Introduction
Even though there is no specific medical condition that is responsible for patient falls, the health of numerous individuals often suffers from these situations. For example, Heng et al. (2020) stipulate that fall rates “typically range from 3 to 11 falls per 100 bed days” (p. 1). Approximately a quarter of these events result in severe health issues, including soft-tissue injures, fractures, and others (Heng et al., 2020). This state of affairs means that it is necessary to implement suitable intervention programs to reduce the number of such traumatic cases. Multiple studies indicate that patient education is a useful option to minimize the number of such falls and contribute to better health outcomes. In an attempt to demonstrate depth and breadth of knowledge on the topic, the given paper focuses on the following PICOT question. Do patients aged 65 and older (P) who undertake education programs (I) experience lower fall rates (O) over four or six weeks (T) when compared to a control group (C)?
Brief Literature Review
As has been mentioned, patient falls are a severe issue in the modern health care industry. It is so because falls are caused by different conditions, including both health problems and environmental factors. At the same time, some individuals can fall because of their changing physical ability (Wilkinson, 2018). Irrespective of the reasons, these events imply dangerous outcomes, which means that medical professionals should address the issue under consideration. Numerous pieces of research, including the ones by Cerilo (2016), Dykes et al. (2017), Hill et al. (2019), and Kiyoshi-Teo et al. (2019) stipulate that education is a suitable resource here. These studies analyze the role of educational efforts using various approaches, which explains that all of them have characteristic features that will be described below.
Thus, Hill et al. (2019) analyze the impact of educational efforts and structured discussions on reducing patient falls. This intervention includes both videotapes and workbooks for older patients (Hill et al., 2019). Furthermore, the thesis by Cerilo (2016) also draws significant attention to the use of multimedia to decrease patient fall rates. The researcher argues that videotapes that are accompanied by direct discussions are sufficient to address the problem under consideration. At the same time, the studies by Dykes et al. (2017) and Kiyoshi-Teo et al. (2019) focus on providing pamphlets and written guides to patients and their caregivers. Since all the articles place the highest value on education, it is not a coincidence that they report shared successful results. For example, the four studies admit that patients can identify fall risks better after the intervention. However, various approaches could not but lead to different outcomes, and they will be presented further.
Description of the Situation
While considering the results of the studies under consideration, one can divide the articles into two groups. The first of them includes the works by Kiyoshi-Teo et al. (2019) and Hill et al. 2019). These researchers indicate that there is no significant difference in fall rates between people who have undertaken educational programs and representatives of a control group. Firstly, Hill et al. (2019) have analyzed 382 patients (mean age 77.7 years) and identified that the fall rate was 5.9 per 1,000 patient days in both experimental and control groups (p. 1511). This conclusion means that education efforts when in isolation, are not sufficient to reduce patient fall rates. Secondly, Kiyoshi-Teo et al. (2019) draw attention to the effect of a motivational interviewing intervention that “was provided at beginning proficiency level” (p. 19). That is why the researchers have failed to identify any changes in fall prevention behaviors among the participants. This scientific work indicates that it is a challenging strategy to provide the patients with superficial information and reckon on positive results.
In turn, the second group comprises the studies that have managed to identify some successful outcomes of their interventions. On the one hand, Cerilo (2016) states that a multimedia prevention program is sufficient to increase fall risk awareness, which contributes to greater engagement in prevention efforts among the patients. Even though some positive results are mentioned, the scientist does not present any information on reduced fall rates. On the other hand, Dykes et al. (2017) emphasize that “the mean patient fall rate decreased from 3.28 to 2.80 falls per 1,000 patient days” (p. 403). This outcome became possible because the researchers invested in translating the evidence into practice. As a result, the participants gained the necessary knowledge and learned how to apply it to avoid harmful situations and protect their health.
Case Summary and Proposed Solution
The information above stipulates that not every educational intervention is sufficient to make a difference. Even though the articles under consideration are valid and reliable, they offer different outcomes. Thus, the studies by Hill et al. (2019) and Kiyoshi-Teo et al. (2019) demonstrate that only providing patients with general information cannot directly decrease their fall rates. The pieces of research show that both written and video materials cannot cope with the task. However, Cerilo (2016) indicates that the “implementation of multimedia programs contributed to changes in the fall risk awareness” among patients (p. 104). At the same time, the most significant portion of knowledge is found in the study by Dykes et al. (2017). The researchers prove that patient fall rates decrease when theoretical information is followed by its practical application.
According to everything mentioned above, it is possible to offer a solution to the problem. Firstly, education is an irreplaceable factor when it comes to reducing patient falls. It is so because it is necessary to explain to individuals why they can fall and what adverse consequences these situations will bring. Once the data are processed, it is rational to teach the participants how to apply the gained knowledge in practice. In this case, various questionnaires, quizzes, and case studies are suitable options. Thus, this two-step intervention plan is an effective way to make patients aged 65 and older experience lower fall rates over four or six weeks.
Conclusion
Patient falls are a severe problem in the modern health care industry. It is so because many older people are subject to these harmful situations that, in turn, contribute to adverse outcomes. That is why medical professionals should address the situation and reduce fall rates. Educational programs for patients of 65 years and older are considered an effective way to make a difference. However, one should note that isolated educational efforts are not sufficient to solve the problem. Consequently, it is also necessary to teach individuals how to use what they have learned. As a result, education becomes useful when it is followed by practical exercises on how to reduce patient fall rates.
References
Cerilo, P. C. (2016). Effectiveness of fall prevention multimedia program on patient awareness, self-efficacy, and engagement (Publication No. 10244751) [Doctoral dissertation, University of Phoenix]. ProQuest Dissertations Publishing.
Dykes, P. C., Duckworth, M., Cunningham, S., Dubois, S., Driscoll, M., Feliciano, Z., Ferrazzi, M., Fevrin, F. E., Lyons, S., Lindros, M. E., Monahan, A, Palev, M. M., Jean-Pierre, S., & Scanlan, M. (2017). Pilot testing fall TIPS (Tailoring Interventions for Patient Safety): A patient-centered fall prevention toolkit. The Joint Commission Journal on Quality and Patient Safety, 43(8), 403-413.
Heng, H., Jazayeri, Shaw, L., Kiegaldie, D., Hill, A.-M., & Morris, M. E. (2020). Hospital falls prevention with patient education: A scoping review. BMJ Geriatrics, 20(140), 1-12.
Hill, A.-M., McPhail, S. M., Haines, T. P., Morris, M. E., Etherton-Beer, C., Shorr, R., Flicker, L., Bulsara, M., Waldron, N., Lee, D.-C. A., Francis-Coad, J., & Boudville, A. (2019). Falls after hospital discharge: A randomized clinical trial of individualized multimodal falls prevention education. The Journals of Gerontology: Series A, 74(9), 1511-1517.
Kiyoshi-Teo, H., Northup-Snyder, K., Cohen, D. J., Dieckmann, N., Stoyles, S., Eckstrom, E., & Winters-Stone, K. (2019). Feasibility of motivational interviewing to engage older inpatients in fall prevention: A pilot randomized controlled trial. Journal of Gerontological Nursing, 45(9), 19-29.
Wilkinson, A., Meikle, N., Law, P., Yong, H. J., Butler, P., Kim, J., Mulligan, H., & Hale, L. (2018). How older adults and their informal carers prevent falls: An integrative review of the literature. International Journal of Nursing Studies, 82, 13