Literature Review Example on Falls in the Elderly

Scope and Significance of the Problem

Falls among the geriatric patients is a common concern that cannot be overlooked. Fundamentally, geriatric falls are a serious health problem with substantial impact on the patients health as well as healthcare costs. The situation in the United States, including its size of the problem as well as the procedures, requires attention because of the studies shortcomings and the healthcare system procedure. However, the fall that occurs among the hospitalized patients is widespread and serious threats to the safety of the patients. Accidental falls are among the most frequently reported incidents in the hospital settings, and this complicates two percent of the hospital stays. Various studies have shown that the rate of falls in the United States range between 3.3 and11.5 falls per 1000 patients days. However, these fall rates exhibit considerable variation by the unit type (Ambrose, Paul, & Hausdorff, 2013). Falls have been reported among the geriatric hospitalized patients subjected under the fall prevention measures and the reduction is quite apparent in this group of patients compared to geriatric patients, not on fall prevention measures (Shorr et al. 2015). The fall prevention measures in hospitals integrate the multifaceted program that reduces the relative risks of falls by nearly 30 percent. Some of these prevention programs include the leadership support, front line staff engaged in program design and staff education training (Ambrose, Paul, & Hausdorff, 2013). As part of this program, most of the hospitals in the United States have focused on the renewed energy on fall prevention strategies through the participation in Hospital Engagement Networks. Geriatric hospitalized patients are being assessed for their risk of falling as well as the information drawn from fall assessments.

Significance of the Problem to Nurses

The PICOT topic is of substantial relevance to the nurses for many reasons. Firstly, it enables them to design and implement appropriate measures and strategies towards the geriatric patients hospitalized. The relationship between fall among the geriatric patients hospitalized and hospitalized helped the nurses to implement a standard operational program for fall and delirium. For the program, the nurses were able to define fall among old people as the sudden and uncontrolled body transition caused by the loss of body balance control or its stability. They were also able to classify inpatients into different categories about the frequency to which they fell. One important aspect of fall prevention in hospitals involves the use of an integrative care management system which is designed around the characteristics and the features of the hospital unit and type (Latt et al. 2016).

Patient safety is at risk when proper communication is missing among healthcare providers (Chelly et al. 2008). Ideally, having an appropriate understanding of the topic has always helped the nurses to conduct a systematic review of the best practices, as well as evaluating the mistakes to quantify the possible risks of certain triggering events for falls. As healthcare providers, nurses are play a critical role in the prevention of falls due to the close interactions they have with the patients. Also, they are involved in overseeing the everyday activities and operations within the hospital (Coussement et al., 2008). Based on the fact that nurses are more accustomed to the risks of individual patients than the rests of the staff at the hospital, they offer a representation of the frontline of defense against falls.

Personal Connection to the Problem

Personal relationship to the problem involves working on the geriatric psychiatric unit where falls are higher than state and national benchmarks. I am interested in this topic based on the fact that elderly people have co-morbidities in nature and are susceptible to many forms of injuries and falls. The incidence rates of fall-related hip fracture have also increased among the geriatric population in the past few years. Given that 95 percent of such injuries emanate from falls, it is essential to minimise fall risks through appropriate approaches aimed at reducing these severe injuries (Coussement et al., 2008). The primary prevention of fall-related injuries involves the reduction of the occurrence of falls. Through this topic, therefore, I may also recommend an intensive individualized home-based multifaceted intervention for high-risk geriatric patients in the environment where enough resources are available for service delivery.

Restatement of Pico Question

Do geriatric hospitalized patients, on fall prevention measures compared to geriatric patients not on fall prevention actions, have a decreased rate of falls during hospitalization?

Search History

I have utilized different search engines to come up with the relevant articles for the literature review. Notably, the Google Scholar formed an essential part of this system. The search history of the article obtained entailed typing the name of the article or topic and then clicking the search button. One should be able to get a variety of articles, including those captured under the reference section of this paper. Many of the articles I used are peer-reviewed, and therefore make them the most preferred articles for literature reviews.

Literature Review Synthesis: Falls on Geriatric Patients

Prevalence of fall among Geriatric Patients

It is not easy to deny that the condition of falls among the elderly and geriatric patients has been a problem whose solution and management requires a deep understanding of certain comparable factors. As research has shown, the elderly have an increased rate of suffering from falls or fear of losing body balance and toppling or stumbling. To summarize the results from a review on falls-related risks factors on the elderly by Ambrose, Paul, and Hausdorff (2013), falls is one of the basic causes of morbidity and mortality in most adult patients. The research has also found that 30 to 40 percent of old people from 65 years and above suffer severe injuries, loss of balance, fear of falling and death at higher rates. The health expenditures on fall-related injuries are higher in Europe (1.5%) than the US (0.1), and the risk factors include polypharmacy, gait, impaired balance and falls history in the patients with the condition. Other studies have shown that geriatric falls are the primary causes of injury to the elderly patients and the prevalence of the condition has reduced whenever certain preventive measures and care are administered. Coussement et al. (2008) observe that falls causes 95% of injuries and death to geriatric patients and the preventive approaches highly reduce the cases of falls and the related outcomes such as injuries and death. The preventive and management measures that can combine the findings from these studies, it is fair to say that falls are the major causes of physical injuries to elderly patients especially those who are not under any preventive and management measures such as bone strengthening, muscle function or balance. In essence, falls can be devastating to the patient and their families in addition to being extremely costly to the facility of occurrence.

Importance of fall in Nursing Practices

The knowledge in treatment and management of falls is a fundamental tool as nurses are caregivers who deal with all sorts of patients with various conditions and age brackets. For this reason, the knowledge in falls builds on the competence and experiences of nurses thereby enabling them to provide a multifaceted individualized care aimed at reducing fall-related injuries and deaths in the elderly patients. Nurses, unlike other caregivers, are highly likely to spend more time with patients, therefore, are better placed to set standards for managing falls. Insufficient nursing competence in this area may result in premature home admissions for nurses (Chelly et al. 2008).

Risks Factors for Falls in the Elderly

There exists a close relationship between falls and morbidity and mortality rates, body functionality, and disability among elderly geriatric patients. The literature on the condition (Chelly et al. 2008) indicates the fall rates of patients admitted in a community hospital were 95%, and the related injuries were 98% as a result of the fall factors. This is a uniform relationship yet rampant despite the numerous efforts and measures that have been put forward to prevent these instances. Age matters a lot in the falls outcomes as 80-year-olds have fallen and injured themselves more often than 50 year-olds. While there is no much information showing the relationship between falls and gender, (Gale, Cooper & Sayer, 2016; Latt et al. 2016) highlight that female patients are more likely to suffer this condition than male. Almost all studies agree that history of falls and the related medical conditions, foot and vision problems are some of the factors that have made falls a common condition (Shorr et al. 2015). None of the reviewed articles reveal how frequent adults who exercise a lot suffer from falls; hence it is prudent to say that lack of or insufficient exercise, and a healthy diet contribute to falls in the older adults.

Interventions to Prevent Falling in Elderly Patients

Various techniques have been identified as ways through which falls can be prevented or managed among elderly patients. Latt et al. (2016) and Shorr et al. (2015) reveal that there are numerous multifactorial assessments as well as interventions that can prevent falls include physical therapy/exercise, management of the home environment, minimized psycho-active medication, intake of vitamin D, managing foot problems. In hospitals, management interventions included walking aids, frequent comfort rounds, appropriate non-slip footwear, and utilization of relevant reorientation strategies, ambulation, call bells and bed alarms.

Critique of the Evidences

Falls are frequent among the geriatric population across the world. This causes frequent morbidity as well as the mortality. This article has substantially made use of various evidence which has facilitated in the identification of the common factors that increases fall among geriatric patients, the importance of falls in the nursing practices and the Interventions to prevent falls in elderly patients. This evidence successfully drew data from various sources, which helped arrive at the final findings. Specifically, the sources used in the literature review were cross-sectional studies that involved some elderly individuals with the different socio-demographic history, history of the geriatric-related diseases such as diabetes, and comorbid diseases, drug use, and the activities one is involved in as part of the daily living. In the same way, the patients were physically examined through some tests, which have also been revealed in the evidence provided.

The abstract, introduction, literature review, methodology, discussion of the findings and conclusion have all been included in the evidence used in this paper. In this way, therefore, the sources emulate all the qualities of the peer-reviewed and provides findings of the related themes discussed in this report. Notably, the evidence further offered exclusive analyses of the people living in the long-term care homes, and which ultimately leads to the additional strength of the current study. A significant limitation, however, occurs regarding the evidence presented. Notably, some sources did not integrate the helpful and psychological tools while attempting to come with their findings. Additionally, there was also lack of comparison group in the community.

In the same way, the evidence used the retrospective designs, which prone to recall bia...