Introduction
The presentation addresses the problem of the risks of falls in the senior population. The mentioned concern will be covered in the “Practice Issue” section, the “PICOT Question” section will outline research possibilities, while the “Literature Review” will summarize the existing studies. The “Recommendations” and “Conclusion” sections will define the possibilities of change.
Practice Issue
Severe fall-related accidents have increased lately due to the growth in the aged populace. The cases of falls are accompanied by fractures, subdural hematomas, severe soft tissue disruption, and head injuries. Frequently, the cause of falls is the prescription of drugs due to somatic problems in patients. Multiple older adults died from falls or have been handled in emergency departments or hospitalized. Hence, this problem in nursing practice impacts health and wellness outcomes.
PICOT Question
In patient with 65 years old or more (P), does the implementation of a Vitamin D supplementation (I), compare with light exercise and equipment use (C), facilitate stronger bone density, independent movements, and a good balance (O), in 4-month period (T)?
There could be a PICOT question proposed for improvements in the nursing practice. The population is sixty-five years old seniors or older in retirement homes. The problem is the training avoidance in these individuals. The suggested intervention is vitamin D supplementation; the intervention for comparison utilizes fall prevention products, like wheelchairs and light exercise. The method’s success depends on improvements in bone density, modifications in muscular tissue mass, and a capability to move independently in 4 months.
Literature Review
The literature concerning the PICOT question provides a unique insight on the topic of falls and related interventions. For example, Wilson’s (2019) research shows that physical exercise helps promote bone density among the elderly, as well as Segev et al. (2018), Benedetti et al. (2018), and Cauley & Giangregorio’s (2020) works. In turn, Uchitomi et al.’s (2020) work suggests that Vitamin D supplements only help elderly people with diagnosed Vitamin D deficiency.
The other literature also contributes to the understanding of the problem. Agostini et al. (2018) inform the utilization of the Vitamin D aspect to promote skeletal health. Bolland et al. (2018) and Ling et al. (2021) suggest investigation of Vitamin D supplements with other elements. However, Thanapluetiwong et al.’s (2020) study scrutinizes Vitamin D supplements’ role in augmenting muscles’ stability. Finally, Mayo Clinic (2020) argues that specific exercises improve bone density and muscle mass.
Recommendations
Since the current state of fall prevention practice is somewhat inadequate, several recommendations could be made. First, it is appropriate that physical exercises are prescribed for elderly patients. However, these should be recommended with caution since all people have various physical strengths. Additionally, vitamin D and calcium could be given to old people for strengthening their muscles; individuals with bone fractures specifically need it.
The recommended change impacts several key stakeholders, as my experience suggests. Before all, the older adults who are at risk of damage caused by falling might improve their health. Second, the nurses are involved in the implementation of the change. Next, public health institutions can promote the proposed techniques. Finally, nursing researchers can provide an investigation of the treatment discussed earlier.
The fit, feasibility, and appropriateness of changes could also be explained. The proposed combination of practices can the current health care organizational infrastructure since the techniques are cost-efficient, according to my experience with hospitals. The proposed treatment program is probable for implementation through training of the medical personnel and assemblage of guidelines. Finally, the change will improve the health outcomes by preventing the falls consequences.
Conclusion
To conclude, falls of older adults due to the absence of appropriate treatment are a critical problem. It is suggested that physical exercises might improve the outcomes, supplied by vitamin D and calcium. As a result, old people would escape falling or at least be lesser fractured. The treatment could be realized in the current settings.
References
Agostini, D., Zeppa, S. D., Lucertini, F., Annibalini, G., Gervasi, M., Marini, C. F., Piccoli, G., Stocchi, V., Barbieri, E., & Sestili, P. (2018). Muscle and bone health in postmenopausal women: Role of protein and vitamin D supplementation combined with exercise training. Nutrients, 10(8), 1103.
Benedetti, M. G., Furlini, G., Zati, A., & Letizia Mauro, G. (2018). The effectiveness of physical exercise on bone density in osteoporotic patients. BioMed Research International, 2018, 1–10.
Bergen, G., Stevens, M., & Burns, E. (2016). Falls and fall injuries among adults aged ≥65 years — United States, 2014. Morbidity and Mortality Weekly Report, 65(37), 993-998. Web.
Bolland, M. J., Grey, A., & Avenell, A. (2018). Effects of vitamin D supplementation on musculoskeletal health: A systematic review, meta-analysis, and trial sequential analysis. The Lancet Diabetes & Endocrinology, 6(11), 847–858.
Cauley, J. A., & Giangregorio, L. (2020). Physical activity and skeletal health in adults. The Lancet Diabetes & Endocrinology, 8(2), 150–162.
Ling, Y., Xu, F., Xia, X., Dai, D., Xiong, A., Sun, R., Qiu, L., & Xie, Z. (2021). Vitamin D supplementation reduces the risk of fall in the vitamin D deficient elderly: An updated meta-analysis. Clinical Nutrition, 40(11), 5531–5537.
Mayo Clinic. (2021). Exercising with osteoporosis: Stay active the safe way.
Segev, D., Hellerstein, D., & Dunsky, A. (2018). Physical activity-does it really increase bone density in postmenopausal women? A review of articles published between 2001–2016. Current Aging Science, 11(1), 4–9.
Sjoding, M. W., Prescott, H. C., Wunsch, H., Iwashyna, T. J., & Cooke, C. R. (2016). Longitudinal changes in ICU admissions among elderly patients in the United States. Critical Care Medicine, 44(7), 1353-1360.
Thanapluetiwong, S., Chewcharat, A., Takkavatakarn, K., Praditpornsilpa, K., Eiam-Ong, S., & Susantitaphong, P. (2020). Vitamin D supplement on prevention of fall and fracture. Medicine, 99(34), e21506.
Uchitomi, R., Oyabu, M., & Kamei, Y. (2020). Vitamin D and sarcopenia: Potential of vitamin D supplementation in sarcopenia prevention and treatment. Nutrients, 12(10), 3189.
Wilson, D. J. (2019). Osteoporosis and sport. European Journal of Radiology, 110, 169–174.