Introduction
Statistics play a crucial role in assessing and analyzing clinical research, providing a quantitative perspective that enables us to understand the effectiveness, significance, and results of different interventions. In the context of preventing falls in the inpatient medical-surgical unit for veterans, an analysis of scholarly articles reveals the various pharmacological and non-pharmacological nursing interventions compared to standard nursing discharge teaching and other therapeutic measures. This examination of statistical data provides insights into the complex range of findings and their implications for practical application. According to the fall data provided by the Centers for Disease Control and Prevention (2023), approximately one in every five falls results in a severe injury, such as fractures or head trauma. Furthermore, it is estimated that on an annual basis, three million elderly individuals seek medical attention in emergency rooms due to fall-related injuries. Consequently, falls represent a significant concern. The objective of this essay is to examine the statistical findings obtained from a literature review on the topic of nursing interventions, pharmacological and non-pharmacological strategies for fall prevention, as compared to standard nursing discharge teaching and other therapeutic approaches, in order to mitigate and manage falls in the inpatient medical-surgical unit for veterans. A more profound comprehension of the complexities and ramifications for the clinical domain can be achieved by carefully examining the statistical approaches, measures, and outcomes given in the research.
Statistical results discussion
Falls are a significant concern for nurses since they affect patient safety both during and after their hospital stay, reducing the likelihood that they may need to be readmitted. According to research (Manlapaz et al., 2019), Factors that increase the likelihood of falling include using certain medications, muscle weakness, decreased walking, and poor balance. Exercises focusing on gait, strength, and balance may help with balance and gait abnormalities, but drug management should be the primary emphasis. The study by Tzeng et al., 2020 aims to improve their ability to self-manage their situation so that they experience fewer falls. Research into why some older adults fail to take this precaution was shown to lag. Tzeng discovered that older persons under-manage the intervention to prevent falls because of the need for behavioral change. Such measures include those that benefit the patient directly, such as those that help them walk or stand more steadily to improve gait and balance. The goal was to facilitate learning for seniors about falls by including healthcare providers in co-designing a fall prevention intervention with seniors before discharge. Tzeng’s study was a systematic review; hence, the study design that the authors used is typically thought to offer higher-quality data than case reports or observational studies (Tzeng et al., 2020). The authors carried out the first search between September 2, 2019, and September 15, 2019, and the second search was updated on February 5, 2020, hence credible source.
Additionally, the “snowball phenomenon” was used to manually search the included articles’ references and find the most substantial level of evidence. They found pertinent peer-reviewed publications in the methodological framework using the methodological quality rating to confirm the caliber of the studies included in this scoping review. The data from the research were compiled and analyzed using statistical measures such as effect magnitude and heterogeneity. The articles included the following characteristics: Ten of the examined publications (58.8%) were published between 2009 and 2014, and seven (41.2%) were published between 2015 and 2019 (Tzeng et al., 2020). Four were conducted in the United Kingdom, five in the United States, and six in Australia. The statistical analysis reveals high levels of evidence from the discussion regarding the major themes identified for motivation-related facilitators: changing inaccurate perceptions of falls and fall-prevention strategies (5 articles, 29.4%); seeing personal gain, benefits, and improvements in gait and balance (1 article, 5.9%); and following up with older adults to clarify their understanding of the fall-prevention program (supported by two articles, 11.8%).
High-risk patients should receive individualized care that addresses their specific risk factors for falling, such as those related to home safety, vision, foot issues, medication, management, and monitoring of hypotension, in addition to the measures used to prevent falls in those at moderate risk. Various interventions are anticipated to reduce the incidence of falls, hip fractures, and the number of patients who fall numerous times. It includes surgeries such as cataract removal, medications such as vitamin D, and exercises. The confidence level in NMA effect estimates was ascertained in this investigation by Dautzenberg et al., 2021 using the Confidence in Network Meta-Analysis (CINeMA) technique, a quality assessment instrument. According to the statistics discussed, NMA comprising 192 studies found that the single interventions of exercise (with a confidence interval of 0.77–0.89) and quality improvement techniques (like patient education) (with a confidence interval of 0.83–0.98) were linked to fewer falls when compared to usual care. Determining the degree of evidence in a study mostly depends on the breadth of the confidence interval, where a narrower interval typically denotes greater precision and more substantial proof.
Other include psychological interventions, fluid and nutrition therapy, management of urinary incontinence, social engagement, assistive technology, and environmental assessments and modifications. A multifactorial approach to caring for the patient is essential to reduce the number of falls. Elderly fall prevention is crucial because it reduces the likelihood of the patient encountering an adverse health outcome, including disability, hospitalization, and the associated costs. Patients’ quality of life may improve in this setting if they become more mobile and participate in regular activities. Vitamin D supplementation has been proven to reduce bone resorption and parathyroid hormone production, enhance body sway, and boost muscle strength, all of which may contribute to a lower risk of hip fracture. Muscle strength, flexibility, balance, and stamina are all improved with regular exercise (Sherrington et al., 2019). Eighty-one trials compared exercise (of all kinds) with a control intervention (one that was not supposed to lower falls), according to Sherrington et al.’s 2019 research. Exercise lowers the risk of falls by 23% (high-certainty evidence; confidence intervals of 0.71 to 0.83).
Conclusion
The examination of statistical data in these publications not only functions as a way for measuring outcomes but also allows for a thorough evaluation of the methodologies employed, the importance of the results, and the possible influence on patient care and treatment approaches. This statistical data analysis will examine trends, patterns, and disparities, thereby enhancing our understanding of the complexities within the domain of nursing interventions aimed at reducing and managing falls in the Veterans’ inpatient medical-surgical unit. It is important to note that as the frequency of falls among older individuals rises, it is essential to examine how this demographic group’s behavior is shifting to understand why so many fail to take advantage of proven methods for preventing falls. Finding the gaps and directing future research development in co-designing fall prevention techniques are tasks for Zeng’s research group. Therefore, patients at risk of falls should be involved in the appropriate management of falls, including exercises, vitamin D supplementation, and patient assessment of the risk factors of falls. From this analysis, discussions on statistical results and levels of confidence contribute to the overall improvement in the quality and dependability of evidence-based articles. Engaging in this practice promotes a more profound comprehension of the research, enables the juxtaposition with pre-existing knowledge, and bolsters well-informed decision-making across diverse domains.
References
Centers for Disease Control and Prevention. (2023, July 19). Facts about falls. https://www.cdc.gov/falls/facts.html
Dautzenberg, Beglinger, S., Tsokani, S., Zevgiti, S., Raijmann, R. C. M. A., Rodondi, N., Scholten, R. J. P. M., Rutjes, A. W. S., Nisio, M. D., Emmelot-Vonk, M., Tricco, A. C., Straus, S. E., Thomas, S., Bretagne, L., Knol, W., Mavridis, D., & Koek, H. L. (2021). Interventions for preventing falls and fall-related fractures in community-dwelling older adults: A systematic review and network meta-analysis. Journal of the American Geriatrics Society (JAGS), 69(10), 2973–2984. https://doi.org/10.1111/jgs.17375
Manlapaz, D. G., Sole, G., Jayakaran, P., & Chapple, C. M. (2019). Risk factors for falls in adults with knee osteoarthritis: a systematic review. Pm&r, 11(7), 745-757. https://onlinelibrary.wiley.com/doi/abs/10.1002/pmrj.12066?casa_token=n28b1CziytgAAAAA:5cw1ua7BKQFAj9GBska29Fn5CP103LI2TItHBYS2R-Z7pd7lQBxyy2cJtwrLKHAxb2kh6G-Ejorux68
Sherrington, C., Fairhall, N. J., Wallbak, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., … & Lamb, S. E. (2019). Exercise for preventing falls in older people living in the community. Cochrane database of systematic reviews, (1). https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD012424.pub2/abstract
Tzeng, H. M., Okpalauwaekwe, U., & Lyons, E. J. (2020). Barriers and facilitators to older adults participating in fall-prevention strategies after transitioning home from acute hospitalization: a scoping review. Clinical interventions in aging, 971-989. https://www.tandfonline.com/doi/abs/10.2147/CIA.S256599
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