INTRODUCTION TO NURSING RESEARCH

 The study findings

The findings show that bone mineral-enhancing agents can be used in a hospital setting as a means of preventing fall-related injuries among the elderly. That means that the nurses and physician should prescribe their elderly patients calcium and vitamin D supplements. A study by Bischoff-Ferrari et al., 2005 showed that low doses of calcium were not effective, while studies are enabling the elderly to take calcium supplements in higher doses less suffered from falls. Also, studies providing the elderly participants with a variety of vitamin D supplements as a strategy to achieve at least 1,000 I/U per day was found to be an effective strategy for the prevention of falls. Thus health care providers should work towards improving the mineral density of the elderly through providing them with vitamin D as well as calcium supplements. Vitamin D supplements improve the muscle balance and strength.

 The study also indicates that health care providers should use hip protectors since they are effective at secondary prevention of fall-related fractures. Health care providers, therefore, have to be compliant in the use of these devices. Also, the study indicates that balance and strength training are also essential strategies that healthcare providers can use to decrease fall-related injuries among the elderly. When the elderly are provided with exercises sessions, their likelihood of falling is decreased considerably. Exercises and strength activities will help the elderly to improve their general health and also increase their bone density which all help to decrease the likelihood of decreasing injury.

 Also, the environmental modification has to be the priority for health care providers providing care to the elderly. The providers should do all things possible to reduce environmental hazards as an intervention for prevention of falls among the elderly. The study also indicates that though the screening of risk factors may not be a direct intervention for falls prevention among the elderly, it is still an essential requirement that health care providers should do to help those at risk from falling. The healthcare providers should, therefore, adopt the screening as a means of identifying the higher-risk individuals. For example, through screening will help healthcare providers to know the elderly patients with visual impairments as well as those with balance deficits. Providers should also know that through limiting of medications, it may cause patients to have altered strength. Also treating conditions such as nocturia may be a cause of night falls which are some of the potential strategies for reducing injuries related to falls. Another environmental modification involves creating spacious hallways, not using slippery floors and clutter removal among others.

The findings of the study show strong support of risk stratification with comprehensive, targeted risk reduction strategies that are tailored to fit the need of the specified high-risk groups. Though mixed strategies help in decreasing injuries related to falls among the elderly, the results are hindered by heterogeneity such as different variable sample sizes, different medication dosages and adherence of a patient. The most favorable studies have been conducted by in healthcare systems that have a central payer and universal access. For the case of alternative health care systems also known as the fee-for-service - system, there will need to assess the effectiveness of such comprehensive strategies.

Health care providers including the clinical and not clinical staff need to communicate this safety intervention that helps in preventing of falls among the elderly population. They have to incorporate these safety precautions as part of the continuum of [patient education and care. The care providers are also expected to apply the change management principles as well as tools for setting strategies for success and enabling changes to be done easily. Health care leaders are also expected to empower staff and ensure that they take accountability. The hospital leaders should also provide staff members with support and commitment towards a sustainable improvement.. as part of support to a robust change management effort, leaders in a health care setting are expected to empower an executive sponsor to ensure adequate resources and equipment. Leaders are also expected to ensure that there is enough number of staff and also the preventive devices such as alarms and having a clinical champion who facilitates staff and stakeholders’ receptivity to requests made by patients in need of assistance.

 Hospital leaders should form an interdisciplinary falls injury prevention team to ensure that the infrastructure and capacity of the organization are capable of reducing injury risk from falls. That means that every worker of the organization has the responsibility of reducing falls, including the patient advocacy, nurses, physicians, pharmacy, information technology, occupational and physical therapists, the risk management and quality team and other vital stakeholders. Finally, the healthcare providers should use a validated and standardized tool to identify the risk factors of falls. The preferable one is the integrated care system that is part of the electronic medical record. The leaders should finally provide staff with training on using the validated tool to ensure inter-rater reliability. 

References

 Guyatt GH, Oxman AD, Vist GE, Kunz R, Falck-Ytter Y, Alonso-Coello P, Schu¨nemann HJ; GRADE Working Group. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008;336(7650):924Y926.

 Drahota AK, Ward D, Udell JE, Soilemezi D, Ogollah R, Higgins B, Dean TP, Severs M. Pilot cluster randomised controlled trial of flooring to reduce injuries from falls in wards for older people. Age Ageing. 2013;42(5):633Y640.

Sawka AM, Ismaila N, Cranney A, Thabane L, Kastner M, Gafni A, Woodhouse LJ, Crilly R, Cheung AM, Adachi JD, et al. A scoping review of strategies for the prevention of hip fracture in elderly nursing home residents. PLoS One. 2010;5(3):e9515.

 Kiel DP, Magaziner J, Zimmerman S, Ball L, Barton BA, Brown KM, Stone JP, Dewkett D, Birge SJ. Efficacy of a hip protector to prevent hip fracture in nursing home residents: the HIP PRO randomized controlled trial. JAMA. 2007;298(4):413Y422.

  Koike T, Orito Y, Toyoda H, Tada M, Sugama R, Hoshino M, Nakao Y, Kobayashi S, Kondo K, Hirota Y, Takaoka K. External hip protectors are effective for the elderly with higher-than-average risk factors for hip fractures. Osteoporos Int. 2009;20(9)

Sherry Roberts is the author of this paper. A senior editor at MeldaResearch.Com in urgent custom research papers. If you need a similar paper you can place your order from nursing school papers services.