Independent and dependent variables on EBP project
Based on how you will evaluate your EBP project, which independent and dependent variables do you need to collect? Why?
Independent and dependent variables on EBP project
Grand Canyon University
Nursing homes play a pivotal role in the provision and improvement of care for the aged population. The increased number of aged populations increases the pressure in these nursing homes, and this is coupled with the high risk of falls for these patients. Aged patients have mobility problems, and some suffer from mental health problems such as dementia that increase their risks of falls. More so, the nursing environment contributes to the patient falls when the patients are not provided with adequate care, such as assisted or supervised bedside sitting and reorientation to the nursing environment among the confused patients. The appropriate measure that is crucial in significantly reducing the risks of aged patient falls is the improvement of the nursing environment by removing the excess equipment and supplies in the room of patients and hallway and cleaning any spills. Extensive research highlights the challenges that elderly patients face and the effective strategic measures of improving the care and quality of life. A key of eight peer-reviewed studies will be analyzed to aid in the expounding of the problem and show the literature gap that will be addressed in the study.
Comparison of the Research Questions
Research questions are fundamental in delineating the purpose of the researcher and the focus of the entire research. Therefore, looking at the research questions will illuminate the researcher’s perspective on the problem of older adult falls. Howland et al. (2018) focus on evaluating the efficiency and effectiveness of the bedside alarms in the prevention of falls as they quick and inexpensive technology. Frith et al. (2019) look at the impact of reducing psychotropics medication and modification of the environments for the minimization of patient falls. Jin (2018) takes a broader view of assessing the guidelines necessary for reducing older patients’ falls. Vieira, Palmer & Chaves (2016) looks at how increased cases of aged patient falls can be mitigated through the utilization of the multifactorial exercise-based strategies tailored to the patient’s needs. Dellinger (2017) affirms that it is feasible to prevent comprehensive patient falls through evidence-based strategies. Yoo et al. (2019) understand that there are patients at higher risks of patient falls; hence, the research question centers on the need to assess the patients at the greatest risk to aid in minimizing falls. Najafpour et al. (2019) analyzed the risk factors that contribute to increased patient risks. Lastly, Gajos et al. (2016) note that psychological assessment is core in identifying the patient with the highest risks of patient falls, which will help reduce patient falls. Based on every research question of the authors, it is evident that some focus on identifying the risks factor for the patients, and others highlight the strategies for the reduction of risks. Thus, collectively, this will provide the necessary information in the problem’s discourse and analyze the prevention strategies.
Comparison of the Sample Populations
A sample population is a representation of the entire population, sharing a common characteristic. Having an adequate sample population size is integral in understanding the problems and assessing the effectiveness of the prevention strategies. Among the eight studies of focus, there are ones that utilize the entire nursing home facility. Others selected a specific number of patients who were eligible for the study based on the research question. Dellinger (2018) and Gajos et al. (2016) studies focused on the entire nursing home population of aged patients. Gajos et al. (2016) study effectively utilized the large population of the entire primary care setting as it entails evaluating the role of psychological problems in increasing the risk of aged patient falls. The patients with progressive weakness and failure in the motor system can be identified, and effective preventive measures employed by looking at psychological assessment. Dellinger (2018) pointed out that it is possible to have a comprehensive patient fall prevention through evidence-based strategies; hence, there was a need of assessing the entire primary care setting and involving certified nurse assistance.
Frith et al. (2019) and Jin (2018) sample population was twenty, and Najafpour et al. (2019) sample population was fifteen. The researchers used a favorable number of samples of a population that is effective in analyzing the problem and preventive measure. The sample of fifteen patients by sample Najafpour et al. (2019) comprised ten patients in the test group and five in the control group. The test group was those that were new admitted to the hospital, and the control group was the one that has long-term stay in the hospital. There was a higher risk for the patient that newly admitted to the hospital compared to the one that was already used to the hospital. Jin (2018) sample population of twenty patients was the one that had assistive devices such as cane walkers as the study aimed at analyzing the effective guideline to the reduction of falls among these patients. It was identified that using the rehabilitation approach on the aged patient reduces the risks of falls. Frith et al. (2019) sample population of twenty patients were all females that were on psychotropics medications such as Seroquel, Risperdal, Clonazepam, and Ativan. It was identified that the reduction of these medications is effective in the reduction of confusion and promotes focus among the older patients in the nursing homes.
Lastly, Howland et al. (2019) and Yoo et al. (2019) used a small sample population of five and ten, respectively. Yoo et al. (2019) sample population of ten patients had suffered from a stroke, post-stroke. Thus, in showing which patients are at higher risk of repeated patient falls, these patients were seen to be at higher risk. However, the implementation of psychological, physical, and environmental strategies can hugely minimize falls risks. Howland et al. (2019) sample population of five participants were the ones that had been diagnosed with mild confusion and dementia; hence need having bed alarms that notified the nursing care. These patients are at an increased risk of falls, and having bed alarms can reduce the risk of falls.
Therefore, based on the requirement of the study, the size of the sample population can vary. Also, the availability of eligible patients for the study limits the size of the sample population. In the case where there is a small sample population, there is reduced applicability of the study based on the population’s size besides helping in the identification of the problem. Thus, this necessitates having future studies that focus on a large population that would effectively assess the problem.
Comparison of the Limitations of the Study
Limitations of the study are factors that influence the interpretation and findings of the study. According to Dellinger (2017), the study’s major limitation was on the time constraints of performing a full assessment of the high-risk patients, which required deferring the assessment to another future date. Frith et al. (2019) note that the study’s major limitation was on the sampling strategies, sample size, some methods of data collection and intervention. More so, there was a limitation in lacking control in the medications of the control group in the study. Najafpour et al. (2019) state that the study’s limitation was on relying on the self-reporting that lead to underreporting, a limited number of sample populations, and the research was conducted in a general hospital that would affect the generalization. Gajos et al. (2016) depicted that the study failed to show which exercises were effective for primary and secondary prevention; hence there is a need for having further studies that will lead to the standardization of the exercise programs. According to Howland et al. (2018), the study faced a number of limitations, starting with a convenience sample that limits the study’s external validity. Vieira et al. (2016) elaborate that the study’s limitation was that the positive effectiveness of using multifactorial intervention could not be affiliated with a given specific intervention. The other two authors failed to mention that there was a limitation in the study, but it is evident that they required a large sample population size to increase external validity.
Conclusion and Recommendations
In conclusion, patient falls among the elderly in the nursing home is a prevalent problem that has not been effectively addressed. These patients’ falls reduce their quality of life and increase the chance of complete loss of mobility, suffering from severe bone fractures, and even death. The increased risk of falls in these patients is attributed to their reduced mobility, suffering from mental problems, increased intake of medication, lack of appropriate care, and unsafe environment. These studies analyzed show that patients with post-stroke and high medication intake are at higher risk of falls. However, having a better approach to identifying the risk factors of a patient can help provide the appropriate remedy timely. Some of the approaches that have been suggested are having tailored exercises, the use of bedside alarms, reduction of medication, and modification of the environment. Future research should focus on the specificity of the exercises that are effective for given patients, additional technology besides bedside alarms that can help in the reduction of falls, and the effectiveness of the improvement of the nursing home environment in the minimization of falls.
Dellinger, A. (2017). Older adult falls: effective approaches to prevention. Current trauma reports, 3(2), 118-123. https://dx.doi.org/10.1007%2Fs40719-017-0087-x
Frith, K. H., Hunter, A. N., Coffey, S. S., & Khan, Z. (2019). A longitudinal fall prevention study for older adults. The Journal for Nurse Practitioners, 15(4), 295-300. https://doi.org/10.1016/j.nurpra.2018.10.012
Gajos, M., Perkowski, R., Kujawska, A., Androsiuk, J., Wydra, J., & Filipska, K. (2016). Physiotherapy methods in prevention of falls in elderly people. Journal of Education Culture and Society, 7(1), 92-102. https://doi.org/10.15503/jecs20161.92.102
Howland, J., Hackman, H., Taylor, A., O’Hara, K., Liu, J., & Brusch, J. (2018). Older adult fall prevention practices among primary care providers at accountable care organizations: A pilot study. PLoS one, 13(10), e0205279. https://doi.org/10.1371/journal.pone.0205279
Jin, J. (2018). Prevention of falls in older adults. Jama, 319(16), 1734-1734. https://jamanetwork.com/journals/jama/fullarticle/2679279
Najafpour, Z., Godarzi, Z., Arab, M., & Yaseri, M. (2019). Risk factors for falls in hospital in-patients: a prospective nested case control study. International journal of health policy and management, 8(5), 300. https://doi.org/10.15171/ijhpm.2019.11
Vieira, E. R., Palmer, R. C., & Chaves, P. H. (2016). Prevention of falls in older people living in the community. Bmj, 353, i1419. https://doi.org/10.1136/bmj.i1419
Yoo, J. S., Kim, C. G., Yim, J. E., & Jeon, M. Y. (2019). Risk factors of repeated falls in the community dwelling old people. Journal of exercise rehabilitation, 15(2), 275. https://doi.org/10.12965/jer.1938086.043