FALL PREVENTION
Falls have been viewed as a primary origin of hospital-acquired damage and have been found to cause complications and lengthening of hospitalizations in often cases. Fall interventions and assessment are typically aimed at preventing injury and enhancing safety. An increased focus has been laid on fall in a bid to prevent damage as well as maintain the security of the patients due to the increased number of reported cases over the past years. Therefore, this paper will be focusing on analyzing the available evidence to see whether it supports the proposed initiative and whether there is a need for more research on the same as well as the application of the evidence to solving some of the problems.
Recently, there has been a variation of activities that are aimed at demonstrating the reduction in the happening of falls within hospitals. Nonetheless, these practices have not been put into proper systematic application within all hospitals thus some hospitals still experience high rates of falls. These falls that can happen to an individual leading to injury within a hospital have been categorized into three types. They include anticipated physiologic, unanticipated physiologic and accidental falls. Falls that occur accidentally is when a patient falls without any ill intention due to an unsafe environment (Lee, H. et.al.2013). Recent evidence shows that most of falls prevention measures are objected towards the accidental falls. Some researchers have argued that those patients who suffer from unintentional falls become hard for them to be noticed before the event and scores not at the demerit of fall when subjected to the predictive instrument.
Thus, it is clear that more inventions targeted at improving environmental safety would help in reducing or preventing these accidental falls. Falls of the anticipated physiologic type frequently happen to patients associated with falls danger factors that are identifiable in advance. These factors may include abnormal gait, frequent toileting emergencies, increased risk medication or altered mental condition (Lee, H. et.al.2013). A patient with such factors is expected to fall anytime. It has been found that majority of the falls within hospitals are those of the anticipated physiologic type. Interventions to prevent these kinds of falls include addressing the risk factors among others. On the other hand, the unanticipated physiologic kind of falls occurs in those patients who do not demonstrate the actual falls causes within the patient’s falls risk factors. This kind of falls is typically associated with physical statuses such as stroke, syncopal episode or even seizure. However, it is evident that these physical conditions prove hard to be identified until the real fall by the patient occurs. Critical interventions for this include the injury prevention precautions in case a recurrence occurs as well as post-fall measures (Lee, H. et.al.2013).
From numerous researchers, a good number of ways of fall anticipation interventions have gone through evaluation. These include multiple interventions, single interventions as well as multifactorial interventions. On single interventions, one component is put into utilization for fall prevention purposes. This may consist of medication review for a single case. Multiple responses include a similar mixture of interventions that tend to be available to every participant. For instance, all patients engaging in supervised or monitored exercise as well as receiving usual toileting fall under the scale of multiple interventions. Multifactorial interventions on the other hand bases themselves on personal assessment of dangers or risks as well as delivery of interventions that are multiple-component. In numerous cases, these multifactorial programs have been viewed as intervention bundles, such as patient education, staff education, toileting as well as reviews on post-falls. Evidence has demonstrated multifactorial approach as one of the best measure specific to patients (Miake-Lye, I.et.al.2013).
The aim of this evidence-based performance is providing a multifactorial method that can be used systematically on a neurosurgical or inpatient orthopedic in hospitals and later be potentially incorporated throughout the systems of the hospital. This approach is utilized in the identification of patients who are at falls risks and offer individualized or personalized interventions that are necessary for preventing falls (Miake-Lye, I.et.al.2013). In recent years medical experts discovered traumas and fall as clinical or hospital-acquired situations, which include dislocations, intracranial injuries, burns, crushing injuries, fractures, and other injuries. A Joint Commission Healthcare Transformation Centre that focuses on patient falls has been put in place in many nations to address these issues. Evidence provided by this commission has suggested that modest to severe damages from falls when averaged sum up to about seven days within a single hospital, and the associated cost is estimated to be at around $ 14056 on each patient under hospitalization. This shows that thousands of patients in hundred folds within our hospitals fall every given year and about 30-50% gets injured (Miake-Lye, I.et.al.2013). This, therefore, raises the cause for alarm and calls for the necessary control measures to be implemented to prevent these falls.
From this evidence of increased falls, the Joint Commission thus launched the patient prevention measures to curb these challenges. Their project aimed at fall prevention focused on implementing interventions that base their foundation on the patient’s assessed danger falls factors. It included online application giving guidance to hospitals on the falls prevention process through discovering and analyzing causes, measuring the present state, implementation of solutions as well as spreading possible improvements and sustaining them (Jung, Y.et.al.2015).
However, evidence has continued to reveal that the most effective move toward falls avoidance within any hospital environment favors multifactorial interventions. Multifactorial interventions that involve increased observation, as well as surveillance, have revealed useful in falls prevention within hospitals. It is for this reason that efforts have been made towards incorporation of these programs within every hospital (Jung, Y.et.al.2015).
However, much research is needed on the multifactorial intervention programs to reveal the full effectiveness of this. For example, looking at some data collected on 254 falls patients from a particular hospital reveals that much of the project is needed. Nonetheless, a clear sample rather than a randomized one lacks to show the exact number of victims who suffer from falls injuries within the given short periods. This show how available is the room for increased research on the project to show its effectiveness in controlling these falls within hospitals. More research is needed to answer questions such as within the neurosurgical unit how effective is the program on the number of hospitalized patients? Is this program effective when compared to the daily care offered to patients? Despite multifactorial intervention program being the best so far for falls prevention a lot is left undone which calls for continuous research on the same (Jung, Y.et.al.2015).
Nevertheless, so far the multifactorial falls prevention program has been effective in solving some of the severe cases and reducing the falls rates registered in hospitals over time. This means that a certain percentage of the problems has been addressed and when put into full incorporation within the hospital’s systems more positive results will be given. With increased research, this program can prove to be the best remedy for falls within the health institutions as seen from the available evidence.
References
Lee, H. C., Chang, K. C., Tsauo, J. Y., Hung, J. W., Huang, Y. C., & Lin, S. I. (2013). Effects of a multifactorial fall prevention program on fall incidence and physical function in community-dwelling older adults with risk of falls. Archives of physical medicine and rehabilitation, 94(4), 606-615.
Miake-Lye, I. M., Hempel, S., Ganz, D. A., & Shekelle, P. G. (2013). Inpatient fall prevention programs as a patient safety strategy: a systematic review. Annals of internal medicine, 158(5_Part_2), 390-396.
Karlsson, M. K., Magnusson, H., von Schewelov, T., & Rosengren, B. E. (2013). Prevention of falls in the elderly—a review. Osteoporosis international, 24(3), 747-762.
Jung, Y., Lee, K., Shin, S., & Lee, W. (2015). Effects of a multifactorial fall prevention program on balance, gait, and fear of falling in post-stroke inpatients. Journal of physical therapy science, 27(6), 1865-1868.
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Question 
To Prepare:
- Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry. Keep in mind that the clinical issue you identify for your research will stay the same for the entire course.
FALL PREVENTION
- Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
- Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
- Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.
Part 1: Identifying Research Methodologies
After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:
- The full citation of each peer-reviewed article in APA format.
- A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
- A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
- A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
- A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.
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