Preventing Falls in Nursing Home

Cooper, R. (2017). Reducing falls in a care home. BMJ Open Quality, 6(1). 1-6.

This article reports about a study that was carried out at an Aberdeen care home whose goal was to reduce the prevalence of falls in the institution in question by 20% (Cooper, 2017). The research collected qualitative data about the staffs’ beliefs pertaining to falls and their level of knowledge of this problem and how to manage it. The information collected was used to guide the development of a training program for the staff in question. After the implementation of the training program, the researcher found out that there was a 36.3% decrease in incidents of falls in the facility (Cooper, 2017). The portion of this article that will is very relevant in my research project is the one that discusses the multifactorial nature of factors that expose seniors to the risk of falls.

Moncada, L. V., & Mire, G. (2017). Preventing falls in older persons. Am Fam Physician, 96(4): 240-247.

This article explores the multifactorial interventions employed to prevent falls among seniors. These interventions include the management of medications, vitamin D supplementation, and exercises (Moncada & Mire, 2017). The part of this article that is very useful is where it discusses the algorithm for fall risk evaluation and interventions in seniors as well as the phases for the implementation of change models for fall prevention. The article is not tailored to seniors in nursing homes. However, the parts where the article discusses one of the tools that can be used to access the extent to which an elderly is exposed to the risk of falls by considering his or her background, medications that he or she is taking and body structure will be very relevant in my project.

Wilkerson, L. (2017). Implementation of a multifactorial fall prevention protocol. Retrieved from https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1112&context=ebpr

In this article, the researcher tested the implementation of a multifactorial fall prevention program in patients admitted in the neurosurgical/orthopedic unit. The study used the Orlando Nursing Process Discipline and the Iowa Model of Evidence-Based Practice to guide the implementation of the intervention protocol. 45 staff members from a neurosurgical/orthopedic unit received training on multifactorial fall protocol with the help of PowerPoint slides (Wilkerson, 2017). The results of the study may not be very applicable in a nursing home since it was conducted in a primary care setting. However, the part where the article discusses background information pertaining to falls, such as possible prevention strategies, their costs and effects on elderlies, is very relevant to my future research paper.

Álvarez Barbosa, F., del Pozo-Cruz, J., Alfonso-Rosa, R. M., Sanudo, C. B., & Rogers, M. E. (2016). Factors associated with the risk of falls of nursing home residents aged 80 or older. Rehabilitation Nursing, 41(1), 16-25.

This article explored how static balance, quality of life, the condition of the lower limb muscle and functional independence expose patients in nursing facilities to the risk of falls. The researchers conducted a cross-sectional study using 52 residents aged 80 years or older (Álvarez Barbosa, del Pozo-Cruz, Alfonso-Rosa, Sanudo, & Rogers, 2016). The research revealed that residents in the no-fall risk category exhibited higher functional status and better quality of life and performance in their lower limb. This article is useful since it helps in the identification of elderlies who may need closer monitoring because of their higher risk of falling. Also, the article offers good insights on how factors such as gait speed and balance increase or decrease the risk of nursing home residents falling.

Ogundu, O. U. (2016). Fall reduction among elderly residents in skilled nursing facility. https://epublications.regis.edu/cgi/viewcontent.cgi?article=1737&context=theses

This article evaluates the implications of using bed alarm and hourly rounding by staff in reducing the prevalence of falls among senior residents of a skilled nursing facility. It employed Whites and Zaccagnini Doctor of Nursing Practice Process Model (Ogundu, 2016). After data collection and analysis, the researcher found that implementing hourly rounding with the use of 4Ps decreases the fall rate by 13.3% while bed alarm was 9.5% effective (Ogundu, 2016). This article is very useful since it explores some of the strategies that can be employed in preventing falls in nursing facilities from occurring. The portion of the article that will be very useful in my research is where it describes the implementation of the two fall prevention strategies.

Najafpour, Z., Godarzi, Z., Arab, M., & Yaseri, M. (2019). Risk factors for falls in hospital in-patients: a prospective nested case control study. International Journal of Health Policy and Management, 8(5), 300.

In this article, the researchers aimed at investigating the relationships between various risk factors present among fallers when compared to the control group. The study included 185 fallers and 1141 participants in the control group (Najafpour, Godarzi, Arab, & Yaseri, 2019). Both groups comprise individuals who had been hospitalized in a university hospital in Tehran. Data was collected about the patients’ clinical conditions, activity level during and before the fall, types of medications, demographics, and comorbidities. After data analysis, the researchers found out that factors that were linked to a higher risk of falls included the use of specific drugs, longer length of stay, balance condition, urinary incontinence, and nurse-to-patient ratio (Najafpour, et al., 2019). This article is useful in exploring how certain comorbidities, medications and staff factors may expose residents of nursing homes to increased risk of falls.

Teixeira, D. K. D. S., Andrade, L. M., Santos, J. L. P., & Caires, E. S. (2019). Falls among the elderly: Environmental limitations and functional losses. Revista Brasileira de Geriatria e Gerontologia, 22(3).

The objective of this article was to explore the extrinsic and intrinsic factors that expose seniors to falls. The researchers employed a descriptive, explanatory design, whereby qualitative data was collected using participants who were seniors living in the Southwest part of Bahia Brazil (Teixeira, Andrade, Santos, & Caires, 2019). Analysis of the qualitative data collected by the researchers revealed that the falls occurring in a domestic environment were caused by structural issues, and health problems played a lesser role in contributing to the occurrence of these events. This article may not be very important since it reports about a study that was conducted outside the United States and the participants were not residents of nursing homes. However, the article provides important insights on how the understanding of structural issues in nursing homes may help in preventing falls among residents of these facilities.

Ismail, G. M., Fahim, H. I., Bakr, I., Wassif, G. O., & Hamza, S. A. (2018). Risk of falls and effect of a health education program in prevention of falls among elderly in geriatric homes in Cairo, Egypt. The Egyptian Journal of Geriatrics and Gerontology, 5(2), 1-7.

The article explores risk and protective factors for falls among senior residents of geriatric homes located in Cairo. Also, the article assesses the extent and efficacy of information availed to elderly participants pertaining to fall prevention. Ismail, Fahim, Bakr, Wassif, and Hamza (2018) conducted a quasi-experimentation study using 120 senior participants from seven geriatric facilities in different parts of Cairo. After data analysis, the researchers found that there was a statistically significant improvement in the level of knowledge pertaining to falls among the geriatric participants. Also, the elderly participants who took part in the education intervention program experienced a reduction in their incidents of falls from 35.8% to 27.4% within six months (Ismail et al., 2018). The portion of the article that will be very useful is where it provides background information pertaining to the prevalence of falls. Also, the article serves to show how education can be a tool for falls prevention in nursing homes.

Phelan, E. A., Aerts, S., Dowler, D., Eckstrom, E., & Casey, C. M. (2016). Adoption of evidence-based fall prevention practices in primary care for older adults with a history of falls. Frontiers in Public Health, 4, 190.

In this article, the researchers examined the extent to which multifactorial approach is applied in older patients who have fallen in the past. As a result, the researchers conducted a retrospective chart assessment to examine the degree in which patients aged over 65 years who had fallen in the past took part in multifactorial risk evaluation and intervention (Phelan, Aerts, Dowler, Eckstrom, & Casey, 2016). The study included 116 participants who were patients in a primary care facility in the Pacific Northwest (Phelan et al., 2016). The researchers revealed that geriatrics professions had a higher likelihood of using a structured note template and conducting more fall-risk factors evaluation in comparison to the general internists. The article is very useful, especially in the part where it discusses the importance of multifactorial assessments in falls prevention among the elderly.

Ang, C. G., Low, S. L., & How, H. C. (2020). Approach to falls among the elderly in the community. Singapore Med J, 61(3), 116-121.

This article explores some of the strategies that can help prevent falls among seniors in the community. The article adopts an exploratory research design, whereby it reviews other articles that have been written on the topic of falls among the elderly. According to this article, osteoporosis treatment, strengthening and balance exercises and timely cataract operations can help in reducing the risks of injuries outcomes and falls among seniors in the community (Ang, Low, & How, 2020). This article will be very relevant when discussing the psychological implications of falling for seniors. At the same time, the article does a good job providing background information pertaining to falls among the elderly such as the causes, prevalence, and possible solutions.

References

Ang, C. G., Low, S. L., & How, H. C. (2020). Approach to falls among the elderly in the community. Singapore Med J, 61(3), 116-121.

Cooper, R. (2017). Reducing falls in a care home. BMJ Open Quality, 6(1). 1-6.

Moncada, L. V., & Mire, G. (2017). Preventing falls in older persons. Am Fam Physician, 96(4): 240-247.

Najafpour, Z., Godarzi, Z., Arab, M., & Yaseri, M. (2019). Risk factors for falls in hospital in-patients: A prospective nested case control study. International journal of health policy and management, 8(5), 300.

Ogundu, O. U. (2016). Fall reduction among elderly residents in skilled nursing facility. https://epublications.regis.edu/cgi/viewcontent.cgi?article=1737&context=theses

Wilkerson, L. (2017). Implementation of a multifactorial fall prevention protocol. Retrieved from https://scholar.valpo.edu/cgi/viewcontent.cgi?article=1112&context=ebpr

Preventing Falls in Nursing Home

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