Preventing Falls in Elderly Patients Timelisa Smith MSN-DE Herzing University NSG 660-7B Scholarly Practice Dr. Sheri Byrnes June 24, 2024

[Virtual Presenter] Hello everyone, my name is Timelisa Smith. Welcome to my presentation of Preventing Falls in Elderly Patients..

[Audio] The agenda for this presentation includes answering my PICOT question, discussing a mixed research study and two qualitative research studies. I will also discuss the potential changes to implement after reviewing the findings. Additional topics include areas of opportunity for future research, next steps, and the conclusion..

[Audio] Fall prevention among the elderly is important for patient safety. Identifying ways to prevent falls is a topic worth researching and implementing the findings into clinical practice..

[Audio] Today, I will address the PICOT question, How do we decrease falls in elderly patients aged 65 and up using improved fall prevention programming versus traditional fall prevention programming over the course of a year? The next couple of slides will break down each step and lead into content from the research studies..

[Audio] Addressing the correct target population allows insight into the appropriate risk factors and needs when identifying the appropriate solution for a problem. For the elderly population ages 65 and up, they need multiple interventions to reduce fall risk due to their age declining function. With traditional fall programs, there are still millions of falls occurring in the elderly population annually. Health concerns, vision wear, assistive devices, home modification, financial resources and more are important when considering interventions to prevent falls..

[Audio] Utilizing a multifactorial fall prevention program to address the numerous underlying reasons that patients falls is successful. Some of the interventions include assessing the target population for gait and balance, managing fractures and osteoporosis. Conducting a medication review. Promoting exercise, vision and footwear correction. Cardiovascular interventions such as taking blood pressure medication that cause drowsiness at night is also effective in reducing falls..

[Audio] In clinical practice, there are fall prevention strategies currently in effect. With the number of falls still occurring on an annual basis, additional interventions are needed. Traditional fall prevention programs focus on changing staff behaviors and ward risk minimization practices. Nurse education received during patient discharge to prevent falls still result in millions of falls annually. The goal is to empower the elderly through multifactorial interventions which include medication management, exercise promotion, and many more strategies that further decrease patient falls..

[Audio] Research findings show whether the outcome of the intervention produces a certain result. The outcome of the studies reviewed reveal decreased falls among the elderly population after the implementation of a multifactorial fall prevention strategies..

[Audio] All the research studies had varying completion time. When implementing a multi-factorial fall prevention program into clinical practice, the time frame of a year may be appropriate. This provides time for the elderly population to complete an annual wellness exam. Additionally, the primary provider may involve multiple referral sources to assist in carrying out different parts of the program. It takes time for modification of exercise to produce results that are assist in fall prevention. New bathroom modifications may be needed as well..

[Audio] A systematic review of 198 recommendations across 15 selected guidelines recommended fall risk stratification, assessment tools, fractures or osteoporosis management, multifactorial intervention, medication review, exercise, physiotherapy referral, environment modification vision, footwear and cardiovascular interventions. Search strategy. I used Proquest. In the query box, I keyed in fall prevention program which yielded thousands of results. I refined the results using date to reduce the results. I selected qualitative research that was most current and addressed the PICOT question..

[Audio] Racine and fellow researchers address older people attending community based multifactorial fall risk assessment clinics. The conclusion of the study is that "multifactorial falls risk assessments reduce the rate of falls in older people. In ProQuest, I search multifactorial fall risk prevention; qualitative study. The study conducted by Racine et al., was one of the studies that I chose after reading the.

[Audio] The qualitative study identified facilitators and barriers for older adults at risk of falling. Self efficacy is a barrier. Once elderly people are given tools to become independent such as exercise programs, home modifications and other tools the likelihood of falling decreases..

[Audio] The results of the research is addressing multiple factors that cause falls is more effective than brief education received in primary care or at discharge. Coordinating care amongst multiple individuals produce success. The change that is needed is transitioning to one health care software and creating a page where a multifactorial fall assessment tool is utilized each year at the annual wellness visit by the primary care physician, during a hospital event by the attending nurse, and every 6 months by the nurse or social worker, if the person is receiving home health services. This will reduce the number of falls in the elderly population..

[Audio] Using a digital device like a phone, Fitbit or Apple Watch as a reminder for the elderly population. It can remind them of times to take medication that causes drowsiness, when to exercise and what type of exercises to complete and appointments to make for eye exams, and wellness opportunities..

Next Steps. The next steps for implementing research is to take research to the appropriate committee at the workplace for consideration. Additionally, a nurse may attend nursing conferences to learn more about ways to implement evidence-based research into clinical practice..

[Audio] In conclusion, the research that I had the opportunity to review all emphasize a multifactorial approach in reducing falls. Currently, there are reminders in patient rooms and education is given at discharge or admission that caution against falls. Including interventions such as Assess for gait and balance. Manage fractures and osteoporosis, Conduct a medication review, Promote exercise, Vision and footwear correction, Physiotherapy and Cardiovascular Interventions, Works more effectively to reduce falls. Adding a digital component is another intervention worth further exploration. Attending continuing education on how to implement evidence-based practices is can only enhance a nurses' critical thinking skills..

17. Racine E, Soye A, Barry P, et al. (2020). ‘I’ve always done what I was told by the medical people’: a qualitative study of the reasons why older adults attends multifactorial falls risk assessments mapped to the Theoretical Domains Framework. BMJ. doi:10.1136/ bmjopen-2019-033069.

Thank you. User. Timelisa Smith. Envelope. [email protected].