Literature Evaluation Table
Student Name:
Summary of Clinical Issue (200-250 words): Monitoring Falls among Elderly Patients in Nursing Homes
Falls among elderly patients are common in healthcare facilities, especially in nursing homes. Falls among the elderly are said to be prevalent in nursing homes since most patients in these facilities are the elderly and people living with disabilities. There are several aspects that contribute to falls among elderly patients, where some of them include the medications used and their health conditions. Individuals who experience fall are said to develop several health issues, including bone fractures and physical injuries. Under some circumstances, an elderly may lose his or her life depending on the severity of falls experienced. However, falls are among the issues that can be prevented, especially by different nursing interventions applied. Some interventions may include educating patients to engage in physical exercises, use of medications, and frequent monitoring. Among these interventions, the one that is considered more effective in preventing falls is monitoring, whereby the nurses frequently watch over the patient. The more frequent the monitoring, the higher the risk of reducing falls. However, it is necessary to review literature from different articles to understand whether monitoring can reduce patient falls, especially among the elderly. Therefore, a PICOT question has been created to guide the relationship between monitoring and the frequency of falls.
PICOT Question: Do elderly patients (P) monitored by nurses (I) on an hourly basis compared to monitoring after six hours (C) reduce their risk of falls (O) during their stay (T) in nursing homes?
Criteria
Article 1
Article 2
Article 3
APA-Formatted Article Citation with Permalink
Citation: Westerlind, B., Östgren, C. J., Mölstad, S., Midlöv, P., & Hägg, S. (2019). Use of non-benzodiazepine hypnotics is associated with falls in nursing home residents: a longitudinal cohort study. Aging clinical and experimental research, 31(8), 1087-1095.
Permalink: https://doi.org/10.1007/s40520-018-1056-0
Citation: Toots, A., Wiklund, R., Littbrand, H., Nordin, E., Nordström, P., Lundin-Olsson, L., … & Rosendahl, E. (2019). The effects of exercise on falls in older people with dementia living in nursing homes: a randomized controlled trial. Journal of the American Medical Directors Association, 20(7), 835-842.
Permalink: https://doi.org/10.1016/j.jamda.2018.10.009
Citation: Hanlon, J. T., Zhao, X., Naples, J. G., Aspinall, S. L., Perera, S., Nace, D. A., … & Thorpe, C. T. (2017). Central nervous system medication burden and serious falls in older nursing home residents. Journal of the American Geriatrics Society, 65(6), 1183-1189.
Permalink: https://doi.org/10.1111/jgs.14759
How Does the Article Relate to the PICOT Question?
The article is related to the PICOT since it shows one of the causes of falls that need to be monitored.
The article is related to the PICOT question since it shows how exercise is related to falls and how it affects different genders.
The article is related to the PICOT questions since it assists in determining whether patients using central nervous system medications should be monitored.
Quantitative, Qualitative (How do you know?)
Quantitative: Numbers and statistics are highly applied
Quantitative: Tables were used to compare the data obtained from the participants
Quantitative: numbers, statistics, and tables have been highly used in the article for data comparisons.
Purpose Statement
To find out the relationship between various drugs and fall among the elderly in nursing homes
To understand how exercises among the elderly are associated with falls and whether the risk of falls varies among different genders
To find out the relationship between CNS medication use among the elderly and their risk of falls.
Research Question
Does the use of certain drugs increase the risk of falls among the elder?
How does engaging in exercise affect falls among the elderly, and does the falls vary among different gender?
Is there a relationship between CNS medication use among the elderly and their risk of falls?
Outcome
The study showed that 93% of the patients who used non-benzodiazepine hypnotics were at risk of falling due to their reduced brain activity after using the medications.
Most men who engaged in physical exercises had a low risk of falls compared to men who did not. Men were at a higher risk of falls compared to women.
The participants who were using CNS medication were found to be at a high risk of experiencing severe falls
Setting
(Where did the study take place?)
The study took place in Sweden nursing homes.
The study was conducted in Umea, Sweden, nursing homes.
The study took place in unidentified nursing homes in the United States
Sample
There were 331 elderly patients who were obtained from 12 different nursing homes.
There were 45 men and 141 women involved in the study as participants
There were 5,556 elderly patients from various U.S. nursing homes who were involved in the study as participants.
Method
Purposive sampling
A cluster-randomized controlled trial
Nested-case control study
Key Findings of the Study
Non-benzodiazepine hypnotics are highly associated with falls, especially among the elderly, since the patients who used the medication were at a high risk of falls compared to their counterparts.
Men are more likely to fall compared to women. Besides, exercise reduces the risk of patients to falls.
Elderly patients who use CNS medications are highly likely to experience serious falls.
Recommendations of the Researcher
Older adults who use non-benzodiazepine hypnotics should be monitored regularly to prevent them from falling.
Older adult men should be monitored more frequently compared to women. The elderly patients with a history of engaging in exercises should be less monitored compared to their counterparts.
Elderly patients in various healthcare facilities who use CNS medications should be closely monitored to reduce their risk of falls.
Criteria
Article 4
Article 5
Article 6
APA-Formatted Article Citation with Permalink
Citation: Øygard, S. H., Andersen, J. R., Sandvoll, A. M., & Ytrehus, S. (2017). Deficient reporting of falls in nursing homes. Peer-Reviewed Research.
Permalink: https://sykepleien.no/sites/default/files/pdf-export/pdf-export-63464.pdf
Citation: Bor, A., Matuz, M., Csatordai, M., Szalai, G., Bálint, A., Benk, R., … & Doró, P. (2017). Medication use and risk of falls among nursing home residents: a retrospective cohort study. International journal of clinical pharmacy, 39(2), 408.
Permalink: https://doi.org/10.1007/s11096-017-0426-6
Citation: Sterke, C. S., Panneman, M. J., Erasmus, V., Polinder, S., & Van Beeck, E. F. (2018). Increased care demand and medical costs after falls in nursing homes: a Delphi study. Journal of clinical nursing, 27(13-14), 2896-2903.
Permalink: https://doi.org/10.1111/jocn.14488
How Does the Article Relate to the PICOT Question?
The article relates to the PICOT question since it involves the documentation on how nurses monitor patients to prevent their risk of falls
The article is related to the PICOT since it shows how medications use is associated with falls and whether monitoring is necessary.
The article relates to the PICOT questions since it indicates whether monitoring among the elderly increases after experiencing falls in nursing homes.
Quantitative, Qualitative (How do you know?)
Qualitative: Words and explanations are highly used rather than numbers and statistics.
Qualitative: Words and explanations are highly used rather than numbers and statistics.
Qualitative: Words and explanations are highly used rather than numbers and statistics.
Purpose Statement
To find out whether nurses documents how they monitor elderly patients from falls during their stay in nursing homes.
To find out the relationship between medication use and fall among the elderly in nursing homes
To determine whether medication costs and nursing care increase after an individual experiences falls.
Research Question
Do nurses document how they monitor elderly patients from falls during their stay in nursing homes?
Does the use of medications increase the risk of falls among the elder?
Do medication costs and nursing care increase after an individual experience falls?
Outcome
There is a significant difference between the falls experienced among the elderly in the identified nursing homes and those that were documented.
Falls among the participants varied based on the medication used as some medications improved falls while others increased fall risks.
Patients who experienced falls paid high medical costs due to their long stay in the facility, and they require more nursing care compared to their counterparts.
Setting
(Where did the study take place?)
The study was conducted in Norway nursing homes.
The study was performed in nursing Szeged, Hungary nursing homes.
The study was conducted in Netherland’s nursing homes.
Sample
There was a total of 652 participants involved in the study.
A total of 197 elderly patients in nursing homes were considered as participants, whereby women were 150 and men were 47.
A group of 41 panelists working in various nursing homes in the Netherlands were involved in the study as participants.
Method
A retrospective descriptive method
A retrospective epidemiological method
A three‐round Delphi method
Key Findings of the Study
Nurses rarely document the actual cases of falls among the elderly in various nursing homes.
Some medications increase the risk of falls while others do not.
Patients who experience falls are likely to pay high medical costs due to their longer stay in the facility, and they may require more nursing care compared to their counterparts.
Recommendations of the Researcher
Nurses should always document the actual number of falls experienced in nursing homes to understand how frequent monitoring should be done.
Nurses should monitor patients based on the type of medications they use. Patients who use medications that increase the risk of falls should be monitored closely compared to those who use medications to improve falls.
Nurses should monitor patients with a history of falls more than how they monitor those who have never experienced alls.
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