Fall Prevention - Nursing Assessment Answers

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Fall prevention is the nursing intervention that exists and allows the protection of patients from the risk of injury in case of falls. It is mostly common among older people due to issues with health that mostly deteriorate with old age. Falls can be classified in different aspects depending on the causes and the consequences that come with the fall. This therefore means that a fall can be a sudden change that is not intentional and may occur as a result of a seizure, sudden onset of a paralysis or even an overwhelming external force (Johansson et al 2015). There are recommendations made by the Preventive Services Task Force on counselling older patients about the measures that they should take in order to reduce the risk of falling. The most common measures include exercise meant to improve the individuals’ balance, skills that are related to safety and good dietary habits. Home-based multifactorial interventions are also highly recommended in the prevention of injuries that mostly result from falls. This only applies for older people and is intended to make them have an adequate amount of reliable resources that are also necessary in the assurance of the safety of those under this care. Case Background It has been found that older people have a frequent constituency in falls. The public health structure considers it a serious problem and one that highly impacts the health of the older people along with the health costs that come along with the injuries and treatment procedures. Falls have been rated one of the most common symptoms that threaten the level at which older persons can be independent. They are also complex and very costly to solve or cure (Day et al, 2016). Adults that are above the age of 65 suffer most injuries as a result of falls. They are mostly not independent after they face an injury and they are therefore, in a position to be either depressed or with a poor nutrition system. Statistics show that in every year in the United States an average of three older adults fall and injure themselves. The common aspect of hospitalising injured older people is preceded by five times the number of people that are not hospitalised due to injuries. It is also recorded that women are more-likely to incur injuries from falls than men are. The falls may have serious repercussions on the friends and family of those who have been injured. They are always most likely to fracture a hip, forearm, spine, bones of the pelvis, hands and ankles. These are considered very delicate parts which if injured may result to disabilities or even make it worse for the older person’s memory and their ability to discern correctly. The interactive and complex mix of biological, medical behavioural and environmental factors, many of which are relative to intervention is a great risk factor. The level and rate at which an older person goes through intervention is a determinant of the process through which the injuries take to heal. Summary Table

	Author/s (year)	Aims	Sample/ Settings	Design/ Methods	Main Findings or primary argument	Strengths and Limitations of the paper
1.	Canning et al, 2015 Australia	To assess whether falls prevention can be prevented with minimal supervision of exercise that targets potential risk factors that can be remedied	Patients with Parkinson disease	231 people randomized into exercise or usual-care control groups. 40-60 minutes exercise, 3 times a week, 6 months	The study’s outcomes included fall rates and proportion fallers being determined during the intervention. Physical effects, psychological effects. No difference between groups in the rate of falls	The strengths of the paper are that the facts are well aligned in line with the disease focused on. The limitations could be the inconsistency of those involved in the 40-60 minute exercise thus causing results that are partly accurate.
2.	Day et al, 2016 Australia	Evaluating the implementation of group and home-based programs bound to prevent falls	Exercise program leaders in medical fields	Interviews done with the program staff. Analysis of the feedback to create themes from programs	Positive outcomes from the programs, such as strategies towards providing more technical support for the exercise program leaders.	The strengths of this program involve the ability to create accurate themes based on the findings. The limitation of the study is that it s highly dependent on people’s opinions which may differ and affect the research results
3	Johansson et al, 2015 Sweden	Evaluating how effective a multi-disciplinary and client centred fall prevention program is.	Older adults both healthy and those at risk	131 older adults divided into two groups and the use of the intention-to treat strategy was put in place	Limited effect on the experiences that are subjective to participation and autonomy in everyday life. Each subjective experience varies with each person. Measurements capture both subjective and objective experiences	The limitation of the study is that there is no consistency in the research done on those that are subjective to the participation of the research. The strength of the study is that the measurements have accurately been captured for both the objective and subjective experiences
4	Nyman & Victor, 2012 Australia	Augmenting the Cochrane systematic review by analysing older people’s participation in prevention interventions	Community Participants: Adults aged 60+	Using the aggregate data of the recruited 12 month follow-up intervention protocol	The use of median rates to recruit. An average of 50% of the community dwelling older people adhere to falls prevention interventions.	The Limitation of this study is the Production of mixed results The strength of the study is the accuracy of the study in relation to the choice of methods used.
5	Silva, Elsick & Dique, 2013 America	Analysis of the impact and characteristics of the most physical exercise regime meant to prevent falls and fractures in this setting	Long term care residents	Randomized Controlled trials between January 1974 and June 2012	Exercise prevents falls. Combined, frequent, long term exercise programs are effective in preventing falls in long term care facilities.	The strength of the study is that only accurate methods are made use of.

Study Critique The goal of the studies carried out on the falls and the measures necessary to prevent the same has the aim of producing a report that edifies the society on the importance of increased awareness and knowledge regarding older people and their injuries as well as their results. The report also collects data on the numbers of injuries that take place within a year and the measures that mostly apply towards offering the best solutions to the cases that follow falls among the older people. The research done on collecting such data involved the use of the internet and the search engine system (Canning et al 2015). Falls in this case are mostly relative to the older age and the requirements needed for support. Findings Adults who dwell in communities are between 30-40 per cent. Demographic changes affect the rate of injury according to a study done in Australia, whereby the cost increases with an increase in injuries. It has been proven that the numbers of falls that occur per annum are a result of environmental factors. These factors put the older people at risk by being hazardous and causing common disturbances and muscle weakness. The problem that is associated with falls in older people is mostly associated with the community from which they hail. There are not enough elderly health programs provided within the communities (Silva, Eslick & Duque 2013). These programs are what the community relies on in order to increase awareness and grow in the knowledge of the requirements towards a greater aspect of being able to control falls. The programmes also enable them to see to it that the community provides the right resources. According to research, the bigger percentage of hip fractures is a result of falls and the way to minimise this is by taking a practical approach towards the reduction of the same. The limitations that cause more injuries are a lack of interventional studies and also a lack of economic evaluation with the countries that are mostly affected by the falls. The findings suggest that there are various areas that require research such as the epidemiology of falls in old age, which defines what injuries impact the older community and the level at which they are able to avoid them. The intervention programs being multifaceted are in need of in depth evaluation and strategies that will rise above the injuries to provide ready solutions for each of the individuals in the same situations (Nyman & Victor 2012). Intervention programs have to be well designed and evidence-based practices which should take precision in especially the eastern Mediterranean regions where the older people falls are most common. Conclusion It is evident that falls are a threat to older people within the society. In order to stop this, clear intervention programmes, which focus on spreading awareness and knowledge on the relevance of being clear of clustered and hazardous communities that put the older people at risk, are required. There should also be excellent educational materials and hazard checklists in the homes.

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