Interventions for Preventing Falls in Elderly People - Essay Example

Appraisal of Articles-Nursing PICOT Univesity: Appraisal of Articles-Nursing PICOT Critically, prevention of falls among the elderly cannot be achieved through a single proposed method. It is multivariate dependent on other confounding factors. The proposed solution is a package that consists of patient and family education, early identification of risk factors, a multidisciplinary approach and adequate staffing in preventing patient falls. In lieu of this, this paper will analyze and conduct an appraisal of articles, research-based studies and interventions in the reduction of patient falls among the elderly in support of the proposed solution. In an article published in the American Family Physician journal, the author, observe that patient falls is considered one of geriatric problems that threaten the independence of the elderly. Statistically, in patients aged 65 years and above, 30-40% experience falls every year (Rao, 2013). However, the article does not provide an incidence, morbidity and mortality rate in the general population. The article supports the proposed solution as the author concurs that management of falls is multifactorial. An article published in the Cochrane database Systematic Review, the authors observe that patient falls is high in health care institutions and long-term care facilities. It gives a statistical approximation of 30% falls in patients aged 65 years and above especially in health care institutions. However, the article does not provide data on the incidence, morbidity and mortality rate in the general population. The article supports the proposed solution as it opines that careful modeling of the interventions is necessary in the context of local health care system (Gillespie, Gillespie, Robertson, Lamb, Cumming, & Rowe, 2011). Moyan and Binder (2014), in an article published in the American journal of Medicine, posits that falls are common among the elderly, and appropriate screening should be done during routine health maintenance examination. The article does not provide statistical data on the gravity of falls nor does it provide data on the incidence, morbidity and mortality rate in the general population. However, the article concurs that early assessment of risk factors in key in prevention of falls among the elderly (Moylan & Binder, 2014). Close, Ellis, Hooper, Glucksman, Jackson and Swift (2013), in an article published in The Lancet, observes that falls among the elderly is s common presentation at the accident and emergency units of hospitals. The article does not provide statistical information to demonstrate the gravity of the problem; neither does it provide mortality, morbidity ad incidence rates. However, it opines that management of falls among the elderly is an interdisciplinary approach (Close, Ellis, Hooper, Glucksman, Jackson, & Swift, 2013). In an article authored by Wu, Li, Hu and Liao (2012) and published in the US National Library of Medicine National Institutes of Health observe that indeed falls among the elderly are of grave concern and effective strategies should be put in place to reduce the incident. However, the article fails to provide statistical information on the incidence, mortality and morbidity rates in the general population. The authors agree that risk assessment in conjunction with targeted intervention is key in reducing incidence of patient falls in the elderly (Wu, Li, Hu, & Liao, 2012) The article by Peeters, Vries, Elders, Pluijm, Bouter and Lips (2011), on the prevention of falls in elderly patients at a high risk of falling, observe that falls in the elderly would lead to serious complications such as fractures. Statistically, 30% of elderly patients aged 65 years and above fall at least once while 15% fall at least twice. In the general population, 5% of falls result in fractures while 5 % result in other serious injuries. The article supports the solution that multidisciplinary assessment of risk factors would reduce the incidence of falls in elderly patients (Peeters, Vries, Elders, Pluijm, Bouter, & Lips, 2011) In an article published in BioMed Central Geriatrics journal, Stenhagen, Ekström, Nordell and Elmståh (2013), observes that accidental falls among the elderly present significant health challenges warranting an extensive research on risks and prevention strategies. The article does not provide statistical data on falls among the elderly; neither does it provide statistical information on the morbidity, incidence and mortality rates. However, it concurs that risk assessment is key in developing interventions to reduce patient falls among the elderly (Stenhagen, Ekström, Nordell, & Elmståh, 2013) In a study published in the Journal of Neuroscience Nursing, the authors observe that patient falls are a common thing in health care facilities and institutions of long-term care. Statistically, 12 % of the falls are attributed to neurological conditions. However, the study does not provide the rates of incidence, morbidity, and mortality in the general population. Nevertheless, it agrees that a comprehensive approach of risk assessment, follow up, and patient education would reduce the incidence of patient falls (Tack, Ulrich, & Kehr, 2012) Johnson, George andTran (2011), in a study published in the International Journal of Nursing Practice, notes that patient falls were high during transfer of patients as well as mobilization. No statistical information regarding the rates of incidence, mortality and morbidity rates are provided. Similarly, there is no information on data reflecting the general population. Nevertheless, the authors concur that patient and family education in addition to the use of alarm devices would prevent patient falls (Johnson, George, & Tran, 2011). Meade, Bursell and Ketelsen (2011), in an article featured in the Journal of American Journal of Nursing observes that patient safety is measured by the rate of falls in elderly patients. The article does not provide statistical data demonstrating the gravity of the problem; neither does it provide rates of incidence, morbidity and mortality. Nonetheless, routine nurses’ rounds, operation changes in hospitals are effective in prevention of falls (Meade, Bursell, & Ketelsen, 2011). Whedon andShedd (2010), in an article featured in the Journal of Nursing Scholarship, observes that falls are a significant contributor to injuries in hospitalized patients. However, the article does not provide statistical information on the gravity of the problem; neither does it provide statistics on the morbidity, mortality and incidence rates of patient falls. Nevertheless, the authors concur that comprehensive high risk profiles should be developed in assessment of patients at risk (Whedon & Shedd, 2010). Miake-Lye, Hempel, Ganz and Shekelle (2013), in a study featured in the Annals of Internal Medicine observe that patient falls are common occurrence among inpatients. They note that multicomponent programs reduce the relative risk of falls by a figure of 30%. However, they do not give statistical data on the incidence, morbidity and mortality rates in the general population. The study supports the proposed change by noting that staff training and education, as well as multidisciplinary approach would reduced incidence of patient falls (Miake-Lye, Hempel, Ganz, & Shekelle, 2013). Wilson (2011), observes that falls are the most common hospital related injuries yet they are the most preventable causes of mortality and morbidity. He notes that falls would result in increased dependence, high chances of being admitted to a facility of long-term care, physical and emotional effects. The article does not provide statistical data on the incidence, morbidity and mortality rates. Nonetheless, it concurs that nurse’s education of risk factors, fall index statistics and prevention strategies would reduce the incidence of falls (Wilson, 2011). Haines, et al. (2013) observes that patient falls impact negatively on the recovery process of inpatients, especially the elderly. The article does not provide statistical evidence on the gravity of the problem as well as rates of incidence, morbidity and mortality rates. However, it supports the proposed change by suggesting the identification of cost effective methods that would give an economic valuation (Haines, et al., 2013). Tricco, et al. (2013), notes that falls are the leading causes of increased mortality and morbidity among older inpatients. Prevention strategies are variant and a clear prevention program ha not been clearly identified. It is still obscure. The article does not provide statistical information on patient falls on the incidence, morbidity and mortality in the general population. However, it concurs that a meta-analysis and systematic review of interventions would identify the most effective fall prevention strategy (Tricco, et al., 2013). References Close, J., Ellis, M., Hooper, R., Glucksman, E., Jackson, S., & Swift, C. (2013). Prevention of falls in the elderly trial (PROFET): a randomised controlled trial. Lancet, 353(9147), 93-7. Gillespie, L., Gillespie, W., Robertson, M., Lamb, S., Cumming, R., & Rowe, B. (2011). Interventions for preventing falls in elderly people. The Cochrane Database of Sytemic Reveiws, (4), CD000340. Haines, T., Hill, A., Hill, K., Brauer, S., Hoffmann, T., Etherton-Beer, C., et al. (2013). Cost effectiveness of patient education for the prevention of falls in hospital: economic evaluation from a randomized controlled trial. BMC Medicine, 11, 135. doi: 10.1186/1741-7015-11-135. Johnson, M., George, A., & Tran, D. (2011). Analysis of falls incidents: Nurse and patient preventive behaviours. Interational Journal of Nursing Practice, 17(1), 60-6. doi: 10.1111/j.1440-172X.2010.01907.x. Meade, C., Bursell, A., & Ketelsen, L. (2011). Effects of nursing rounds: on patients call light use, satisfaction, and safety. The American Journal of Nursing, 106(9), 58-70. Miake-Lye, I., Hempel, S., Ganz, D., & Shekelle, P. (2013 ). Inpatient fall prevention programs as a patient safety strategy: a systematic review. Annals of Internal Medicine, 158(2), 390-6. doi: 10.7326/0003-4819-158-5-201303051-00005. Miake-Lye, I., Hempel, S., Ganz, D., & Shekelle, P. (2013). Inpatient fall prevention programs as a patient safety strategy: a systematic review. Annals of Internal Medicine, 158(2), 390-6. doi: 10.7326/0003-4819-158-5-201303051-00005. Moylan, K., & Binder, E. (2014). Falls in older adults: risk assessment, management and prevention. The American Journal of Medicine, 120(6), 493. Peeters, G., Vries, O., Elders, P., Pluijm, S., Bouter, L., & Lips, P. (2011). Prevention of fall incidents in patients with a high risk of falling: design of a randomised controlled trial with an economic evaluation of the effect of multidisciplinary transmural care. BMC Geriatrics, 2(7),15. Rao, S. (2013). Prevention of falls in older patients. American Family Physician, 72(1), 81-8. Stenhagen, M., Ekström, H., Nordell, E., & Elmståh, S. (2013). Falls in the general elderly population: a 3- and 6- year prospective study of risk factors using data from the longitudinal population study Good ageing in Skane. BMC Geriatrics, 13, 81. doi: 10.1186/1471-2318-13-81. Tack, K., Ulrich, B., & Kehr, C. (2012). Patient falls: profile for prevention. The Journal of Neuroscience Nursing, 19(2), 83-9. Tricco, A., Cogo, E., Holroyd-Leduc, J., Sibley, K., Feldman, F., Kerr, G., et al. (2013). Hi, I have completed the order. The order is a total of five pages. Kindly inform the customer about the additional two pages so he/ she would get the completed assignment. Thank you. Sytematic Reviews, 6(2), 38. doi: 10.1186/2046-4053-2-38. Whedon, M., & Shedd, P. (2010). Prediction and prevention of patient falls. The Journal of Nursing Scholarship, 21(2), 108-14. Wilson, E. (2011). Preventing patient falls. AACN Clinical Issues, 9(1), 100-8. Wu, L., Li, Y., Hu, X., & Liao, Z. (2012). Prevention of falls of hospitalized elderly patients using clinical pathway. Journal of Sichuan University, 43(2), 222-5. Read More