Fall Prevention for Older Clients: Annotated Bibliography

Introduction

Falls Prevention for Older Clients

For this Annotated Bibliography Scholarly Article Research Paper, Jean Watson Nursing Theory reflecting research will be utilized focusing on Patient Centered Care in preventing injuries related to falls. Watson’s Human Caring Theory, Watson’s nursing theory to assess patient perceptions of being cared for in a multicultural environment. It has been proven that it is important to utilize the caring approach when providing care to patients, it is the best route in obtaining the goal outcomes of the interdisciplinary team. Showing that you care can create an agreement and a trusting relationship between the nurse and the patient in the nurse-patient relationship phase. This is the part where the nurse can focus on the patient willingness and ability to participate in his own care and the patient is usually more comfortable divulging more personal and healthcare related information to best help the nurse implement care. The nurse will be able to assess the patient potentials and limitations during the healing process, which will determine the successful outcomes, prevent falls and fall related injuries. The nurse not only use the ten caritas for their patients, they also use it in their personal lives. This theory helps them in maintaining harmony in their personal as well as professional relationships thus improving overall care of elderly patients in particular.

Annotated Bibliography

1. Markle-Reid, M., Browne, G., Gafni, A., Roberts, J., Weir, R., Thabane, L., & … Henderson, S. (2010). The effects and costs of a multifactorial and interdisciplinary team approach to falls prevention for older home care clients ‘at risk’ for falling: a randomized controlled trial. Canadian Journal on Aging, 29(1), 139-161. doi:http://dx.doi.org.ezproxy.apollolibrary.com/10.1017/S0714980809990377

This article is a randomized controlled trial study done in Canada. It showed the affects and costs of a multifactorial and interdisciplinary team approach to fall prevention. The participants were 109 older patients age 79 who are at risk for falls and they received homecare services. The project lasted 6 months and the outcome measure was the number of falls during that time. The analysis demonstrated that the intervention reduced falls in men that express fear of falling and had an impact on their emotional health. Overall, the method of intervention improved the quality of life of the male participants.

2. WANG, P., LOW, K. H., TANI, J., & CHANDRA, T. (2010). INITIAL STUDY ON A HOME-BASED FLOOR-MAT SYSTEM FOR FALL PREVENTION OF ELDERLY BASED ON GAIT ANALYSIS. International Journal of Information Acquisition, 7(2), 135-149. doi:10.1142/S0219878910002129

The authors explained the fatal effect of fall in elderly and demonstrated that falls in seniors are mostly due to imbalance gait. To prevent the risk of fall they suggested evaluating older patients at their home. The health screening will help them to have a home base foot mat system model designed to capture the gait characteristics of elderly in their daily activities. The main objective is to maintain safety among the elderly.

3. Junior, E., & de Lima Paula, F. (2008). The prevention of falls under the aspect of health promotion. Fitness & Performance Journal (Online Edition), 7(2), 123-129. doi:10.3900/fpj.7.2.123.e
4. The study is conducted in Brazil. The authors show great interest for creation on the fall prevention program for public health. They emphasize the need for Brazilian government to implement a fall prevention program for older people. They recommend having educative programs to train people to act in intervention and to have more research done in regards to falls in the elderly. This can help reduce the risk factors for fall in the environment.

5. Costa, B., Rutjes, A., Mendy, A., Freund-Heritage, R., & Vieira, E. (2012). Can Falls Risk Prediction Tools Correctly Identify Fall-Prone Elderly Rehabilitation Inpatients? A Systematic Review and Meta-Analysis. Plos ONE, 7(7), 1-8. doi:10.1371/journal.pone.0041061

This article is about falls of elderly people and the adverse events it may cause particularly in rehabilitation hospitals. The authors have used systematic literature reviews to identify tools to assess elderly people admitted in rehab facilities. They found that inaccurate fall prediction tools can create a false sense of safety on patients and staff. The objective of the study is to identify the fall prediction tools available to assess elderly patients in rehabilitation hospitals.

6. Vind, A., Andersen, H., Pedersen, K., Jørgensen, T., & Schwarz, P. (2009). An outpatient multifactorial falls prevention intervention does not reduce falls in high-risk elderly Danes. Journal Of The American Geriatrics Society, 57(6), 971-977. doi:http://dx.doi.org.ezproxy.apollolibrary.com/10.1111/j.1532-5415.2009.02280.x

This article was written in Denmark. The data of this study derived from a randomized study of multifactorial fall preventions. It addresses patients that experience at least one fall and were hospitalized for treatment. The participants were cooperative and open to change. The objective of the study is to identify the fall prediction tools available to assess elderly patients in rehabilitation hospitals and to assess the usefulness of these predictive tools.

7. Tzeng, H. (2011). Nurses’ Caring Attitude: Fall Prevention Program Implementation as an Example of Its Importance. Nursing Forum,46(3), 137-145. doi:http://dx.doi.org.ezproxy.apollolibrary.com/10.1111/j.1744-6198.2011.00222.x

In this article, the authors indicate that fall prevention programs are universally multidisciplinary. Fall prevention programs are not successful in numerous hospitals because of the barriers they encounter to implement the program. They discuss possible ways to ensure the success of the program and recommend the importance of providing patient centered care with attention to each individual patient’s needs.

8. Barker, A., Brand, C., Haines, T., Hill, K., Brauer, S., Jolley, D., & … Kamar, J. (2011). The 6-PACK programme to decrease fall-related injuries in acute hospitals: protocol for a cluster randomized controlled trial. Injury Prevention, 17(4), 1-6. doi:10.1136/injuryprev-2011-040074

This article was written in Australia and shows great interest to falls that threaten the health of older people in acute care hospitals. They recognize that preventing falls in hospitals is public priority. It presents current evidence to support strategies to reduce falls related injuries and has a great influence in improving health outcomes for patients and older people admitted in acute care hospitals. The program is designed to prevent falls and involve multiple interventions.

9. Day, L., Finch, C., Hill, K., Haines, T., Clemson, L., Thomas, M., & Thompson, C. (2011). A protocol for evidence-based targeting and evaluation of statewide strategies for preventing falls among community-dwelling older people in Victoria, Australia. Injury Prevention: Journal of The International Society for Child and Adolescent Injury Prevention, 17(2), e3. doi:10.1136/ip.2010.030775

Lesley Day and other authors used the RE-AIM model which is an electronic method used in research to identify the group of elderly people admitted in hospital for falls. They analyzed the strategies for fall intervention and identify the possibility to integrate an intervention program that responds to the needs of the fallers. They present the necessary guidelines for the purpose of developing an effective fall program in the state of Victoria, Australia.

10. Gangavati, A., Hajjar, I., Quach, L., Jones, R. N., Kiely, D. K., Gagnon, P., & Lipsitz, L. A. (2011). Hypertension, orthostatic hypotension, and the risk of falls in a community-dwelling elderly population: the maintenance of balance, independent living, intellect, and zest in the elderly of Boston study. Journal of The American Geriatrics Society, 59(3), 383-389. doi:http://dx.doi.org.ezproxy.apollolibrary.com/10.1111/j.1532-5415.2011.03317.x

This study addresses the relationship between uncontrolled orthostatic hypotension and falls, particularly in nursing home residents. 722 adults ages 70 and older participate in the study at the Hebrew Rehabilitation Center in Boston. Data were collected using monthly calendars. Fallers were defined as those with at least two falls. The result demonstrated that the prevalence of orthostatic hypotension is higher in older adults with uncontrollable hypertension than those with controlled hypertension.

11. Boyé, N., et. All (2013). The impact of falls in the elderly. Trauma, 15(1), 29-35. doi:10.1177/1460408612463145

The authors provide us a literature overview of the impact of falls in our society. During the last decades, falls in the elderly have become a public interest and have shown a growing awareness in western societies. Falls have affected a large number of the elderly population and cause considerable mobility and mortality rates, disability, loss of function, and poor -quality life. Adverse events of falls, such as hip fractures and traumatic brain injury, require prolonged hospital stay and more rehabilitation services. It is a substantial burden on the health care system due to the large number of services needed to assist those affected by injurious falls. A definitive answer has to be found for the problem of falls. Aging population is increasing there is a need for public health to advance medical care.

Conclusion

The research shows that analysis of the risk factors for falls, including information on different skills the nurses needed to work with in correlation of providing safe care to patients can decrease the amount of injuries related to falls in the nursing home rehab centers. It is also an appropriate measure that the nurses can used to prevent falls. Development of educational plans from literature reviews, staff audits, and other educational program used in research to enhance learning will eventually decrease the amount of injuries from falls when use appropriately. Facilities and hospitals need to implement those educational programs and reinforce patient safety and well- being. It is imperative to evaluate the effectiveness of the program and ensure that the program goals and objectives are achieved. These type -of research empower nurses with the knowledge and tools they need to conduct successful patient interventions within targeted population at risk for falls.

References

• Jean Watson Nursing Theory Falls in the elderly: reliability of a classification system.
• J Am Geriatr Soc. 1991 Feb;39(2):197-202.
• Berland, A., Gundersen, D., & Bentsen, S. (2012). Patient safety and falls: A qualitative study of   home care nurses in Norway. Nursing & Health Sciences, 14(4), 452-457. doi:10.1111/j. 1442-2018.2012.00701.x
• Day, L., Finch, C., Hill, K., Haines, T., Clemson, L., Thomas, M., & Thompson, C. (2011). A protocol for evidence-based targeting and evaluation of statewide strategies for preventing falls among community-dwelling older people in Victoria, Australia. Injury Prevention: Journal of The International Society for Child and Adolescent Injury Prevention, 17(2), e3.
• Godlock, G. (2016). Implementation of an Evidence-Based Patient Safety Team to Prevent Falls in Inpatient Medical Units. MEDSURG Nursing, 25(1), 17-23 7p.
• Goldin, M, & Kauz, D..D. (2010). Applying Watson’s caring theory, and caritas processes to ease life transitions. International Journal for Human Caring, 14(1), 11-14
• Lusk, J. M., & Fater, K. (2013). A concept analysis of patient-centered care. Nursing Forum, 48(2), 89-98. doi:10.1111/nuf.12019
  • Tzeng, H. (2011). Nurses’ Caring Attitude: Fall Prevention Program Implementation as an Example of Its Importance. Nursing Forum, 46(3), 137-145.