Fall Prevention In Nursing: A Literature Review Essay.

You are required to choose a nursing issue (Fall prevention) that is related to one of the key safety and quality in health care areas from the list below* and then research the issue.

You need to locate three peer reviewed articles/studies related to the issue you have chosen and summarise, analyse and critique the literature related to this issue.

1) Quantitative study
2) Qualitative study
3) Secondary resource ( systematic literature review)

The purpose of the assignment is to research about a nursing issue that is associated with the fact of safety of the patients and quality of service of health care organizations. In this regards the study has chosen fall prevention as the research topic. It has been found that risk of fall in older people has become one of the major concern for the nursing care as it has strong impact on the health and well-being of older people. It could lead to serious injuries and could challenge the medical team regarding the recovery. Thus, it is important to identify effective fall prevention interventions to reduce the risk of fall and ensure the health and safety of the older adults (Robins et al. 2016). Due to such complication such topic has been chosen for the assignment. The following paper will provide brief discussion regarding three relevant articles about fall prevention to evaluate the findings and effectiveness of interventions provided by the literatures.  

In order to critical appraisal of the literatures selected for the study the CASP checklist has been used. It is the most effective tool that provides adequate measures to ensure the effectiveness of the studies. Different tools such as CASP checklist for qualitative study, RCT for quantitative study and systemic review have been used. It would help to measure the research evidences and use those in practice (casp-uk.net 2018).

The study provided by Shier, Trieu and Ganz (2016) aimed to identify the implications for promotion of fall prevention programs available in the healthcare system. In this regards the researchers have used systemic review in order to review the previous literatures on effectiveness of fall prevention program in the health care settings and address the objective of the research in an effective manner. The study has used findings of seven systematic studies including 128 relevant literatures. However, only 29 literatures met the inclusion criteria of the research. The study has used current literatures and represented the result in precise manner that has helped the readers to understand its content. Thus it can be said that the study has used relevant literatures and assessed them properly to identify the findings and address the research question effectively (Casp-uk.net 2018).

In contrast the research approached by Robins et al. (2016) has provided clear aim of the research that is to describe the reason for the using home based or group based fall prevention exercise by older adults and benefits and limitation in participation. In this regards the study has collected data from telephone survey. 13164 telephone numbers have been selected randomly and from Victorian electronic residential telephone listings. It can be said that the study has used appropriate methodology, described the recruitment process of the participants and the study has answered the research question effectively. Statement of findings has been provided. Ethical consideration has been taken from Monash University Human Research Ethics Committee. However, the study has used survey over phone that has increased the risk of biasness and it reduces the rate of generalizability of the findings (Casp-uk.net 2018).

Analysis of the articles

The study of Clemson et al. (2012) has focused to a specific issue that is the effectiveness of lifestyle integrated approach in strengthening the training to reduce risk of falls at home. In the research the researchers have used randomised parallel trials and it has been performed in three sets such as during baseline, after 6 months and after 12 months. A computer based random block has been used to randomise the trial and the result was stored with the help of secure website. People aged 70 years old have been recruited from metropolitan Sydney for the study. 3 effective interventions have been provided to the participants such as life integrated functional exercise, structured program for balancing and strengthen lower limb and sham control program. Prevalence of fall has been taken into consider to measure the primary outcomes and strength and balance have been considered for measuring secondary outcomes. Thus it can be said that the study has recruited the participants effectively and the groups were treated equally, interventions were effective and result was précised. The main strength of the study was its level of generalizability. The study has recruited the control group for less time thus, caution of interpretation and risk of biasness has been identified as limitations of the study (Casp-uk.net 2018).

However from the above methodology and study design, the design used by Clemson et al. (2012) is most effective as it has used proper quantitative study and represented the data with appropriate statistical analysis. Hence, it becomes easy to apply the result in the local population.

The findings of Shier, Trieu and Ganz (2016) have indicated that the fall prevention strategy such as exercise is the most helpful for frail older people as it helps to improve the balance and strength.  In addition the study has informed that population based program need to be implemented to increase the contribution of patients in community programs. On the other hand findings of Robins et al. (2016) have indicated that 23 to 39% respondents have participated in such exercise program because of effective improvement in health. 13 to 19% respondents have participated due to the recommendation of health professional. Interest in participation due to social interaction has been reported by 41 to 67% respondents. Participation in exercise program in order to start rehabilitation has been mentioned by 46 to 63% respondents. However, some respondents have indicated lack of interest due to not liking groups. From such result it has been conclude that home or group based interventions for reducing the risk of fall is effective with the assistance of health professional. Clemson et al. (2012) have identified that risk of fall has been found 1.66/ person in LiFE and 1.90 in structured program. In contrast it was 2.28 in control group. Thus, reduction in incident of fall has been found through the intervention and LiFE program has been identified as the most effective program.

References:

Casp-uk.net 2018. [online] Available at: https://casp-uk.net/wp-content/uploads/2018/01/CASP-Systematic-Review-Checklist.pdf [Accessed 3 Sep. 2018].

casp-uk.net 2018. CASP - Critical Appraisal Skills Programme. CASP Checklists - CASP - Critical Appraisal Skills Programme. [online] Available at: https://casp-uk.net/casp-tools-checklists/ [Accessed 3 Sep. 2018].

Casp-uk.net. (2018). [online] Available at: https://casp-uk.net/wp-content/uploads/2018/01/CASP-Qualitative-Checklist.pdf [Accessed 3 Sep. 2018].

Casp-uk.net. (2018). [online] Available at: https://casp-uk.net/wp-content/uploads/2018/01/CASP-Randomised-Controlled-Trial-Checklist.pdf [Accessed 3 Sep. 2018].

Clemson, L., Fiatarone Singh, M., Bundy, A., Cumming, R., Manollaras, K., O'Loughlin, P. and Black, D. 2012. Integration of balance and strength training into daily life activity to reduce rate of falls in older people (the LiFE study): randomised parallel trial. BMJ, 345(aug07 1), pp.e4547-e4547.

Robins, L. M., Hill, K. D., Day, L., Clemson, L., Finch, C., and Haines, T. 2016. Older Adult Perceptions of Participation in Group- and Home-Based Falls Prevention Exercise. Journal of Aging and Physical Activity, 24(3), 350–362. doi:10.1123/japa.2015-0133.

Shier, V., Trieu, E. and Ganz, D. 2016. Implementing exercise programs to prevent falls: systematic descriptive review. Injury Epidemiology, 3(1).