This paper explains importance of fall prevention interventions. It combines various research articles to explain how interventions are currently implemented in the hospital. In addition, it establishes which intervention methods are more efficient in preventing falls. While explaining the benefit of using these interventions and providing data for the implications of the interventions.
Summary of topic and problem
Falls are the second leading cause of accidental or unintentional deaths worldwide. According to the Center for Disease Control and Prevention “over 800,00 patients a year are hospitalized because of a fall injury (2017)”. Falls commonly occur due to decrease eye sight, hearing, foot pain, vitamin D deficiency, difficulties with walking, throw rugs and clutter in the environment, current illnesses and even medications like sedatives, antidepressants, and tranquilizers. In addition, the dangers associated with falls include head injuries, death, soft tissue injuries, broken bones, osteoporosis and the fear of falling which limits activities of daily living.
The dangers associated with falls can be prevented with implementation of safety measures. Fall prevention can be employed in the health care setting or in the community such as advocating for health care consumers with decreased sensory awareness and by educating them on the importance of the continued use of assistive devices. Furthermore, interventions like making sure that patients know how to operate the call bell and is within reach at all times, bed in low position, side rails up, clutter free environment, adequate lighting, personal belonging within reach and placing the patients with a higher risk for falls closer to the nurses’ station are
examples of fall prevention. If implemented and carefully carried out, the health care consumers
will not have to encounter the dangers related to falls. So, the question is, In a hospital, does an adult patient who is identified as a fall risk based on Morse Fall Risk Assessment, have a decreased incidence of falls, during their hospitalization stay, when the nurse implements a plan to prevent falls (applying fall risk identifiers, providing environment safety, motor and cognitive training, etc..), compared to no measures employed? The interventions stated above are the most common interventions used in the hospital setting. By examining these interventions and acquiring others, we can establish which interventions are more effective at preventing falls.
Summary and synthesis
According to an evidence based protocol article, “Prevention of falls in the hospital”, Morris explains how falls among inpatients are the most frequently reported incident in the hospital .His study showed that identifying the patients risk factors and coupling them with interventions has demonstrated a decrease in patient falls by 20-30% (2017). Morris suggest using a multifactorial fall risk assessment is the best way to decrease the rates of falls. For example, he explains identifying patient risk factors, providing patient education, implementing nursing interventions such as identifying environment safety nursing interventions like keeping the call bell and clients items within reach, having a toilet/continent care plan, and using effective leadership skills is the most effective strategy to reduce patient falls (2017). So therefore, implementing various interventions and strategies, compared to one or none, is the most effective way to decrease in patient falls.
We further examined 2 a systematic review and meta- analysis articles. The first article “Aging clinical and experimental research”, by Park, explains which fall risk assessment tool can best predict the incidence of falls. It examined which fall assessment tool had the highest validity and which provided scientific evidence for selecting the best assessment tool to use.The Article was based on 33 reviewed articles and it focused on patients who were living in a community or in hospitalization. Based on the results it is recommended to use 2 fall risk assessment tools rather than one. For example, Park found that a Hendrich 2 and STRATIFY fall risk assessment focuses on medication taking, consciousness, and urinary output. Furthermore, combining a BBG assessment with a TUG assessment will focus on the clients activities of daily living (2018). By combining these fall risk assessment tools it will help identify the degree of a patient's fall risk status as well as being able to apply fall risk identification bands on those patients.
The second article “Characteristics and effectiveness of fall prevention programs in nursing homes” by Vlaeyen, determined the characteristics and effectiveness of current fall prevention programs. It was based on 14 reviewed articles and examined the number of falls, who the fallers were, and how often did they fall again, when fall interventions were employed. According to the results, when applying fall risk interventions, there was a 21% reduction in the recurrence of fallers. However, when applying multifactorial interventions there was a decrease in the number of fallers by 33%. So therefore, it is shown that multifactorial fall risk interventions are more efficient in reducing the patients fall risk rather than doing one intervention and it provides a greater benefit compared to when no interventions are employed.
In conclusion the results of our research show a collaborative summary about the benefits of employing fall risk interventions. Our data shows that when one or no interventions are employed, there is no decrease in the prevention of in patient falls. However, when implementing various fall risk interventions such as, environmental safety, using two fall risk assessment tools to identify fall risk patients so that we can provide a fall risk identifier band, and using a multifactorial approach to our interventions will reduce the risk of falls.
- Center for Disease Control and Prevention. (2017). Important facts about falls. https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html
- Morris, J. (2017). Prevention of falls in the hospital: A review of evidence-based protocols. Journal of Healthcare Management, 62(6), 399-406. https://journals.lww.com/jhmonline/Abstract/2017/11000/Prevention_of_Falls_in_the_Hospital__A_Review_of.2.aspx
- Park, S. H. (2018). Fall risk assessment tools for elderly living in the community: A systematic review and meta-analysis. Aging Clinical and Experimental Research, 30(1), 1-16. https://link.springer.com/article/10.1007/s40520-017-0800-2
- Vlaeyen, E., Coussement, J., Leysens, G., Van der Elst, E., Delbaere, K., & Cambier, D. (2015). Characteristics and effectiveness of fall prevention programs in nursing homes: A systematic review and meta-analysis of randomized controlled trials. Journal of the American Geriatrics Society, 63(2), 211-221. https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.13270
- Chang, Y. K., Huang, H. C., Liao, Y. T., Huang, S. C., & Chang, W. M. (2019). A randomized controlled trial of a cognitive-motor intervention for fall prevention in older adults with mild cognitive impairment. Journal of the American Medical Directors Association, 20(9), 1115-1121. https://www.sciencedirect.com/science/article/abs/pii/S1525861019300911
- Dixon, S., Endacott, R., & Mahoney, C. (2016). The effectiveness of falls prevention interventions in acute care settings: A systematic review. JBI Database of Systematic Reviews and Implementation Reports, 14(3), 178-212. https://journals.lww.com/jbisrir/Fulltext/2016/03000/The_effectiveness_of_falls_prevention_interventions.7.aspx
- Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Lamb, S. E., Gates, S., Cumming, R. G., & Rowe, B. H. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, (9). https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007146.pub3/full
- Oliver, D., Connelly, J. B., Victor, C. R., Shaw, F. E., & Whitehead, A. (2008). Strategies to prevent falls and fractures in hospitals and care homes and effect of cognitive impairment: Systematic review and meta-analyses. BMJ, 336(7636), 130-133. https://www.bmj.com/content/336/7636/130