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Review of the Literature A study conducted by Neyens, et al (2009) evaluated the effectiveness of a multi-factorial intervention on the incidence of falls in psycho-geriatric nursing home patients. The study was conducted on one psycho-geriatric ward in 12 nursing homes in The Netherlands. Six nursing homes were allocated to the intervention group and six to the control group. The study reported that multi-factorial interventions to prevent falls that includes a general medical assessment focusing on falls; a specific fall risk evaluation tool; assessing fall history, medication intake, and mobility; and the use of assistive and protective aids have significantly reduced the incidence of falls. The researchers concluded that fall prevention targeted at psycho-geriatric patients in a nursing home setting is both possible and effective in reducing falls among those at the highest risk. Kato, et al. (2008) conducted a study to develop a fall prevention program for elderly patients in long-term care facilities who are at risk for falls by increasing the care giving skills and the motivation of the staff members. Exercise program consisting of a warm-up, static stretching, muscle strengthening in the lower extremities, toe exercises, proprioceptive neuromuscular facilitation, and cool-down were used to increase motivation and increase the care-giving skills. The results of the study concluded that the fall prevention program helped to reduce injuries from 41.9% to 9.7% among the elderly participants while increasing the emotional support and self-efficacy among the staff members. Empowerment was considered a driving force for change. The fall prevention program demonstrated to be acceptable for use among elderly individuals in a long-term care facility. A study conducted by Sherrington, Whitney, Lord, Herbert, Cumming, & Close (2008) examined the effects of exercise on fall prevention in the elderly worldwide. This systematic review of 44 trials with 9,603 participants revealed that the pooled estimate of the effect of exercise was that it reduced the rate of falling by 17%. The researchers concluded that this review provides strong evidence that exercise programs can reduce fall rates in older people. The sample size and astute methodology of this study provides confidence that these findings and may be generalizable to the larger population of elderly in long-term care facilities. A study conducted by Wiens (2001) examined the role of the pharmacist in falls prevention in the elderly. The report concluded that the incidence and risks for falls could be decreased through interventions that include medication review with appropriate modifications to the elderly client’s medication regimen. Wiens explained that while there is not strong evidence for a pharmacist independently intervening to reduce falls, there is support for a pharmacist participating on a multidisciplinary team to review medications, provide appropriate suggestions to reduce high-risk medications, and provide education to the patient and the health care. Hartikainem, Lonnroos & Louhivuori (2007) conducted a study to determine whether medication was a risk factor for falls. The study concluded that central nervous system drugs, especially psychotropics, seemed to be associated with an increased risk for falls. The researchers found that older adults taking more than three or four medications were at increased risk of recurrent falls. However, the studies included in the meta-analyses had minimal adjustment for confounding factors such as an underlying indication for drug use, dosage, or duration of pharmacotherapy. Koski, Luukinen, Laippala & Kivela (1996) conducted a study to determine the physiological factors and medications predicting injurious falls among the elderly population in a rural home-dwelling population. The study showed some physiological factors and the use of some medications to be important risk factors. According to the study, lower-extremity muscle weakness, peripheral neuropathy, lower pulmonary capacity, difficulties in gait and use of long acting benzodiazepines and cardiovascular medications were the most important risk factors for injurious falls. The researchers found that the majority of injurious falls occurred when walking or taking a seat. Thus, training of lower extremities and supervised walking could be an effective nursing intervention for elderly clients.
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Relationships among the Elderly: The Effects on One’s Health and Psychosocial Well Being
Advances in medicine are allowing many adults to live longer lives than previous generations. In fact, the elderly population is becoming one of the largest growing sectors of the present ...
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Nurse’s Legal Plight
A poem...!
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Looks Can Be Deceiving
I asked his family to step out for a moment so I could empty his JP drains. I emptied them into a basin and I noticed that they were very dark. I inspected them a little closer and I noticed it had a ...
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Culturally Competent Nursing in Homecare
Homecare nurses must be culturally aware in order to appropriately care for homecare patients. Culture plays a part in the care of all types of patients but it plays a more important role in homecare.
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The Importance of Supporting Mothers Who Breastfeed
There are many health benefits to breastfeeding children such as lower mortality rates, ideal nutritional values, and long term benefits such as healthy weights and higher intelligence later in life. ...
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Maximizing Pain Relief in Pediatric Patients
Pain management is a complex issue that has become increasingly significant in the nursing profession; so much so that the assessment of pain has become known as the fifth vital sign. This issue ...
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TO GOWN OR NOT TO GOWN?
The Center for Disease Control (CDC) states that standard precautions should be used for all patients and should be enough to prevent the spread of most MRSA cases. However, in acute-care settings ...
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Family Presence During CPR in the Emergency Department
A descriptive survey conducted in 2000 (Myers, et al 2000) investigated attitudes and beliefs of patients’ families and ER staff members about FWR. The survey reported that 98% of patients’ ...
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Keeping a Positive Outlook: My Clinical Experience as a Student Nurse
My experience in my senior year clinical preceptorship was without a doubt unique but I feel its uniqueness was in what I made of it, something every nursing student can do for themselves. If there ...
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Managing Diabetic Patients on Dialysis: The Nurse and Practitioners Role in Multidisciplinary Team Essentials
The chronic state of diabetes mellitus (DM) mainly type II, is an increasingly common cause of end stage renal disease (ESRD) in all countries, accounting for 51% of dialysis patients in the U.S. and ...
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A Solution for Solving the Nursing Shortage? Advantages and Disadvantages of Recruitment of Foreign-Trained Nurses
The Nursing shortage is not only an American dilemma but a phenomenon threatening the entire global community. Developed, as well as undeveloped, countries are experiencing an increasing number of ...
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Memories from a Haitian Cholera Treatment Center
In January and February of this year I worked in Haiti with United States NDMS DMAT and ImSurt teams providing medical and surgical care to the victims of the January 12th earthquake. What I ...
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