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Literature Review
Fall risk in acute care is one of the primary causes of the appearance of a wide range of complications. The latter may significantly decrease the quality of lives of elderly patients and deprive them of an opportunity to recover.
Realizing the importance of the discussed topic, many researchers in the field have devoted a lot of their time to studying the factors connected to the falls experienced by elderly patients. For instance, one particular method to decrease fall rates among the elderly was studied by El-Khoury, Cassou, Charles, and Dargent-Molina (2013). Their study was aimed at extending the knowledge on fall prevention methods and they focused on exercise intervention for patients. Among other things, the authors concluded that exercise programs could help to decrease not only fall rates but also the number of cases when falls resulted in heavy injuries. Therefore, it has been proven that exercises may help to fulfill two goals: to make falls in the elderly occur less often and to mitigate their negative effects for patients.
The importance of physical exercises (especially those aimed at strengthening trunk muscles) was also studied by Granacher, Gollhofer, Hortobágyi, Kressig, and Muehlbauer (2013). Nevertheless, the conclusion that they made was different from one of the previous studies. The authors proved that the correlation between the strength of trunk muscles and fall rates was not as strong as expected; therefore, they did not confirm the great importance of such exercises for fall prevention.
The study conducted by Sherrington et al. (2016) is also devoted to assessing the effects of special exercises on fall rates. More than that, the authors focused on the importance of self-help measures explained to the patients.
Another important research related to the approaches to fall prevention was conducted by Miake-Lye, Hempel, Ganz, and Shekelle (2013) whose conclusions also confirmed the idea of the importance of exercise interventions supported by a great number of other researchers working in the field. On top of that, they proved that the most effective training programs were primarily multicomponent. Nevertheless, speaking about the particular measures, it is necessary to say that the authors concluded that there was little evidence allowing to single out a few exercises that could be called the most effective, and this fact can be regarded as a significant knowledge gap that needs to be filled.
To continue, the link between certain recommended measures and their influence on fall prevention was also studied by Uusi-Rasi et al. (2015). The researchers focused on two factors such as taking vitamin D supplements on a regular basis and exercising to strengthen muscles. At the end of their research, the authors were able to conclude that the results concerning these factors were quite contradictory. Thus, the authors could not prove that these methods had helped to reduce significantly the fall rates among the participants.
Another important factor that could help to prevent falls and was connected to bodily comfort was studied by Chari et al. (2016). The researchers focused on wearing special footwear and its role in helping the patients to move safely. In the end, they concluded that there was an additional problem connected to patients lack of knowledge concerning the importance of proper footwear and clothes.
It can be said that there is a certain diversity of opinions related to the role of physical exercises in fall prevention. Nevertheless, it is important to extend the knowledge on fall prevention methods and their effectiveness in acute care settings with the help of further research.
Methodology and Design
Due to the urgency of the problem, it is necessary to fill the knowledge gap and consider the problem from the point of view of the nurses working in acute care settings. Therefore, the present research is aimed at defining the most popular methods of fall prevention among nurses and comparing their opinions on their effectiveness to the outcomes of important experiments in the field. At the end of the research, it will be possible to formulate a set of recommendations that can be helpful for the nurses in acute care. The study will consist of two parts.
First, it is necessary to interview nurses working in acute care facilities. It will be important to ask the participants whether they consider their knowledge on fall prevention to be substantial. Furthermore, they will be asked about their own experience in fall prevention and specific situations that were ameliorated with the help of their actions. In the end, the participants will be asked about certain fall prevention methods that they use in their practice more often and less often; then, they will have to evaluate the effectiveness of each method and mention certain limitations connected to them. The results of the interview will be processed and the most typical answers will be defined.
Second, it is important to compare the statements that are the most typical for nurses with the conclusions made by the previous researchers.
Sampling Methodology
Considering the importance of the research, it will be necessary to choose experienced nurses as the participants. Thus, non-probability techniques such as selective sampling will be used. To be more precise, it will be aimed at studying the experience of acute care nurses who have at least 5 years of practice. In order to make a conclusion that can be implemented into practice, it is important to interview at least 30 nurse practitioners.
As for scientific articles that will be reviewed and compared to the results of the interview analysis, they will be chosen based on their citation rating.
Necessary Tools and Algorithms
In order to conduct research and make a logical conclusion based on the result of the experiment, it will be necessary to use speech transcription software for those participants who will be interviewed during a face-to-face meeting. Furthermore, it will be important to use the software for text analysis that will allow us to define the fall prevention methods that were mentioned by the majority of the participants. Then, the results for different methods will be calculated and compared to nurses statements concerning their effectiveness. In the end, these tools will help to create a rating demonstrating the most popular fall prevention methods and the most effective ones (based on participants experience). In order to conduct the study, it will be necessary to use the following algorithm:
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Define and describe the problem more thoroughly
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Select a number of credible articles on fall prevention and summarize the conclusions
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Prepare interview questions
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Select at least 30 participants among acute care nurses with more than 5 years of practice
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Conduct interviews
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Transcribe and analyze the interviews
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Compare the results to statements made by the researchers
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Make a conclusion
References
Chari, S. R., McRae, P., Stewart, M. J., Webster, J., Fenn, M., & Haines, T. P. (2016). Point prevalence of suboptimal footwear features among ambulant older hospital patients: Implications for fall prevention. Australian Health Review, 40(4), 399-404.
El-Khoury, F., Cassou, B., Charles, M. A., & Dargent-Molina, P. (2013). The effect of fall prevention exercise programmes on fall induced injuries in community-dwelling older adults: Systematic review and meta-analysis of randomised controlled trials. BMJ, 5(16), 6234.
Granacher, U., Gollhofer, A., Hortobágyi, T., Kressig, R. W., & Muehlbauer, T. (2013). The importance of trunk muscle strength for balance, functional performance, and fall prevention in seniors: A systematic review. Sports Medicine, 43(7), 627-641.
Miake-Lye, I. M., Hempel, S., Ganz, D. A., & Shekelle, P. G. (2013). Inpatient fall prevention programs as a patient safety strategy: A systematic review. Annals of Internal Medicine, 158(5), 390-396.
Sherrington, C., Fairhall, N., Kirkham, C., Clemson, L., Howard, K., Vogler, C., & Sonnabend, D. (2016). Exercise and fall prevention self-management to reduce mobility-related disability and falls after fall-related lower limb fracture in older people: Protocol for the RESTORE (Recovery Exercises and STepping On afteR fracturE) randomised controlled trial. BMC geriatrics, 16(1), 34.
Uusi-Rasi, K., Patil, R., Karinkanta, S., Kannus, P., Tokola, K., Lamberg-Allardt, C., & Sievänen, H. (2015). Exercise and vitamin D in fall prevention among older women: A randomized clinical trial. JAMA internal medicine, 175(5), 703-711.
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