Geriatric Evidence Collection

Problem: Are fall prevention programs effective in reducing the number of falls in nursing home elderly and community dwelling elderly?

Most hospitalized patients of 65 years and above have been established to be more vulnerable to falling within their homes or in a facility. These falls have been attributed to various causative agents that need to be assessed and managed in an attempt to completely avert falls (Wilbert, 2010). Prevention of falls should be mandatory since they cause more danger to patients, including breakage of the main bones and even death. As a result, the patient may develop a more serious condition such as decrease functional immobility in addition to that which caused hospitalization. Most of these falls have been found to be caused by therapeutic impacts and ignored diagnostic information (Naqvi, Lee & Fields, 2009). For instance, a great number of elderly people who are hospitalized are diagnosed with dementia at the time of admission; hence, such information needs to be taken into consideration during the care of such a patient. Dementia is likely to cause disorientation and confusion which may result in recurrent falls. Therefore, falls may be described as the abrupt and unintended loss of uprightness that leads to body displacement towards the ground falls (Wilbert, 2010). The purpose of this paper is to develop a falls prevention, management program that will reduce the number of falls occurring within an organization.

Falls among any individual can cause significant trauma, often leading to an increase in mortality. According to the Centers for Disease Control and Prevention (2012), one in every three adults over the age of 65 falls each year. Long-term care facilities account for many of these falls, with an average of 1.5 falls occurring per nursing home bed annually (Vu, Weintraub, & Rubenstein, 2004). In 2001, the American Geriatric Society, British Geriatric Society, and the American Academy of Orthopaedic Surgeons Panel on Falls Prevention published specific guidelines to prevent falls in long-term

The widespread falls among the geriatric population reduce their quality of life and take away their functional independence. Lee et al (2013) state that falls leads to the rise in mortality rates and morbidity complications such as fractures and disabilities,1 out of 3 elderly persons in a community setting falls in a year. About 87% of all fractures in the elderly are due to falls. Several of the risk factors that are associated with falls are visual impairments, cognitive impairments, and health-related problems: arthritis, orthostatic, back pains, lack of balance-weakening muscles, previous falls, polypharmacy or psychoactive drugs (Lee et al, 2013).

Falls are a common and complex geriatric syndrome that cause considerable mortality, morbidity, reduced functioning, and premature nursing home admissions. Falls have multiple precipitating causes and predisposing risk factors, which make their diagnosis, treatment, and prevention a difficult clinical challenge. Identifying effective interventions to prevent falls and fall-related injuries among older adults is a major area of research and policy development in geriatrics. Several published clinical guidelines review the evidence for fall prevention strategies and provide recommendations for assessment and intervention (Rubenstein & Josephson, 2006).

In DC, community based fall prevention programs have been rising to address falls but fall related incident, injuries and the cost has continuously been rising among elderly people (Costello & Edelstein, 2008). In the study conducted by Berland et al. (2012), showed that in home health, not viewing patient safety as primary prevention, lack of investigation causing fall and frailty of elderly adult have been some factors contributing to falls in home health. Falls negatively impacts an individual living in their home by causing them physical, emotional problem, giving rise to additional cost by losing workdays and income.

The purpose of this research paper was to examine the latest research and evidence-based practices related to inpatient falls. Falls among the elderly within a hospital setting has increased within the last decade. Inpatient falls have become the second leading cause of death, causing longer hospital stays and indirect costs for the hospital. The research reviewed multiple studies, which discussed the causes of inpatient falls. A few causes included nurses and staff not knowledgeable of current hospital practices, lack of individualized plan of care, and lack of training related to falls. The findings assisted the writer to revise the current fall policy and procedure for Arrowhead Regional Medical Center (ARMC). A fall reduction program

Broken bones, hip fractures, head injuries, and even death are a serious concern among the elderly in the long-term care setting resulting from falls. Fall prevention in a long-term care facility with dementia residents presents an ongoing challenge to the entire interdisciplinary care team due to their cognitive impairment. Even with significant protocols in place, falls are still to common. There must be other interventions such as distraction techniques that can help reduce the incidence of falls among this population.

I am going to focus on a particular and an effective intervention for fall prevention in aged care facilities, which is medication review. According to Australian Commission on Safety and Quality in Health Care (2009, p. 72), almost all of residents in aged care facilities are prescribed one medication and more than 60% of residents are prescribed 4 or more medications, 47% taking psychoactive drugs regularly, 11% taking sedatives regularly and 21% taking antidepressants regularly. Polypharmacy is highly common in aged care facilities in this country and has been proven as one of the main factors for falls (Baranzini et al. 2009, p. 228). Certain types of medications are strongly associated with the negative outcomes, such as diuretics, antiarrhythmics,

The following research question was addressed: What is the effect of falls in the older adults while hospitalized? CINAHL Complete and Google scholar databases were used to search for relevant quantitative research articles. CINAHL Complete was searched using words like “falls in older adults while inpatient”, “impact of falls in older adults while hospitalized”, falls in older adults”, “and falls in the hospital amongst older adults“, ” fall impact in older adults while hospitalized”. Google scholar databases was searched using keywords such as “impact of falls in hospitalized older adults”, “Fall in the older adults during hospitalization”, “effects of fall on older adults while hospitalized”. Quantitative research article published in English, where any author is a nurse, and adult subjects were analyzed; dates of publications for all articles were limited to the years between 2011–2016. The University of Texas at Arlington’s library site titled finding quantitative and qualitative research was used to evaluate the qualities of the research article to ensure quantitative articles were utilized. Research articles that were utilized were those that involve interventions focused on effects of falls in the older adults population while hospitalized. Multifactorial fall prevention programs, environmental, educational

Patient safety is one of the nation's most imperative health care issues. A 1999 article by the Institute of Medicine estimates that 44,000 to 98,000 people die in U.S. hospitals each year as the result of lack of in patient safety regulations. Inhibiting falls among patients and residents in acute and long term care healthcare settings requires a multifaceted method, and the recognition, evaluation and prevention of patient or resident falls are significant challenges for all who seek to provide a safe environment in any healthcare setting. Yearly, about 30% of the persons of 65 years and older falls at least once and 15% fall at least twice. Patient falls are some of the most common occurrences reported in hospitals and are a leading

A fall is a lethal event that results from an amalgamation of both intrinsic and extrinsic factors which predispose an elderly person to the incident (Naqvi et al 2009). The frequency of hospital admission due to falls for older people in Australia, Canada, UK and Northern Ireland range from 1.6 to 3.0 per 10 000 population (WHO 2012). The prevalence of senior citizen’s falls in acute care settings varies widely and the danger of falling rises with escalating age or frailty. Falls of hospitalized older adults are one of the major patient safety issues in terms of morbidity, mortality, and decreased socialization

Method: The study question investigated was; what impact will individualized fall-prevention education, supported by training and feedback for staff reduce have on the number of falls during hospital stays? The study was a pragmatic study of patients admitted to one of 8 rehabilitation units in general hospitals that were over sixty years old, with a projected hospital stay of at least three days, and had basic cognitive functioning. 3,606 patients admitted were admitted to the eight units during the study period, with 1,983 in the control group and 1623 in the intervention group. The pragmatic nature of the study is a strength given the nature of the intervention. However, the investigators do not explain the logic of limiting the study to patients over age 60, with a length of stay of at least three days, and this restricts the extrapolation of the results to these groups.

Falls are very common among nursing home residents. Residents in nursing homes are more likely to fall due to their age, chronic health conditions, medication, or change in the environment after admission to the facility. The people who provide care every day in nursing homes know firsthand how critical falling can be to the health of the residents they care for. Fall prevention is critical in order to decrease falls in nursing homes. There are programs that are designed to help nursing home staff members identify the reason for resident fall. These programs give a preventive measure that assures accuracy and sensitivity of patients risk from falling. The Falls Management Program (FMP) is one of these programs.

Vivanti, Ward & Haines’ (2011) article focused on falls, mobility and nutrition status and was conducted in a Geriatric Assessment and Rehabilitation Unit (GARU). Study length was 6 month, history of falls from patient was collected and in ward tests and questionnaires were conducted by relevant health professionals within 72 hours of