THIS WEEK TASK REQUESTED
Write a literature review of your change project topic using peer-reviewed articles and books, as well as non-research literature such as evidence-based guidelines, toolkits, and standardized procedures. Identify and cite all sources of data according to APA guidelines. The goal is to review and critique the most current research to support your change project; this research will help drive the focus of your research. Summarize the key findings and provide a transition to the methods, intervention, or clinical protocol section of your final paper. Describe any gaps in knowledge that you found and the effects this may have on nursing practice as it relates to your change project topic. The literature review should be a synthesis of how each article relates to your change project. Also, when writing your literature review, remember to include subtopics to your main topic and gather data on these areas as well. For example, if you are doing a project on cancer, then subtopics for cancer treatments should be included.
Your integrative literature review should be at least 5 pages in length, not including the cover or reference pages, and must contain a minimum of 10 scholarly articles, published within the past 5 years.
Falls among the Elderly: Literature Review
The elderly population has been of concern in clinical practice following the number of falls that occur among the elderly while they are in the hospitals and primarily even outside the medical facilities and in their homes. The health of the elderly is one that is given priority due to their susceptibility to infection and other related consequences. In essence, the elderly have been victims of a number of accidents that would otherwise have been prevented and still influenced by a number of factors within their environment. Factors such as medication that is administered to the elderly may render some subconscious of their environment and any unauthorized movement may result in the elderly patients falling. In other cases, the texture of the ground is slippery and without due knowledge the elderly patients end up falling and in the process suffers more injuries. In this regard, there have been studies conducted on the impact of falls among the elderly alongside the causes and prevention measures that can be used and some that have been implemented for purposes of improving and reducing the rates of falls that occur unnoticeably among the elderly in the medical facilities.
The causes of falls among the elderly, the injuries experienced and the management of falls among the elderly is the primary focus of Abraham and Ciminio-Fiallos (2017) in their study on falls among the elderly. Based on the findings of their research, falls are the leading mechanism of injuries among the elderly. These falls have both mild and adverse impacts on the elderly in terms of injuries whereby, while some situations may result in minor bruises, other cases will be the source of fractures and intracranial injuries. The study further revealed that between 2006 and 2010, traumatic brain injury deaths that the elderly population faced was as a result of falls. While majority of the falls are preventable and can be managed, many of the elderly patients fail to let their physicians know about their falls thus creating a gap in their treatment in the event that the fall resulted in an underlying issue. The study further stipulates that in some cases, unavoidable factors such as age and a history of falls contribute significantly to the occurrence of falls among the elderly. In this directive, the authors blame lack of initiatives that are aimed to protect the wellbeing of the elderly patients to be factors that further contribute the problem.
Medical conditions such as hypertension, diabetes and impaired hearing have also been perceived to be additional contributors to the increased risk of falls among the elderly. This is based on a study conducted by James et al (2014) from the perspective of Jamaican elderly population. Primarily, while the study looks into the wider scope of falls among the elderly to include situations outside the medical facilities, the authors point out that medical conditions and the medication administered to the elderly increase the risk of falls as much of their cognitive and balance abilities become impaired from the use of strong medication and also due to their health conditions. The lack of awareness on the impact and risk of falls among the elderly as projected in the study reveals how little is known about the severity of the impact of falls among the elderly and thus, the lack of preventive measures and even necessary infrastructure such as rails to help in ensuring that the elderly have sufficient points of support to prevent the falls. In essence, the authors propose the necessity of conducting health education and promotion activities to advance more awareness on the risks and management of falls among the elderly.
Matters regarding the use of multiple medications and their effect on the stability and cognitive awareness of the elderly is deeply discussed by Maher, Hanlon and Hajjar (2014). Polypharmacy is defined as the use of multiple medications than is necessary. This is a clinical practice that is commonly extended towards the elderly as in most cases it is difficult to diagnose the specific condition that the elderly individuals are suffering from. This is such that, in most cases, the symptoms and signs that are displayed by the elderly can easily be confused with the effects of old age. Hence, prior to the determination of the actual condition to be treated, the elderly are usually dowsed in multiple medications. This practice consequently affects their ability to support themselves following the various side effects of the medications that they take. Primarily, from the negative consequences that arise from polypharmacy, the study suggests interventions that can reduce the risks and necessity of multiple medications being administered to the elderly. In essence, in working towards reducing polypharmacy, the elderly have the opportunity to reduce the rate of falls as experienced.
The position on the use of various medication and underlying health factors are supported by Alshammari et al (2018) in their study looking into the falls among the elderly and the relation these falls have to health factors and environmental factors with focus in Riyadh. The study takes on a cross-sectional analytical study and involved a total of 357 participants to the study. Subject to the approach duly used in the study, the outcomes revealed that underlying health factors and a history of falls contributed significantly to increased risks of falls among the elderly. However, the environment also played a significant role thus supporting other research that postulate that the environment is a factor that enhances the occurrence of falls among the elderly.
Pfortmueller et al. (2014) also look into the environmental factors with strong emphasis on how these contribute to falls among the elderly population. The environment, based on the study, is an area that enhances the occurrence of falls among the elderly leading to serious injuries and frequent hospitalization of the elderly. According to the study, the lack of consideration of the elderly population only serves to advance the negative consequences of falls on the wellbeing and health of the elderly. Further, Pfortmueller et al. (2014) acknowledge that the interventions and measures that have been put in place do not necessarily apply to all elderly persons as some of the interventions such as the substitution of diets with vitamin D would only be suitable for elderly patients with vitamin D deficiency and cannot be applicable to the elderly with hearing impairment that has affected their balance. There is a gap in the studies surrounding falls among the elderly with regard to establishing wholesome measures that accommodate different circumstances that influence falls among the elderly.
In essence, subject to the various studies that have been conducted over the decades, falls among the elderly remain e among the leading sources of healthcare expenditure among the elderly (Gelbard et al., 2014). This is even after decades of research on falls among the elderly. The outcomes in the modern society remain highly identical to past outcomes thus revealing a significant gap in the studies and in the implementation of better measures to assist in the elimination of the high risks of falls among the elderly population. As such, there have been little measures that have been implemented and considered in alleviating the situation and the measures have remained to be insufficient to curb the situation. The elderly’s needs in essence with reference to protecting them from the risk of falls have been overlooked and there is a growing need to develop and establish better measures and interventions that will secure the safety of the elderly in different environments and avoid the risks of falls.
Scholarly work surrounding falls among the elderly reflect the magnitude of the problem at hand and the importance of change in the approach of handling the situation. The elderly experience significant injuries and even death threatening injuries from the falls that they experience. It is thus imperative that better interventions are put in place to ensure that the risk of falls are reduced significantly. Better monitoring of the movement and health of the elderly will also suffice to maximize on protecting the wellbeing of the elderly and protect them from grievous injuries that may contribute to their suffering and even sudden deaths.
Abraham, M. & Cimino-Fiallos, N. (2017). Falls in the elderly: Causes, injuries and management. MedScape (February 1, 2017) Retrieved from https://reference.medscape.com/features/slideshow/falls-in-the-elderly#page=5
Alshammari, S. A. et al. (2018). Falls among elderly and its relation with their health problems and surrounding environmental factors in Riyadh. Journal of family & community medicine, 25(1), 29-34.
Gelbard, R. et al. (2018). Falls in the elderly: A modern look at an old problem. The American Journal of Surgery, 298(2): 24-253.
James, K. et al. (2014). Falls and Fall Prevention in the Elderly: Insights from Jamaica. Department of Community Health and Psychiatry Mona Ageing and Wellness Centre University of the West Indies Mona, Jamaica. https://www.who.int/ageing/projects/AMRO-Jamaica.pdf
Maher, J., Hanlon, J. & Hajjar, E. (2014). Clinical consequences of polypharmacy in elderly. Expert Opinion on Drug Safety, 13(1): 57-65.
Pfortmueller, C. et al. (2014). Fall-Related Emergency Department Admission: Fall Environment and Settings and Related Injury Patterns in 6357 Patients with Special Emphasis on the Elderly. Minerva Medica, 105(4): 275-281.