Introduction
The falls of elderly patients in hospitals elderly patient are seen as a problem in the first study described in this paper. This study is significant to nursing as it addresses the fact of interaction between the patient and the healthcare worker. The objective of the study is to determine the level of possibility to prevent cases of patients falling (De Jong et al., 2018). By focusing on the missing aspects of fall prevention practice, the authors serve the purpose of improving the care of elderly patients. The research question is the prevention of falls among older patients and the minimization of these risks.
The second article comes from the perspective of the patients themselves, posing a problem of their own perception of their ability to walk. The aspect of how the patient perceives their own role in preventing falls is also considered in other patient-centered studies, which proves its significance to nursing (Radecki et al., 2018). This article serves the purpose of providing patient-centered care to older hospital residents. The objective of the study is to contribute to the prevention of falls in older patients using an educational methodological strategy (Naseri et al., 2021). The research question is focused on the necessity of providing patients with the skills to help prevent falls even after discharge from the hospital.
How Do These Two Articles Support the Chosen Nurse Practice Issue
Each of the proposed papers is useful to some extent for the key PICOT question. Such type of questioning is a necessary part of evidence-based nursing practice, which includes Patient, Intervention, Comparison, Outcome, and Time in sequence (Teolis, 2020). The question is: which of the two ways, observation and support or educational therapy, best prevents patients from falling before and after discharge from the hospital. The clinical issue in this case is falling of elderly patients, and the ability to help prevent these incidents from the perspective of a healthcare worker via support or educational measures.
Articles are compared with the PICOT question on the principle of effectiveness, from which it can be seen that the combined method of observation and education is the most reliable in the long term. The first article considers aspects of patient safety, the second one implies that the patients themselves need to be educated in order to prevent falling. The aspect of time is also important to this question, and the second article takes a long-term perspective, touching on the time after discharge from the hospital. Thus, to compare two types of qualitative research, including interventions, helps to get closer to the answer to the question of fall prevention and to establish the most effective methodology combining care and pedagogy.
Methods of Study
Describing the methods of the first study, it should be noted that they simultaneously consider the role of both the patient and the sitter, who controls the balance of the ward of an elderly person on his shift. The study is guided by statistical frequency, providing a percentage of the frequency of manifestation of certain aspects when interviewing a selected focus group (De Jong et al., 2018). This makes it possible to identify the most common causes of falls and determine the percentage of the sitter’s ability to prevent falls.
The second study is more clearly related to the aspect of the passage of time. It takes into account three main stages: admission to the hospital before the educational program, stay in the program, and the period of departure of an elderly patient from the hospital (Naseri et al., 2021). The study compared two types of intervention that the patients received via randomized trial: tailored education or social supervision. The methods differ in the principles of collecting material – the first article is more generalized and calculates the frequency of manifestations of certain factors, while the second is a full-fledged test observed over time.
The advantage of the first method is the achievement of maximum statistical accuracy. The combination of questions including Likert scale, multiple choice, and the requirement of a categorical answer provides heterogeneous, but statistically adjusted information (De Jong et al., 2018). The shortcoming of the study is the lack of methodological recommendations beyond improving the professional skills of nurses, as insufficient attention is paid to the educational work with patients.
The advantage of the second trial is its patient-centricity, that is, the study seeks to find out the individual capabilities of older people and to what extent they can be supported without depriving them of independence (Naseri et al., 2021). However, the negative characteristic of the selected method stems from the same aspect. The problem lies in the fact that this group of excluded includes not only people with cognitive impairments, but also those suffering from blindness or deafness, that is, those who could receive an additional specialized and tailored education for the needs.
Results of Study
The key findings of the first study are a statistical compilation of causes of falls among the elderly, divided into external and internal factors. The need for advanced training for nurses is evident from the results of the survey, as 84% ​​say they would acquire additional professional skills if given the opportunity (De Jong et al., 2018). The result of the second study is evidence of a clear help of educational work with elderly patients to prevent falls (Naseri et al., 2021). The duration of the experiment only reinforces the results of the study, since those discharged from the hospital who received only close monitoring by health workers did not experience positive differences in the ability to support themselves. Learning self-prevention of falls not only greatly enhances the ability to maintain independence and self-care of health, but also increases motivation in the process of post-hospital recovery.
The first study has positive implications for medical practice as it helps to take into account and systematize aspects that can prevent a patient from falling and eliminate possible causes of a fall. Individual consideration of the needs of the patient with the help of the resulting checklist is extremely useful for any employee of the geriatric hospital department. The second study proves the need not only to prevent falls, but also to teach this to the patient if their mental and physical capabilities allow it (Naseri et al., 2021). Such training can be a reliable guarantor of patient safety and also have a holistic positive impact.
Ethical Considerations
In any qualitative research, it is required to take into account such ethical aspects as full informing of voluntary participants and anonymity when publishing the results. The first study was approved by the Ethics Committee of Sir Charles Gardner’s Group Human Research (De Jong et al., 2018). The second study also functioned on the principle of written consent and affected only participants with no obvious intellectual disabilities (Naseri et al., 2021). Thus, patients were fully aware of the nature of their participation in the research. In both cases, the data is presented in strict anonymity. The exact name of the premises in which both studies took place is also hidden, only approximate locations are shown. The researchers were guided by the principles of full consent of the respondents and maintaining the confidentiality of data and corresponded to the established ethical considerations.
References
De Jong, L. D., Kitchen, S., Foo, Z., & Hill, A.-M. (2018). Exploring falls prevention capabilities, barriers and training needs among patient sitters in a hospital setting: A pilot survey. Geriatric Nursing 39, 263-270.
Naseri C., McPhail S. M., Morris M. E., Haines T. P., Etherton-Beer C., Shorr R., Flicker L., Bulsara M., Lee Den-Ching A., Francis-Coad J., Waldron N., & Hill A.-M. (2021). Tailored education increased capability and motivation for fall prevention in older people after hospitalization. Frontiers in Public Health 9, 1-8.
Radecki, B., Reynolds, S., & Kara, A. (2018). Inpatient fall prevention from the patient’s perspective: A qualitative study. Applied Nursing Research 43, 114-119.
Teolis, M. G. (2020). Improving nurses’ skills and supporting a culture of evidence-based practice. Medical Reference Services Quarterly, 39(1), 60-66.