Answer

Choi, Y., Lawler, E., Boenecke, C., Ponatoski, E., & Zimring, C. (2011). Developing a

multi-systemic fall prevention model, incorporating the physical environment, the care process, and technology: a systematic review. Journal Of Advanced Nursing, 67(12), 2501-2524. http://dx.doi.org/10.1111/j.1365-2648.2011.05672.x

The article reports the evaluation of the effectiveness and features of fall prevention plans used in hospitals. From the evidence, the authors created a multi-systemic prevention model that would establish a practical framework for prevention. References published between January 1990, and June 2009 were searched in databases and reviewed to identify the evidence that would be used in creating a fall prevention framework.

The article is useful in presenting the evidence-based practices that influence falling. Among them include technology, care process and culture, and the physical environment. The technology used is the assistive technology which helps prevent falls. These preventive measures can be utilized both at home and in hospitals and have a high level of effectiveness. However, despite the efficiency of environment related interventions, the review discovered that few hospitals have established such interventions. The nurse practitioners in their capacity to provide care can facilitate such interventions by arguing their importance. Since they are placed in a unique position to provide care, such suggestions can be more effective coming from them.

Although the model was created by the authors, they propose more test to determine efficacy. This admission is significant in allowing more research to be carried out on the same. Additionally, they recommend promotion of a practical strategy by hospitals that will enable them to benefit from collective effects of the three factors that influence falls.

Dykes, P., Carroll, D., McColgan, K., Hurley, A., Lipsitz, S., & Colombo, L. et al. (2010).

Scales for assessing self-efficacy of nurses and assistants for preventing falls. Journal Of Advanced Nursing, 67(2), 438-449. http://dx.doi.org/10.1111/j.1365-2648.2010.05501.x

The article focuses on the scales that would be adequate to provide an assessment of nurses and nurse assistants’ efficacy in preventing falls. Four phases were used to develop individual items from eight focus groups, developed prototype scales, determine the content validity and conduct test to refine and confirm the scales. The data was performed from February to December 2008.

Using scales would help in assisting nurse to gauge their efficacy in preventing falls even when using assistive technology. Such a novel system would work towards the improvement of fall prevention especially in the elderly where the occurrence of falls is high. The scale measures performance based on actions the nurse takes to prevent falls. This aspect renders the scale appropriate for the use of assistive technology as the nurse is the principal caregiver to elderly patients in a hospital setting. The scale can act to evaluate willingness to prevent falls and innovativeness in coming up with better ways to prevent such falls.

The article concludes with a recommendation for bedside nurses to use such scale in determining how efficient they are in preventing falls. Additionally, the scale proved to have psychometric adequacy and is, therefore, an accurate method of determining efficacy.

Powell-Cope, G., Quigley, P., Besterman-Dahan, K., Smith, M., Stewart, J., &

Melillo, C. et al. (2014). A Qualitative Understanding of Patient Falls in Inpatient Mental Health Units. Journal Of The American Psychiatric Nurses Association, 20(5), 328-339. http://dx.doi.org/10.1177/1078390314553269

The authors conducted research to determine how to encourage fall prevention in acute inpatient psychiatric care. It used 22 nurses, two physicians, and one physical therapist as the focus group. Interviews were conducted to analyze the attitude towards fall prevention and the prevention methods available. Fall risk assessment, clinical fall risk precautions, programs fall prevention, and selling of the prevention practices were the categories that the study tackled.  The study is important as there is a lack of availability of research based on prevention of falls in mental patients. Due to their particular needs, studies will ensure that nurses are provided with evidence-based practices to prevent falls.

The use of more nurses than psychiatrist and physician indicates the importance of nurses in fall prevention. The study determined the willingness of the participants to learning new ways of fall prevention and found it profoundly present. Nurses are tasked with ensuring patient safety, and assistive technology is one of the means of preventing falls. With the study providing evidence of willingness to learn in the nurses, it is a significant step toward introducing assistive technology as a fall prevention method. Additionally, the commitment of the nurses to improving safety paves ways for the introduction and mainstream use of assistive technology. The sample size is however not sufficient to ensure generalizability of the study. A bigger sample group would have provided a better image of the results.  The willingness to learn prevention methods is also important as new and improved methods are continually being developed and as nurse practitioner knowledge of better prevention methods is an important aspect of fall prevention.

The article concludes with the success of selling fall injury prevention to psychiatry staff and equates the success to other health institutions. Patient safety and its importance act as a motivation for adoption of fall prevention practices.

Titler, M., Shever, L., Kanak, M., Picone, D., & Qin, R. (2011). Factors Associated

With Falls During Hospitalization in an Older Adult Population. Res Theory Nurs Prac, 25(2), 127-152. http://dx.doi.org/10.1891/1541-6577.25.2.127

The study conducted determined the factors that affected the occurrence of fall in hospitalized elderly men aged 60 and above. The aim was to identify if among those variables nursing intervention also played a role in the prevalence of the falls.

The study has attempted to explain the role of nurses in prevention and cause of falls in hospitalized elderly patients. After conducting research in 10,187 hospitalizations of 7,851 patients, aged 60 or older, admitted to acute care services over a 4-year period, the results indicated that in addition to the falls as a result of medical and pharmacy intervention, falls are also influenced by nursing intervention. The registered nurse skill mix inversely associated with falls while medications such as antidepressants increased the risk of falls.

The study is significant in indicating that if appropriate intervention methods are utilized, such falls could be controlled. This guarantee is of particular importance as the study provides the role of a nurse in prevention. Nursing practitioners are placed in a situation where they can introduce strategies based on evidence of variables that contribute to falls to reduce falls prevalence. Additionally, it shows that the correct skill mix of a registered nurse can make a significant contribution to fall reduction.  Furthermore, the study provides a range of factors that nurse in their capacity of ensuring safety can concentrate on to prevent falls.

The study concludes that an interdisciplinary effectiveness research is essential and should include nursing care. The factors that are associated with falls are nursing, pharmacy and medical interventions and the dose of nursing treatments and registered nurse skill mix.