Fall Prevention in the Elderly
Formulate a PICOT question using the PICOT format provided in the assigned readings. The PICOT question will provide a framework for your capstone project. Make sure to include your PICOT question in your paper. In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome. Make sure to address the following in the PICOT paper: 1. Evidence-Based Solution (2) Nursing Intervention (3) Patient Care (4)Health Care Agency – organization or location (5)Nursing Practice – nursing problem Prepare this assignment according to the APA format. An abstract is not required.
Fall Prevention in the Elderly
Course Name: Course Code
Fall Prevention in the Elderly
The clinical issue considered as part of this report is falls among elderly persons in nursing homes. Elderly persons face a high likelihood of falling in nursing care environments, which exposes them to serious health care risks. Falls often result in cognitive and sensory impairments depending on their severity. Nursing and acute homes are the most common health care environments where elderly patients experience the highest number of falls. That is because these facilities accommodate elderly residents for long periods as they receive care. This report aims to identify an evidence-based solution to dealing with falls related to elderly persons in nursing homes.
Description of the Clinical Issue
The number of elderly persons living in nursing and acute homes increases significantly, considering that these facilities can provide them with the necessary care. However, falls remain a critical health concern for the elderly persons living in these facilities attributed to their health implications. Lee & Kim (2017) note that between 50% and 75% of elderly nursing facility residents fall each year, where approximately 15% of such cases result in severe injuries and between 2% and 6% result in some fracture. Based on these statistics, it is evident that falls are vital issues that nursing homes should consider as they improve their residents’ quality of life.
Falls remain a vital issue of concern because of the health and cost implications that they are having on long-term residents in nursing homes. In severe cases, falls often result in death or lifelong injuries that would impact the quality of life that one leads. Nursing homes’ managements have a mandate of creating a risk-free environment for their residents to protect them from falls. Toots et al. (2019) recognize that a significant number of falls occurring in long-term care facilities are preventable; thus, highlighting the need to establish strategic measures to not only identify risk factors but reduce them significantly. However, managements often ignore some of these risks, which exposes their residents to high fall possibilities.
Nursing homes are adopting a vast array of clinical guidelines to maximize their capacities to minimize the risks of patient falls, which is becoming a key challenge for long-term facilities. One notable solution offered through the clinical guidelines involves environmental modifications. The environment is one of the key contributors to many falls experienced in nursing homes; hence, the need for modifications. Environmental modifications would help deal with patient falls by changing nursing home environments to accommodate elderly patients, some of whom have mobility challenges predisposing them to risk of falls (Zimmerman et al., 2017). Undertaking modifications to the health environments in which elderly persons stay would help minimize their risk of exposure to falls. For example, nursing homes’ managements need to evaluate the health environments for wet areas, clutter, and poor lighting, among other risk factors. Eliminating these risk factors means that nursing homes will create a much safer environment for their residents regardless of their mobility challenges.
Nurses have an essential role in improving the quality of care offered to elderly patients in nursing homes to reduce their exposure to falls. Zubkoff et al. (2018) note that nurses must assess patients to determine their risk of falls and categorize them into low, moderate, and high risk depending on their evaluation. For patients in the moderate and high-risk categories, nurses may apply a fall risk armband, which is color-coded depending on the risk. Nurses must also maintain a safe environment for their patients regardless of their category, which would minimize their risks significantly by taking specific measures. Firstly, nurses must remove excess equipment, supplies, or furniture in patients’ rooms or hallways to avoid tripping. Secondly, nurses should clean any spills in patients’ rooms or hallways immediately because they are likely to expose patients to a risk of falls when not handled immediately.
Improved Patient Care
Patient care may also play a central role in reducing the risk of falls among elderly patients by limiting their risk exposure significantly. Firstly, nurses should supervise or assist elderly patients in bedside sitting, personal hygiene, and toileting when needed to ensure that they do not encounter possible risks of falls. Nurses should always be available to assist their patients, considering that lack of assistance is one of the risk factors exposing most elderly persons to fall risks. Secondly, nurses should reorient confused patients when necessary. Some elderly residents may suffer from confusion, which exposes them to high risks of falls, considering that it becomes hard for them to remember how to move around. When necessary, reorientation will serve as a guarantee that the number of falls that these patients experience will reduce significantly; thus, improving their quality of life.
PICOT Statement Focused on Resolution, Improvement, Application, and Intervention
For elderly patients in nursing homes, will environment modifications compared to other nursing interventions help minimize their exposure to falls?
PICOT Statement Including Population, Intervention, Comparison, Outcomes, and Time
For elderly patients in nursing homes, how will environmental modifications compared to non-modification of the health environment reduce the risk of falls within six months?
Lee, S. H., & Kim, H. S. (2017). Exercise interventions for preventing falls among older people in care facilities: A meta‐analysis. Worldviews on Evidence‐Based Nursing, 14(1), 74-80.
Toots, A., Wiklund, R., Littbrand, H., Nordin, E., Nordström, P., Lundin-Olsson, L., … & Rosendahl, E. (2019). The effects of exercise on falls in older people with dementia living in nursing homes: A randomized controlled trial. Journal of the American Medical Directors Association, 20(7), 835-842.
Zimmerman, S., Greene, A., Sloane, P. D., Mitchell, M., Giuliani, C., Nyrop, K., & Walsh, E. (2017). Preventing falls in assisted living: results of a quality improvement pilot study. Geriatric Nursing, 38(3), 185-191.
Zubkoff, L., Neily, J., Quigley, P., Delanko, V., Young-Xu, Y., Boar, S., & Mills, P. D. (2018). Preventing falls and fall-related injuries in State Veterans Homes: Virtual breakthrough series collaborative. Journal of nursing care quality, 33(4), 334-340.