults.

Criteria	Article 5	Article 6	Article 7	Article 8
Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article	White, H., &Cuavers, K. Y.Journal of National Black Nurses’ Association: JNBNA, 29(2), 17-22. https://europepmc.org/article/med/31022335	Matchar, D. B., Duncan, P. W., Lien, C. T., Ong, M. E. H., Lee, M., Gao, F., … &Eom, K. Archives of physical medicine and rehabilitation, 98(6), 1086-1096. https://www.sciencedirect.com/science/article/abs/pii/S0003999317303301	Woods, T. M. Effectiveness of a Standardized Fall Assessment Tool in Reducing Falls Among Elder Home Health Clients. https://scholarworks.waldenu.edu/dissertations/8350/	Cockayne, S., Adamson, J., Clarke, A., Corbacho, B., Fairhurst, C., Green, L., … &McIntosh, C. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0168712
Article Title and Year Published	Do alarm devices reduce falls in the elderly population? Published in 2018.	Randomized controlled trial of screening, risk modification, and physical therapy to prevent falls among the elderly recently discharged from the emergency department to the community: the steps to avoid falls in the elderly study. Published in 2017.	Effectiveness of a Standardized Fall Assessment Tool in Reducing Falls Among Elder Home Health Clients. Published in 2020	Cohort randomised controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people (the REFORM trial). PLoS One, 12(1), e0168712. Published in 2017
Research Questions (Qualitative)/Hypothesis (Quantitative)	To determine whether bed/body alarms reduce the incidence of falls and/or subsequent injuries in a facility that uses such devices, as compared to a facility in which no bed/body alarms were used among the elderly over a 5-month period	To determine whether screening, risk modification and physical therapy play a role in preventing falls among the elderly.	The research questions were Can the implementation of tools such as a multifactorial fall assessment tool accurately identify patients at risk for falls, therefore allowing strategies to be implemented to reduce the occurrence of falls?	To determine whether Routine podiatry care reduces the number of falls among the elderly.
Purposes/Aim of Study	To determine whether alarm devices reduce falls among the elderly population.	To evaluate the effect of exercise and cognitive training on falls reduction and on factors known to be associated with falls among community-dwelling older adults with mild cognitive Impairment.	To determine whether the implementation of a standardized multifactorial tool decreases the number of falls among elderly home health patients 65 years of age and older.	To determine the extent to which Routine podiatry care as an intervention to reduce falls among the elderly is effective. To determine whether Routine podiatry care is cost effective.
Design (Type of Quantitative, or Type of Qualitative)	Quasi-experimental design	Meta-Analysis	Quasi- experimental, presence of baseline and control groups.	Quasi- experimental, presence of baseline and control groups.
Setting/Sample	The sample size was N = 160 across the 2 facilities and included 80 residents at each facility.	Random sampling Seventeen RCTs (1679 participants; mean age ± SD, 74.4±2.4y) were included.	A narrative analysis was used to analyze the included articles. Information was extracted from each article using sample characteristics, including age; descriptive characteristics, including time period; inclusion and exclusion criteria, intervention characteristics, including effect of intervention; risk factors, including extrinsic and intrinsic; and fall-related outcome data, including the number of recent falls.	Random sampling We powered the study to detect a 10% absolute reduction in the proportion of people having one or more falls over 12 months. We assumed that 50% of the control group would experience a fall. To reduce this to 40% with 80% power (α = 0.05) required 890 participants (445 in each group) allowing for 10% attrition. We chose to power the study using a difference in proportions rather than fall incidence as the latter is not straight forward but this approach should generally be a more conservative estimate of the power of the study to show a difference in falls incidence.
Methods: Intervention/Instruments	Use installation of alarms near the beds of the elderly as an intervention to reduce the number of falls.	Review Instrument (JBI-MAStARI) tool. Study quality was assessed using the JBI-MAStARI appraisal instrument.	Fineout-Overholt, Melnyk, Stillwell, and critical appraisal guide for quantitative studies was used to ensure the articles were appropriate for inclusion by seven identified criteria related to each article.	Routine podiatry care as an intervention to reduce falls among the elderly.
Analysis	Test of statistical Inference.	Regression Analysis	Descriptive Research Design	Analyses were conducted using Stata v13 on an available case, modified intention-to-treat (ITT) basis using a two-sided statistical significance level of 0.05, unless otherwise stated. The incidence rate of falls was analysed using a mixed-effects negative binomial regression model controlling for gender, age, and history of falling, with centre as a random effect to account for this potential clustering. The model took account of the different observation periods for each individual by including a variable for the number of months that the participant returned a monthly falls calendar
Key Findings	The use of bed/body alarms did not reduce falls within the elderly population.	This review suggests that exercise, and combined exercise and cognitive training improve specific factors associated with falls such as gait speed, cognitive function, and balance in MCI.	The study revealed the efficacy of a fall assessment tool as it is used in conjunction with a multifactorial fall assessment program.	There was a small reduction in falls. The intervention may be cost-effective.
Recommendations	The article recommends that hospitals should also research on the response time while taking installation of alarms as a measure as an intervention to reduce falls in hospitals.	Further research on the direct effect of exercise and cognitive training on the fall rate and incidence in older adults with MCI with larger sample sizes is highly recommended.	My recommendation for future studies is to focus not only on the intrinsic factors of the elderly but also on the extrinsic factors such as the home environment	My recommendation would be to incorporate patients who see a regular NHS podiatrist and those who do not.
Explanation of How the Article Supports EBP/Capstone	The article supports the Capstone project in that it refutes installation of alarms as an intervention measure to prevent falls.	The article contributes to the Capstone project in that it depicts the effectiveness of cognitive training and exercise in preventing the number of falls among the elderly.	The article contributes to the Capstone project in that it helps in the recognition of multifactorial fall assessment program that goes hand in hand with its strategies.	The article contributes to the Capstone project by providing an intervention that helps in reducing falls among the elderly.

Reducing falls in the elderly population

admin

Related posts

Role Of Health Education In Health Promotion

Nevada Constitution Reform Outline

Written Communication Skills Assignment

Leave a Reply Cancel reply