Falls: Clinical Nursing Issue and Evidence Search

Clinical Nursing Practice Problem

There are many clinical priorities that include safety or quality measures in a modern nursing environment. It is hard to choose one concept only because each aspect deserves attention and recognition in research. In this project, the necessity to underline the urgency of falls as a safety issue will be discussed. According to the World Health Organization (2018), falls are defined as a second leading cause of accidental injury death around the globe. For example, in the middle- or low-income countries, approximately 650,000 people die because of falls (World Health Organization, 2018). Therefore, it is recommended to investigate the nature of falls and predict them by means of such preventive strategies as patient education, the creation of a safe environment, or staff training. Although older adults introduce a group of people who are at high risk of falls, the same problem may be observed in different patients. The problem of falls is one of the most important in nursing practice because it may be prevented in case much attention is paid and enough interventions are developed.

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Clinical Nursing PICOT Question

In 65+ and older adults with a one-year history of falling (P), does family involvement through education (I) compared to care without family participation (C) decrease the number of falls and fall-related complications (O) over six months (T)?

Define PICOT Elements

P– (patient population/patients of interest): 65+ and older adults with a one-year history of falling

I– (Intervention): family involvement through education

C– (Comparison): care without family participation

O– (Measurable outcome): the decrease in the number of falls and fall-related complications

T– (Time frame in months): 6 months

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Evidence Retrieval Process and Summary

The problem of falls in different patients is frequently discussed by a variety of researchers. As a rule, these studies are based on the statistical data offered by such credible organizations as the Centers for Disease Control and Prevention to the World Health Organization. In this project, falls statistics by the World Health Organization (2018) will be used to underline the urgency of the problem around the whole world, but not in the United States only. Falls create unpredictable threats to people of different ages, but older adults are at high risks due to the existence of other chronic diseases and physical problems like vision impairment, gait abnormalities, or medication usage (Ott, 2018). This source with evidence is relevant to the study due to the possibility to explain why older adults introduce the best sample group. Evidence that was taken from Opsahl et al. (2016) and Schoberer, Eglseer, Halfens, and Lohrmann (2018) contributed to the discussion of the chosen nursing practice problem. First, the authors recognized the worth of education interventions in fall prevention. Second, the participation of family members in fall control is highly appreciated.

The chosen articles introduce the results of pilot studies with a quasi-experimental design for qualitative or quantitative research projects. The authors identify the strengths and limitations of the work and add recommendations for further researchers to strengthen the offered area of safety practice. Level III evidence is chosen because these articles have enough peer-reviewed material to be developed in a new study and contain a new perspective on the already existing problem:

Opsahl, A. G., Ebright, P., Cangany, M., Lowder, M., Scott, D., & Shaner, T. (2016). Outcomes of adding patient and family engagement education to fall prevention bundled interventions. Journal of Nursing Care Quality, 32(3), 252-258.

Ott, L. D. (2018). The impact of implementing a fall prevention educational session for community-dwelling physical therapy patients. Nursing Open, 5(4), 567-574.

Schoberer, D., Eglseer, D., Halfens, R. J. G., & Lohrmann, C. (2018). Development and evaluation of brochures for fall prevention education created to empower nursing home residents and family members. International Journal of Older People Nursing, 13(2).

Implications of the Evidence

The evidence chosen for the discussion of fall prevention among older patients helps to clarity the already known approaches in the nursing practice and get prepared for new evaluations and research. The peculiar feature of the articles is their authors’ recognition of falls as a serious public health concern that has to be elaborated in nursing. Falls have specific physical symptoms and outcomes of patients (Ott, 2018). Falls may happen anywhere, either it is a nursing home or a family house, a child or an older person may fall and put his or her life at threat (Schoberer et al., 2018). In all three articles, the authors underline the role of education and explain that family involvement cannot be ignored as a part of a treatment plan. Educational engagement of patients’ families can result in a positive decrease in falls (Opsahl et al., 2016). Nurses should collaborate with patients and explain the level of their responsibility in each step taken and every decision made. However, despite the level of patient preparedness and awareness of falls, people should never forget about the worth of family support.

In fact, such intervention as family involvement in older patients’ fall prevention is not expensive. Some time and properly developed steps are required to prove the appropriateness of the chosen idea. Therefore, the nursing evidence-based practice committee should pay attention to this problem and its solution to help healthcare institutions and families predict the growth of falls. Sometimes, the answer to the problems lies on the surface, and people are in need of a good guide to take the first step. In this case, the study about family involvement through education is a chance for older patients to predict falls and improve the quality of life.

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Evidence Search Terms

To succeed in this search for evidence, several relevant searchable terms were identified:

  1. falls
  2. prevention
  3. older patients
  4. family involvement
  5. family education

The decision to combine these terms and use them separately was made to find out what approaches and alternatives could be available for a potential researcher.

References

Opsahl, A. G., Ebright, P., Cangany, M., Lowder, M., Scott, D., & Shaner, T. (2016). Outcomes of adding patient and family engagement education to fall prevention bundled interventions. Journal of Nursing Care Quality, 32(3), 252-258. Web.

Ott, L. D. (2018). The impact of implementing a fall prevention educational session for community-dwelling physical therapy patients. Nursing Open, 5(4), 567-574. Web.

Schoberer, D., Eglseer, D., Halfens, R. J. G., & Lohrmann, C. (2018). Development and evaluation of brochures for fall prevention education created to empower nursing home residents and family members. International Journal of Older People Nursing, 13(2). Web.

World Health Organization. (2018). Falls. Web.

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