Literature Review:Nursing

Literature Review:Nursing

Falls frequently occur in elderly patients living in nursing homes, with about two falls occurring in every nursing home bed-years. Though most of the falls are benevolent and injury-free, 10 to 25 percent lead to hospital admission or fractures. Therefore, primary care providers for nursing home residents should focus on reducing both fall rates and the rate of fall-related morbidity in the long-term care facilities. Various interventions have been proven to be effective in decreasing the rates of falls in community-dwelling elderly patients. However, some fall prevention programs are not supported by adequate evidence. There are various studies conducted on the issue of preventing falls in nursing homes, and the results of the studies are varied. The major components of these intervention programs include environmental assessment, assistive device evaluation, and modification, medication changes, gait analysis and training, exercise program, blood pressure evaluation, staff education, and hip protector use. Numerous studies support the use of environmental assessment and intervention in decreasing falls in nursing homes and indicates a link between particular medication and falls. However, there are no studies that examine the impact of medication adjustment on fall rates, and literature does not support recommend the use of exercise to reduce falls in nursing homes.

Comparison of Research Questions

The first article aims at comparing the performance of measures linked to falling risks such as balance gait, medical conditions, living environment, cognitive status, sensory loss, and feet, and footwear. These are the significant issues identified by the article as the major risk factors of falls (Zhang,Zeng,Weng,Yan& Fang,2019). The second article aims at recognizing factors that influence the implementation of fall prevention programs from both physician and family perspectives. The authors also talked about some of the measures, such as balance training and hydrotherapy. Balance therapy has been found to be effective in decreasing falls. However, it has various challenges that prevent the aging population from performing them well. Therefore, finding an alternative to balance training is significant, and the authors stated that hydrotherapy to be a better alternative to balance training. The third article aims at examining the impacts of combinations of two mental activities and exercise programs on physical function. The third article also aims at investigating the effects of interventions designed to decrease the incidences of falls in elderly individuals residing in nursing homes and hospitals (Cameron,Dyer,Panagoda,Murray,Hill,Cumming& Kerse,2018). The fourth article aims at comparing the effectiveness of numerous interventions and single intervention used to prevent falls among the elderly population.

Comparison of sample populations

In the first article, the authors registered 260 participants aged 60 years and above through multistage sampling from 13 LTC facilities in Xiamen, China. The authors observed and recorded the epidemiological characteristics and fall for a period of 12 months using a reviewed FROP – Com Scale. In the second article, there were no participants used in the study. In the third article, the authors performed 95 trials in 71 care facilities and 24 hospitals because falls in hospitals and care facilities are common events that cause substantial mortality and morbidity for the elderly population. The fourth article used 2049 older adults of 60 years and above enrolled through a one-stage sampling procedure within Mumbai, Panvel, and Thane Cities, Maharashtra..

Comparison of limitations of the study

There are various limitations associated with the first study. First, the data was obtained from a cross-sectional survey, and it restricted the interpretation of the results, making it very challenging to make casual conclusions. The second limitation of this study is that participants were sampled from the only city in China, and the number of participants was small, which may not be a complete representation of the whole situation in the country (Turner,Chander& Knight,2018). The second article’s limitations include it did not enroll participants for the study. Therefore, it is very challenging to determine the effectiveness of the study’s findings. Secondly, the authors failed to indicate the specific internal and external factors affecting the elderly population’s ability to maintain an erect posture. The major limitation of the third article is the majority of trials were at high risk of bias in one or many domains, primarily relating to lack of blinding. Some of the significant limitations of the fourth study include the study found that many fallers experienced fall in the mooring. However, this finding is different from other previous studies performed nationally and internationally (Pitchai,Dedhia,Bhandari,Krishnan,D’Souza& Bellara,2019). This may have been caused by the fact that many older people like performing their duties in the morning.

Conclusion

Fall prevention programs should integrate some aspects of Tai Chi into therapy programs for elderly populations who are at risk of falling. Tai Chi programs can enable the elderly population to learn some balancing techniques which play an essential role in preventing falls. Systemic approaches should also incorporate policies, preventive measures, and evidence-based clinical practices. These policies, preventive measures, and evidence-based clinical practices help in formulating the best fall prevention techniques which suit all the elderly population according to their medical and environmental needs. Some fall prevention measures such as exercise help in teaching the elderly population balancing techniques aimed at preventing falls.

References

Cameron, I. D., Dyer, S. M., Panagoda, C. E., Murray, G. R., Hill, K. D., Cumming, R. G., &      Kerse, N. (2018). Interventions for preventing falls in older people in care facilities and hospitals. Cochrane database of systematic reviews, (9).

Pitchai, P., Dedhia, H. B., Bhandari, N., Krishnan, D., D’Souza, N. R. J., & Bellara, J. M. (2019).             Prevalence, risk factors, circumstances for falls, and level of functional independence among geriatric population-a descriptive study. Indian journal of public health, 63(1), 21.

Turner, A. J., Chander, H., & Knight, A. C. (2018). Falls in geriatric populations and hydrotherapy as an intervention: a brief review. Geriatrics, 3(4), 71.

Zhang, L., Zeng, Y., Weng, C., Yan, J., & Fang, Y. (2019). Epidemiological characteristics and    factors influencing falls among elderly adults in long-term care facilities in Xiamen,      China. Medicine, 98(8).