Fall Prevention by Nursing Assistants Among Community-Living Elderly People

Introduction

One of the acute problems experienced by elderly patients is falls. At the same time, in healthcare institutions, these incidents are also frequent. Nursing staff who are responsible for the safety of patients find it difficult to control all movements of those who undergo treatment. The consequences of falls in adulthood may be dangerous, which explains the need to find solutions to this issue. In nursing practice, there are special models that involve specific types of care in accordance with the needs of people, the nature of diseases, and other attendant factors. In this case, Orlando’s theory can be considered one of the effective methods of providing systematic patient observations (Shumba & Abraham, 2017). Also, a literature review on this topic can help to identify the ways to prevent falls and programs aimed at helping the elderly population. Relevant academic sources may be a good rationale for developing a separate study to exclude the fall of older patients in healthcare settings.

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Nursing Theory Application

Strategies to prevent falls among elderly patients may be compiled into an evidence-based proposal where appropriate techniques can be presented in the form of nursing interventions. However, in addition to practical methods, some theoretical concepts also deserve attention since no projects can be implemented without appropriate justification. As an auxiliary source, Orlando’s nursing model may be considered one of the methods of helping elderly patients. According to Shumba and Abraham (2017), this theory provides that “the nurse-patient relationship is a collaborative endeavor, in which practical action plans can be developed and implemented that result in quality patient care outcomes” (p. 4). To be more precise, continuous medical personnel’s monitoring is one of the primary components of this concept.

One of the causes of falls is the insufficiently good physical condition of those patients who undergo treatment. If junior medical staff monitors such people in their departments closely, dangerous consequences may be avoided. As Shumba and Abraham (2017), nurses’ reactions and actions are the direct consequence of patients’ behavior, and the timely prevention of excessive mobility is one of the most rational solutions. If an older adult falls unsuccessfully, there is a risk of a long and complex therapy, which does not always end positively. Therefore, a more appropriate solution is to prevent any attempts at an excessive physical activity. Particular attention should be paid to those who are not able to help themselves independently and are forced to rely on nurses’ help. Such patients’ intention to move on their own is fraught with falls, which should not be allowed. Consequently, careful monitoring as one of the key provisions of Orlando’s theory is an effective and necessary technique.

Literature Review

In order to avoid the risk of falls among elderly patients in healthcare settings, attention should be paid to some academic studies where valuable information is provided. For example, Luk, Chan, and Chan (2015) suggest addressing the special physical training of those who are at risk. According to them, “the exercises need to be of sufficient intensity to improve muscle strength” (Luk et al., 2015, p. 166). At the same time, a balance should be maintained between loads and rest so that patients could not overwork and could perform appropriate exercises regularly. This technique can be useful in those departments where people are able to engage in physical activity. However, it is useless for patients with those traumas that do not allow them to be tired.

Podhorecka et al. (2016) suggest paying attention to specialized assisting equipment that can be useful for preventing falls. According to the authors, “the usage of crutches or walking frame should be taken into consideration among people with considerable balance disorders” (Podhorecka et al., 2016, p. 9). Also, as one of the mandatory components of protection against falls, comfortable shoes should be selected in accordance with the individual characteristics of patients. A special anti-slip base allows staying on one’s feet more steadily and protecting oneself from losing balance on a slippery floor. If these measures are followed, it is likely that older adults will move more confidently in healthcare settings.

When evaluating the effectiveness of nursing interventions not at clinics but patients’ homes, it is possible to pay attention to the study by Fahlström, Kamwendo, Forsberg, and Bodin (2018). The authors offer medical professionals’ ongoing consultations as the way to monitor the condition of older adults (Fahlström et al., 2018). Working with each patient enables nurses to not only help restore health but also to offer appropriate educational practices that can be useful in the future. As a consequence, the authors argue that an individually developed assistance program “can produce positive changes regarding balance” and restore motor functions without the danger of falls (Fahlström et al., 2018, p. 581). Therefore, this intervention also deserves attention.

López-Soto et al. (2016) focus on the statistics of falls among elderly patients in healthcare facilities and cite the information from four-year observations in their study. Different data are presented, which can be taken into account by nurses. For instance, “falls typically took place in the patient’s hospital room (72%) and bathroom (23%)” (López-Soto et al., 2016, p. 435). Also, they remark that “major causes were patient instability (32%) and accident (13%), and most occurred when not wearing footwear (45%) or wearing inappropriate sling-back open-toe shoes (39%)” (López-Soto et al., 2016, p. 435). This statistical analysis may be of practical value for nurses since relevant causes may be considered in detail in order to prevent them.

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Vlaeyen et al. (2015) cover a large list of existing studies on the prevention of falls among the elderly population and group results by different categories. The features of prevention programs, the number of participants, strategies involving educational methods, and other criteria are included in the study. The authors managed to draw valuable conclusions – “a significant effect of fall prevention interventions on falls or fallers but, for the first time, showed that fall prevention interventions significantly reduced the number of recurrent fallers by 21%” (Vlaeyen et al., 2015, p. 211). Therefore, their project can also be useful as one of the reasons for nursing work in relation to the issue under consideration.

Conclusion

The academic articles presented along with Orlando’s nursing model are sufficient justification for paying attention to such a problem as elderly patients’ frequent falls in healthcare facilities. The papers reviewed show different approaches and strategies aimed at eliminating this problem and searching for the best ways to increase literacy among the target population. Orlando’s theory is an effective concept that can be used for nursing interventions to increase the control of junior medical staff over patients’ mobility and timely response in case of any non-standard situations.

References

Fahlström, G., Kamwendo, K., Forsberg, J., & Bodin, L. (2018). Fall prevention by nursing assistants among community-living elderly people. A randomised controlled trial. Scandinavian Journal of Caring Sciences, 32(2), 575-585. Web.

López-Soto, P. J., Smolensky, M. H., Sackett-Lundeen, L. L., De Giorgi, A., Rodríguez-Borrego, M. A., Manfredini, R.,… Fabbian, F. (2016). Temporal patterns of in-hospital falls of elderly patients. Nursing Research, 65(6), 435-445. Web.

Luk, J. K., Chan, T. Y., & Chan, D. K. (2015). Falls prevention in the elderly: Translating evidence into practice. Hong Kong Medical Journal, 21(2), 165-171. Web.

Podhorecka, M., Kędziora-Kornatowska, K., Główczewska, J., Gębka, D., Sucharska-Szymkowiak, M., Ciesielska, N.,… Weber-Rajek, M. (2016). Falls in the elderly – Risk assessment and procedding. Medical and Biological Sciences, 29(4), 5-11. Web.

Shumba, C., & Abraham, S. (2017). Patient falls in the acute care hospital setting as perceived by the frontline staff. Prensa Med Argent, 103(3), 2-10. Web.

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Vlaeyen, E., Coussement, J., Leysens, G., Van der Elst, E., Delbaere, K., Cambier, D.,… Dejaeger, E. (2015). Characteristics and effectiveness of fall prevention programs in nursing homes: A systematic review and meta-analysis of randomized controlled trials. Journal of the American Geriatrics Society, 63(2), 211-221. Web.

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