Question

After completing your literature review, how did you feel about the information that you found? How has your opinion changed on the topic you researched? Do you see yourself exploring this topic further in the future? Why or why not?

150 words

Fall Prevention Among Elderly Clients and its Impact on Nurses

This literature review talks about fall prevention among elderly clients, and the effectiveness of non-slip socks in hospital settings, and the impact it has on nurses. Falls in older adults are a major public concern, which can lead to chronic pain, inability to perform daily activity, and increased length of stay in hospitals. These facts were conducted using GroundedDimensional Analysis (GDA) to explore nurses’ experiences with fall prevention in hospital settings, and the impact of those experiences on how nurses provide care to fall-risk patients(Strauss, 2008). According to the National Database of Nursing Quality Indicators, and the Agency for Healthcare Research and Quality (AHRQ), falls are second only to medication error. For the literature review, we search for fall prevention, older adults, non-slid socks, nurses, and articles written by nurses. The information was obtained from scholarly articles.  

Centers for Medicare and Medicaid Services (CMS) defines patients’ falls as an “unintentionally coming to rest on the ground, floor or lower level.” Fall is stated to be one of eight “never events” for hospital settings. It is noted that 700,000 to 1,000,000 elderly patients are injured annually, due to falls while they are already hospitalized. Fall prevention is a deliberating nursing process. Therefore, it is agreed upon that preventative measures, and fall precaution in the hospitals throughout the nation, should be a good implementation (Estupinan, Crumblish, & Risher 2018).

The study was to implement the use of non-skid socks, and bed and chair alarms. The goal was to provide the nurses and the nurse techs with knowledge of the preventative measures to lower fall risks. Success on the measure can only be accomplished by the collaboration of the staff members, and the patients’ participation. When nurses understand how to implement this protective measure, the nurse techs will also be directed on their responsibility as well, and during ambulation,the patients will asked for assistance. Fall incidents will decrease, and fewer injuries will be reported. In addition, findings have suggested that patients’ knowledge and perceptions may impact use of fall prevention strategies (Lim et al. , 2018 ;Tzeng & Zin , 2015).

Data were collected from two hospitals. Both have a nurse-to-patient ratio of 1:4. Recruitment was open to nurses who were taking care of high risk fall patients on the participating unit. Theoretical sampling was used to ensure density of categories (Strauss, 2008). The sample consisted of 27 RNs, and CNAs who were employed on a medical, surgical, or medical/surgical adult inpatient unit, and caring for patients aged 65 years and older.

 Unstructured, open-ended, and focused questions wereused. For example, can you describe your concern about getting in trouble (reference)? Some nurses felt that they were under pressure to reduce the incidents of falls, in the form of frequent messages from administration, and to “get the number of falls down” (King, Pecanac, Krupp, Liebziet & Mahoney, 2016). The studies showed that the best way for hospital nurses on high-fall units, to achieve zero falls, was to restrict patients from moving around without assistance.  In contrast, nurses who worked on low-fall units received positive feedback, because they were meeting the hospital goal of zero falls. The attitude of nurses in low fall units toward patients was not the restriction of patients,but the promotion of patient movement with the goal of progressing patients.

In addition to the increased risk of hospitalization hip fracture, and when one of these individual falls, it also resulted in a higher risk of dying within a year. Due to falling, patientsalso may suffer serious medical conditions (Strauss, 2008). It was determined that non-slip socks will be beneficial as an alternative to footwear while the patient is hospitalized. Contrary to what research is saying about the non-slip socks, nurses are vulnerable as well as the elderly from risk for fall. Staff nurses have the greatest impact on preventing and reducing patients’ falls due to their consistent contact and monitoring of patients. However, nurses become a second victim, as they blame themselves for what happened. They express self-doubt, anxiety, guilt and concern for liability. As hospitals demand to decrease patient falls, nurses are pressured to urgently respond to bed alarms. This results in chaos. Many nurses run in the hallway at the same time, the pressure to respond to bed alarms increase nurses’ anxiety and stress about caring for fall risk patients (King, Pecanac, Krupp, Liebziet & Mahoney, 2016).  

In conclusion, it was found that when non-slip socks, bed and chair alarms, the medications that cause dizziness were reduced, and patients were more compliant when calling for assistance, both the patients and the nurses benefited. Education will remain an ongoing process. Prevention in hospital settings,and the impact of those experiences show how nurses provide care to fall-risk patients. Falls in older adult patients are a source of high injury rates and a common occurrence in hospital settings. Nonetheless, the use of bed/chair alarms is controversial. Several studies have demonstrated that these alarms are not effective in reducing fall rate or injurious falls (Shorr et al. , 2012). The study provides an in-depth view of fall prevention, which enhances the reader’s understanding of the subject. Hospitals have set zero falls goals, and exert pressure on nursing staff to attain the goal to lower unintended and potentially harmful consequences to nurses and older adults. Additional research is needed to acquire an improved understanding of how nurses provide care to fall risk patients. 

Answer 1

Preventing fall in elderly is a relevant topic as the famoly support and care are now a days declining.Hence while in hospital nurses have increased responsibilty of giving care to them.This article mainly focused on the useage of non slip socks ,bed and chair alarms and reducing the use of dizziness causing drugs among elderly patients to reduce the incidence of fall.

Non slip socks and reducing medications are effective in this aspect but use of bed and chair alarms are not that much effective to reduce fall but it provide us a sign that they may have fallen.More than these measures we can alter our hospital settings to be more elders friendly setup.It includes:

Setting up support system for elders to hold on while walking in their section.

Ensure rough surface in th geriatric wards to avoid slippage.

Promoting their family to be with them to provide a support while on hospital this make them more comfortable than with nurses and decreases the burden of work of nurses.

Pratice of exercise or physical actives to decrease body weight and make them emotionally active

Proving timely medications and adequate nutrition will also help them to be steady.

Hence in providing care for elderly patients it is important to consider medical ,emotional ,physical support for them.These measures will also decreases the stress and burden of work in nurses as the nurse to patient ratio in most hospitals is being 1:4.

This topic needs an increasing demad for research as we have much more to do in this filed and provide facilities to make them more comfortable.It includes a research in the topic "Health problems of aged and the implications in preventing their health issues." This include discussion on topics :

Problems due to aging.

Problems due to health conditions.

Problems due to mental illness and emotional imbalance .

Preventive methadologies and nursing care.