A fall is when a person traumatically finds them on the floor unexpectedly. Often, falls are common among older people due to a lack of stability and underlying health conditions. According to research studies, one in four older people encounter a fall. Falls result in fractures, affecting mobility and co-dependence with other people. Thus, falls among the older generation are a significant healthcare system problem. Falls can lead to the risk of prolonged hospitalization due to the need for closer monitoring of the patients. Therefore, this paper aims to generate a literature review of the PICOT question among individuals aged 65 and older undergoing fracture treatment. Is the application of fall prevention programs developed by nurses compared to the routine of fall prevention programs more effective in preventing and reducing fall-associated injuries within the first three months of intervention?
The evidence-based articles used in evaluating this article have a prevalence and relation to the PICOT question. Fall injuries are shared among older adults, thus begging the question of how nurses and caregivers can help solve and manage the problem. Falls are a significant concern in the health care system, and providing insight on how to deal with the problem helps the health care system develop and analyze care solutions. Therefore, the articles aim to establish a relationship between the application of the fall prevention program designed by nurses and the routine fall prevention program, which is effective in administering care within three months.
According to the PICOT question, whether the application of fall prevention programs developed by nurses compared to the routine fall prevention program is more effective in preventing and reducing fall-associated injuries within the first three months of intervention, we need to understand the literature review that analyzes both the programs. The fall prevention program is the management of the risks that can cause falls and providing an environment whereby patients can ease their mobility. The routine fall prevention program is a process where nurses help patients assess the risks that lead to their falling and implement an action plan to prevent the patient from falling. For example, understanding the patients may have underlying fears that trigger them from brain coordination, thus risking falls. While both programs aim at helping patients who have already had falls while preventing them from re-occurring, the literature review helps us understand which program is more efficient and effective in reducing falls among the older generation.
The routine of a fall prevention program may be regarded as effective compared to the application of fall prevention programs developed by nurses whereby nurses come up with a specific plan of providing care to fall patients to help them reduce extra falls among them and create a program that enables patients to nurse their falls without implicating them in fractures. It is easier to manage falls than extensive fractures acquired from falling. Care planning by nurses includes comprehensive factors related to the patient’s prior problems; thus, the nurses should use available patient data to develop solutions for implementing the care plan. Every patient has different factors and issues that could lead to falls; therefore, creating a care plan helps the treatment process.
While falls are shared among the old generation, the fall program was generated to ensure that the number of falls can be easily managed. Some factors considered to achieve falls among patients include stepping on, balance, enhancing fitness, and Otago exercises. These nursing programs have been set to address risk factors that lead to falls. Improving balance and muscle development through fitness and removing home hazards that may lead to falls in homes. While these factors may aid in reducing falls generally in homes, the programs must be counter-effective, according to research. As people age, their brain functionality affects their balance and how they respond to things. Therefore, the risk of falling is more in how our bodies react to specific issues like posture, visual visibility, cognitive illness, underlying issues, etc. Therefore, a fall prevention program would come in handy compared to the risk fall prevention program by nurses.
While a patient has been admitted once due to a fall, it makes it easier for nurses to evaluate the reasons and factors that could have resulted in the fall. However, implementing prevention programs cannot entirely prevent falls; instead, they must be managed. The main goal of implementing the fall prevention program is to ensure that patients build feelings of trust, confidence, safety, and security within their environments. When the patient is unafraid of his location, his brain changes and focuses on other issues; knowing they are safe and in control gives the older generation the strength to overcome their fears.
The increase in population-based health management requires the government to implement programs that require extra care linked to the patients and community-based care. Other than implementing a nurse program, fall patients need additional monitoring after falls to prevent more, which may lead to fractures. Nurses should identify critical factors that may be implemented in the healthcare system to help reduce the number of patients who suffer from fall injuries.
We found that programs sponsored by primary care providers (PCPs) or specialists may help with recruitment into exercise programs. PCPs have the opportunity to identify people at risk and promote participation since most older adults regularly visit and inquire about exercise from their physicians. Regarding referral options, both home-based and group-based exercise programs are effective in preventing falls; however, each approach has strengths and limitations.
According to Bernocchi et al. (2019), research indicates that primary care providers (PCPs)- )-sponsored programs help encourage the older generation to participate in exercises. Regular exercises help develop muscles, allowing the brain to be altered and engaged at all times. Through PCPs, caregivers can quickly identify patients with a risk of falling, enabling administering help before any injuries occur.
While the number of aging people in both America and Britain is increasing, clinicians need to adapt to the clinical fall prevention program. However, according to research studies, most clinicians need to gain the knowledge to administer the program to the patients. Most caregivers have been recorded to have minimal or zero understanding of how to assist care to fall victims. Another social problem identified is the scarcity of caregivers who can help solve the problem. Therefore, to help provide basic knowledge on how to care for fall patients, the Center for Disease Control and Prevention (CDC) established STEADI (Stopping Elderly Accidents, Death, and Injuries) initiative. The initiative helps healthcare facility members know how to care for fallen patients in any circumstance.
However, the continuity of providing care even after patients have been discharged is crucial in the healing process. It enables the nurses to monitor the patients while counter-checking the factors that led to their falls within their environments. Also, rehabilitation allows the patients to be more assertive and confident that they can do things for themselves no matter what.
While healing falls tends to be a severe challenge among older adults, implementing the routine prevention program enables the healing process due to the brain trigger and behavior of the patient towards healing. Influencing patients’ cognitive thinking while undergoing treatment activates the healing process. A research study indicated that the prevalence of falls resulted from chronic health, memory disparities, health conditions, and low muscle structures to support a patient. However, dealing with and implementing both the prevention program and routine program helps in the healing process.
The outcome of the care influences the fall program provided by nurses. It determines the ratio of nurses and the quality of care they can give to fall patients. Implementing the fall program treatment is essential to the older generation, especially within the first three months of receiving treatment. Falls fractures can accelerate their healing process because the tissues of older adults take time to heal. Therefore, nurses need to plan the treatment program, implement and evaluate the interventions that will be made for a patient to recover fully, and ensure they are not at risk of falling again.
In conclusion, we have identified that applying the fall prevention program’s routine is more effective than implementing the fall prevention programs developed by nurses. While both strategies aim at helping fall injury patients, there is a need to understand the behaviors, attitudes, and what triggers the patients to fall. Understanding how the brain functions and how it affects patients during a fall allows nurses to work on the factors of dealing with the fall itself. Also, by understanding the fall factors that trigger falls, the patient can efficiently work on their fears and build strength within themselves.
References
Bernocchi, P., Giordano, A., Pintavalle, G., Galli, T., Spoglia, E. B., Baratti, D., & Scalvini, S. (2019). Feasibility and clinical efficacy of a multidisciplinary Home-Telehealth program to prevent falls in older adults: a randomized controlled trial. Journal of the American Medical Directors Association, 20(3), 340–346. https://doi.org/10.1016/j.jamda.2018.09.003
Giovannini, S., Brau, F., Galluzzo, V., Santagada, D. A., Loreti, C., Biscotti, L., … & Bernabei, R. (2022). Falls among older adults: Screening, identification, rehabilitation, and management. Applied Sciences, 12(15), 7934.
Ojo, E. O., & Thiamwong, L. (2022). Effects of nurse-led fall prevention programs for older adults: a systematic review. Pacific Rim international journal of nursing research, 26(3), 417.
Rocha, P., Baixinho, C. L., Marques, A., & Henriques, M. A. (2023). Safety-promoting interventions for the older person with hip fracture on returning home: A systematic review. International Journal of Orthopaedic and Trauma Nursing, 101063.
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