The Problem of Fall Risk in Elderly Patients

Falcão, R., Costa, K., Fernandes, M., Pontes, M., Vasconcelos, J., & Oliveira, J. (2019). Risk of falls in hospitalized elderly people. Revista Gaucha de Enfermagem, 40, 1-8. 

Ensuring patient safety and preventing additional injuries or any other deterioration of the condition is an essential aspect of the quality of services in healthcare organizations. Falls are one of the common adverse events that impair safety and lead to hospitalization and deterioration of the patient’s condition, especially for older adults. Using the Morse Scale, Falcão et al. (2019) conducted a study that included elderly over 60 years old from several university hospital departments to assess the risks of falling. The sample consisted of participants of both genders and excluded patients with functional fallibility. The target population included 1,079 people, and the sample size was 284 patients (Falcão et al., 2019). Thus, the authors took measures to ensure that the sample contributed to the accuracy of the results.

The researchers investigated several factors that could lead to falls and included several variables. Independent variables were Morse Scale items, demographics, and patients’ diseases and medications. In particular, the Morse Scale consists of the history of falls, walking assistance, mental state, and other factors. Age, education level, and gender are distinguished among the demographic indicators. The last group of variables included the use of sedatives, antidepressants, and additional drugs, as well as the presence of diabetes, hypertension, or other diseases. The dependent variable of the study is the risk of the patient falling.

The study follows a quantitative approach to research and is consistent with a cross-sectional design. To collect data, Falcão et al. (2019) used a structured script, the Mini-Mental State Examination, and the Morse Scale. The information obtained was structured, exported to the Statistical Package for the Social Science (SPSS), and analyzed using Multivariate Correlation Analysis, Chi-Square test of linear association, and other techniques. The results demonstrated that intravenous therapy, heart failure, vision deficiency, diuretics, and urinary incontinence contribute to the risk of falling. The study’s findings can be used to develop fall prevention measures and are valuable for the subject’s exploration.

Liu-Ambrose, T., Davis, J. C., Best, J. R., Dian, L., Madden, K., Cook, W., Hsu, C. L., & Khan, K. M. (2019). Effect of a home-based exercise program on subsequent falls among community-dwelling high-risk older adults after a fall: A randomized clinical trial. JAMA, 321(21), 2092–2100. 

Preventing falls is an important issue for older adults who have already experienced it, and they often refer to health care representatives for help. Liu-Ambrose et al. (2019) conducted a study of the target population group consisted of people over 70 who do not want a fall repetition. The experiment aims to determine whether exercises will help avoid a new fall. Researchers carefully selected participants receiving care at a fall prevention clinic for several years. The sample included older people with a history of falling and an increased risk of the incident in the future, and 296 of them completed the study.

Following the goal set in the study, the authors explored a correlation between exercise performance and reduced probability of falls in older patients. Accordingly, the independent variable was the performance of a set of exercises – the Otago Exercise Program. Such gymnastics are aimed at performing at home and improving balance and strength. The physiotherapist helped participants master the program and adjust its implementation. The study’s dependent variable is the risk of falling, which the intervention was supposed to reduce.

To answer the posed question of the study, the researchers designed the intervention and divided the patients into two groups for their parallel participation. The selected study design is a randomized clinical trial conducted over several months. The researchers collected data on the participants’ diseases, their ability to live independently, and their mental state before the intervention. After the experiment implementation, their data focused on the incidence of falls and possible adverse effects of exercises, and information was studied using statistical analysis tools. The results demonstrated that the proposed home exercise program reduced falls, and there were no reports of its adverse effects. The study is of interest to explore the topic and can be included in the literature review, as it has reliable data on reducing the risk of falls.

Najafpour, Z., Godarzi, Z., Arab, M., & Yaseri, M. (2019). Risk factors for falls in hospital in-patients: A prospective nested case control study. International Journal of Health Policy and Management, 8(5), 300–306.

Falls have consequences for both patients and hospitals, and therefore organizations seek to calculate and reduce the risk of falls. In particular, identifying factors that predict the probability of falling could be valuable for developing tools and interventions to prevent injuries in medical settings. The study by Najafpour et al. (2019) covered 1,326 patients, of whom 185 were patients with a fall case, and 1,141 were in the control group with a high risk of falling. The average age of participants was 52.9 and 58.6 years for the respective groups. Dividing participants into groups was required to identify factors that contribute to the fall, which is the study’s goal.

When examining the correlation between different factors and fall risk, the authors used the Morse scale and indicated several variables. Independent variables were the causes and factors of falls, which included demographics, information about the drugs taken, the presence of other diseases, and actions during the fall (Najafpour et al., 2019). The patient’s fall rate acted as a dependent variable of the study. The authors chose a prospective nested case-control design following a quantitative approach to research to identify the relationship. The data sources for the analysis were patients’ medical records, observations, and interviews with patients, their relatives, and caregivers.

The researchers used multilevel analysis to study the findings and infer the results. The authors used Chi-square and Fisher exact tests to compare patient characteristics. Other instruments included the Kruskal-Wallis test, odds ratio, logistic regression, and Poisson regression (Najafpour et al., 2019). The researchers concluded that the key factors contributing to falls are sedative and chemotherapeutic drug use, visual acuity, and urinary incontinence. Such results are consistent with Falcão et al. (2019) study, which confirms the reliability of both articles. The source can be included in the literature review as it provides reliable and valuable information that service providers can apply in medical settings to prevent falls.

References

Falcão, R., Costa, K., Fernandes, M., Pontes, M., Vasconcelos, J., & Oliveira, J. (2019). Risk of falls in hospitalized elderly people. Revista Gaucha de Enfermagem, 40, 1-8.

Liu-Ambrose, T., Davis, J. C., Best, J. R., Dian, L., Madden, K., Cook, W., Hsu, C. L., & Khan, K. M. (2019). Effect of a home-based exercise program on subsequent falls among community-dwelling high-risk older adults after a fall: A randomized clinical trial. JAMA, 321(21), 2092–2100.

Najafpour, Z., Godarzi, Z., Arab, M., & Yaseri, M. (2019). Risk factors for falls in hospital in-patients: A prospective nested case control study. International Journal of Health Policy and Management, 8(5), 300–306.

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1. NursingBird. "The Problem of Fall Risk in Elderly Patients." April 7, 2023. https://nursingbird.com/the-problem-of-fall-risk-in-elderly-patients/.


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NursingBird. "The Problem of Fall Risk in Elderly Patients." April 7, 2023. https://nursingbird.com/the-problem-of-fall-risk-in-elderly-patients/.