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Introduction
A comprehensive literature review helps to build the logic of the research. In addition, it provides an opportunity to evaluate the existing body of knowledge and determine the gaps that exist in it. The purpose of this paper is to review the articles related to the approved change topic.
Synthesis
According to Stenhagen, Ekstrom, Nordell, and Elmstahl (2014), senior individuals can experience various health-related issues if they fall frequently. The team has researched 2931 patients using Short-Form Health Survey, and they found out that the majority of individuals experiencing repeated falls are dissatisfied with the quality of their life. These results evidence the need for immediate interventions such as proposed by the PICOT question. According to Moraes Oliveira et al. (2016), one of the tools utilized to predict falls in senior patients is AIFE instrument. Nevertheless, it has proved its inefficiency; therefore, the team has refined it to include the aspects of vulnerability. In their turn, Aizen and Zlotver (2013) investigated the feasibility of developing risk-prediction tools to prevent falls. In their cohort study, they researched 1013 senior patients and analyzed the results using logistic regression models. They determined that predictive tools do not lead to a reduction in falls. Thus, these findings also support the PICOT question and evidence the need for practical interventions such as patient training.
Researchers assume that senior adults can benefit greatly from regular exercising since it improves their balance, muscle tone, and gait, which decreases the possibility of falling. Otago exercise program is considered an effective intervention to improve balance in older adults. Patel and Pachpute (2015) have proved that this program positively affects the senior population; the strength and balance training that they received has decreased the number of falls in 24 individuals out of 30. Yoo, Chung, and Lee (2013) have observed similar results. They researched 21 elderly women and found that augmented reality-based Otago exercise has drastically improved the balance and gait of females. In addition, Imaoka, Higuchi, Todo, Kitagwa, and Ueda (2016) have proved that patients receiving low-frequency exercising accompanied by vitamin therapy exhibited reduced fall rates.
Tai Chi training is also considered effective in reducing falls in the elderly. According to Zhao and Wang (2016) who have analyzed the results for 2796 individuals, Tai Chi training significantly improves balance in elderly individuals. These findings correlate directly with the items of the PICOT question and require research on hospitalized patients. Moreover, Haines et al. (2013) found out that patient education has the potential to reduce hospital expenses by 4%. Therefore, future research will apply the discussed findings to hospitalized patients to determine whether patient education and physical therapy will result in fall reduction.
Comparison
The articles by Patel and Pachpute (2015), Zhao and Wang (2016), and Yoo et al. (2013) provide evidence proving that regular exercises performed by senior adults positively affect their balance and stability. Thus, they minimize the possibility of falls. Nevertheless, the main limitation of these studies can be concluded by the fact that they do not center on hospitalized patients.
The research by Imaoka et al. (2016) studies institutionalized patients, but it does not provide guidelines in terms of concrete therapeutic strategies. The outcomes of the study by Stenhagen et al. (2014) also do not provide evidence regarding hospitalized patients. One of the controversies noticed in the articles is linked to the evaluation of vulnerability to falls. According to Aizen and Zlotver (2013), prediction tools have a low value in preventing falls while Moraes Oliveira et al. (2016) consider that certain instruments can be refined. Nevertheless, the article by Haines et al. (2013) supports the assumption that patient education is a feasible measure; therefore, institutions should resort to it to address the issue of falls and minimize costs for organizations.
Analysis
Increased patient education and participation in regular exercise have the potential to decrease the incidence of falls in senior adults, which has been evidenced by the literature review. Nonetheless, the limitations suggest that further research is needed to understand whether similar results can be achieved if the proposed interventions are applied to hospitalized patients. Therefore, the proposed change project can contribute greatly to the existing body of knowledge and will provide new insights into possibilities of fall reduction in senior patients.
Conclusion
Thus, falls in elderly patients are rather common. Nonetheless, there are certain gaps in the research on this topic. The proposed project intends to close these gaps by applying the approaches aimed at the general population to senior hospitalized patients.
References
Aizen, E., & Zlotver, E. (2013). Prediction of falls in rehabilitation and acute care geriatric setting. Journal of Clinical Gerontology and Geriatrics, 4(2), 457-461.
Haines, T. P., Hill, A. M., Hill, K. D., Brauer, S. G., Hoffmann, T., Etherton-Beer, C., & McPhail, S. M. (2013). Cost effectiveness of patient education for the prevention of falls in hospital: Economic evaluation from a randomized controlled trial. BMC Medicine, 11(135), 1-12.
Imaoka, M., Higuchi, Y., Todo, E., Kitagwa, T., & Ueda, T. (2016). Low-frequency exercise and vitamin D supplementation reduce falls among institutionalized frail elderly. International Journal of Gerontology, 10(4), 202-206.
Moraes Oliveira, D., Silveira de Almeida Hammerschmidt, K., Dornelles Schoeller, S., Balbinot Reis Girondi, J., Godinho Bertoncello, K. C., & Ferreira de Paula, N. (2016). Assessment instrument for falls among the hospitalized elderly (hospital AIFE): Nurse analyzing vulnerability and mobility. Journal of Nursing UFPE, 10(11), 4065-4074.
Patel, N. N., & Pachpute, S. (2015). The effects of Otago exercise program for fall prevention in elderly people. International Journal of Physiotherapy, 2(4), 633-639.
Stenhagen, M., Ekstrom, H., Nordell, E., & Elmstahl, S. (2014). Accidental falls, health-related quality of life and life satisfaction: A prospective study of the general elderly population. Archives of Gerontology and Geriatrics, 58(1), 95-100.
Yoo, H., Chung, E., & Lee, B. H. (2013). The effects of augmented reality-based Otago exercise on balance, gait, and falls efficacy of elderly women. Journal of Physical Therapy Science, 25(7), 797-801.
Zhao, Y., & Wang, Y. (2016). Tai Chi as an intervention to reduce falls and improve balance function in the elderly: A meta-analysis of randomized controlled trials. Chinese Nursing Research, 3(1), 28-33.
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