Haines et al. (2011) conducted a randomized control trial (RCT) to ascertain the effectiveness of two types of multimedia patient education in preventing falls among elderly inpatients. The study consisted of three group RCT conducted on older hospital patients admitted to acute, and sub-acute hospital wards in two Australian hospitals. Blinded research assistants collected data on falls by reviewing the incident reports in the hospital and carrying out patient interviews. There was a significant association between the intervention and the existence of cognitive impairment. The authors concluded that the multimedia patient education programme with expert healthcare providers was effective in reducing falls among the hospitalized elderly.
The trial addressed the issue under consideration because the intervention, the study population, the comparator, and the outcomes are all identified and clearly explained (Haines et al., 2011, pp. 517). Additionally, the assignment of the patients to treatments was randomized by the use of random allocation sequence generated by the computer which was placed into opaque envelopes there were sequentially numbered. The trained health experts conducted baseline assessment and were not cognizant of the outcomes of the participant (Haines et al., 2011, pp. 519). The participant falls the primary outcome measure, and the meaning of a fall was derived from the World Health Organization (WHO, no date (n.d)). Data on falls was gathered from three sources and recorded regarding the rate of falls, the number of patients who fell once or more, and the frequency of fatal falls. The approximations of the impact of the patient education intervention were measured using adjusted risk ration at a confidence interval (CI) of 0.28-0.93, and in the control group, the CI was 0.24-0.78 both at 95%CI. The study outcomes are very much applicable to any local context because the participants included in the study are older adults who had experienced falls before. The study outcomes are worth the effort because they suggest that patient education is more effective in preventing fall injuries. This will ensure that the fall victims and families will be relieved of pain and stress in addition to minimizing treatment cost (Miake-Lye et al., 2013, pp. 393-394). Furthermore, the fact that the study results confirm previous studies (Cameron et al., 2012, pp. 176; Ang et al., 2011, no page (n.p)) assures the reliability of the findings.
Calhoun at al. (2011) carried out qualitative research on the perceptions of senior adults on clinical fall prevention strategies. The aim was to assess the factors that motivate and de-motivate them from engaging in prevention and fall risk evaluation programs. The authors conducted face-to-face interviews with 20 senior adults who had consented to the invitation for evaluation and 19 who had declined. The prevention programs among other areas were assessed. Those who had participated in the intervention expressed their need for the program whereas those who refused never saw the significance. Thus fall prevention strategies should first address the beliefs of each person in addition to social and structural aspects.
The objective of the study was clearly stated and its significance outlined under background information. A qualitative design was the most appropriate for the study because it is aimed at assessing the experiences of old patients who had fallen before. Turner III (2010, pp. 754-755) observes that qualitative studies are more effective when investigating actions or experiences of subjects. Purposeful stratified sampling was used and justified by the authors as the best in ensuring a sufficient balance of the study groups (Suri, 2011, pp. 4-5). The recruitment process fitted the objective of the study. The process of recruitment has clearly been highlighted (Calhoun at al., 2011, pp. 2) alongside the number of those who accepted to join the program and those who refused due to individual views and beliefs. Data collection was accomplished through interviews and the setting justified (Calhoun at al., 2011, pp. 2). Details on data collection such as the use of interview guide, verbatim transcription for recording, and the use of grounded theory approach in coding have all been elucidated and justified. The study has factored in ethical considerations. For instance, it was approved by the Institutional Review Board. However, there is no direct disclosure of informed consent obtained. Comparison analysis was carried out after coding to find out any differences or similarities (Kolb, 2012, pp. 83-84).
Balzer et al. (2012) carried out a systematic literature review on the prevention of falls among the elderly with an objective of determining the most effective strategy for prevention. The authors examine the Health Technology Assessment (HTA) report to provide relevant information for decision making and economic use of resources. The authors carried out searches in 31 databases restricting it to the article published between 2003 and 2010 January. 12,000 references were found, and only 184 met the inclusion criteria and were included in the analysis. Several interventions were identified and discussed in details.
The review did focus on the research question because the initial total number of searches and the corresponding references included in the study have been presented. Additionally, the outcomes were considered (Balzer et al., 2012, pp. 1). The appropriate type of studies was included in the review since out of the 12,000 references only 184 references were reviewed because they met the inclusion criteria and were relevant to the research questions. The study questions focused on the cost efficiency of the fall prevention strategies, their social, ethical and legal effects. The authors examined the rigor of the articles and reported that the validity of some of the articles was weak due to numerous bias factors. The outcomes have been displayed with similar outcomes being combined under the relevant theme of fall prevention strategy. Overall, the outcomes of the review show that exercise interventions are more effective in relatively senior people than in the fragile elders. Furthermore, the ethical analysis indicates that the implementation of specific prevention strategy depends on the varying views of the target population, whereas legal analysis poses the difficulty of uncertainty on which law to apply to which scenario. However, the outcomes may not be beneficial neither have the study provided a list of reviewed references, nor the findings have not been compared with other studies.
Ang, E., Mordiffi, S.Z. and Wong, H.B., 2011. Evaluating the use of a targeted multiple intervention strategy in reducing patient falls in an acute care hospital: a randomized controlled trial. Journal of advanced nursing, 67(9), pp.1984-1992.
Balzer, K., Bremer, M., Schramm, S., Lühmann, D. and Raspe, H., 2012. Falls prevention for the elderly. GMS health technology assessment, 8.
Calhoun, R., Meischke, H., Hammerback, K., Bohl, A., Poe, P., Williams, B. and Phelan, E.A., 2011. Older adults' perceptions of clinical fall prevention programs: A qualitative study. Journal of aging research, 2011.
Cameron, I.D.G.L., Gillespie, L., Robertson, C., Murray, G., Hill, K., Cumming, R. and Kerse, N., 2012. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane database of systematic reviews, 12, pp.CD005465-1.
Haines, T.P., Hill, A.M., Hill, K.D., McPhail, S., Oliver, D., Brauer, S., Hoffmann, T. and Beer, C., 2011. Patient education to prevent falls among older hospital inpatients: a randomized controlled trial. Archives of internal medicine, 171(6), pp.516-524.
Kolb, S.M., 2012. Grounded theory and the constant comparative method: Valid research strategies for educators. Journal of Emerging Trends in Educational Research and Policy Studies, 3(1), p.83.
Miake-Lye, I.M., Hempel, S., Ganz, D.A. and Shekelle, P.G., 2013. Inpatient fall prevention programs as a patient safety strategy: a systematic review. Annals of internal medicine, 158(5_Part_2), pp.390-396.
Suri, H., 2011. Purposeful sampling in qualitative research synthesis. Qualitative research journal, 11(2), pp.63-75.
Turner III, D.W., 2010. Qualitative interview design: A practical guide for novice investigators. The qualitative report, 15(3), pp.754-760.
World Health Organization, n.d. Violence and Injury Prevention. Viewed 28 October 2018, <https://www.who.int/violence_injury_prevention/other_injury/falls/en/ >.