Patient falls and assistive technology decreasing them

Answer

Purpose

The goal of this study is to determine how satisfied with the assistive technologies available in selected hospitals the elderly inpatients and nurses taking care of them are. The study will also compile the types of assistive technologies used in selected hospitals. The compilation will be done using the responses from the patients and nurses. The study will also seek to determine the cause of the satisfaction or lack thereof. This study is important as evidence show that falls regularly occur in hospitals (Quigley & White, 2013). Additionally, hospitals are increasingly looking for ways to reduce such falls. However, despite the concentrated efforts in reducing falls, the concerned parties should be included in the assessment of the intervention measures. Although there are studies that determined the level of satisfaction in assistive technologies they are using, there are limited studies to determine the satisfaction of nurses with the technologies available to them in assisting the elderly.

Introduction

Problem statement

Nurses are included in the survey as they are the primary caregivers of the hospitalized older people. The importance of nurses is articulated in several studies (Cameron et al., 2010, Quigley & White, 2013 & Rush et al., 2009). The lack of studies that articulate the satisfaction levels of nurses as integral parts of the fall prevention strategy should be addressed. 10% of falls occur in the hospitals (Dykes et al., 2010)). Assistive technology his used by hospitals to prevent falls (Miskelly, 2001). In hospitals, most of these falls occur in the acute care patients and nurses, especially those working with acute care patients are in a position to witness these falls and prevent them.

Background and significance

Inpatient falls are not only a matter of safety but also a quality problem. According to studies, most of these falls occur in the patients’ rooms and bathrooms (Bates et al., 1995, Kraus et al., 2007 &Liang, 2002). Falls can result in an injury that can be fatal. According to Liang (2002) in the elderly with 65 years or above, falls are leading causes of death. Despite the safety associated with hospitals, 10% of these falls occur in hospitals. Serious falls can result in fractures and excessive bleeding.  In a study conducted by Eileen, indicated that 85 % of the falls in a hospital occurred in the patient’s room. The average age of the patients who fell was 63.4 and 79% were unassisted.  Falls increase the cost to the patient and the hospital since the patient will stay for longer in the hospital and there will additional treatments needed (Dykes et al., 2010 & Krauss et al., 2007). Compared to other hospitalized patients, fall victims have costs that are 60% higher (Bates et al., 1995, Liang, 2002 & Tzeng et al., 2009). The cost to the hospital is expected to reach $54.9 billion by 2020(16). The estimate is the cost resulting from severe injuries sustained from a fall. 

Risk factors for falling have been explored by numerous studies. Cummings (1995) found out that in patients who suffered fall-related fractures, there was an interaction of multiple factors including ailment.  About 15% of the falls are as a result of an external event, and a similar proportion has a single factor that can be identified such as Parkinson’s while the rest are from a multiple of interacting factors (Campbell, 2006). Cummings (1995) argues that due to the many related risk factors, it was challenging to determine the efficiency of intervention method in preventing hip and other fall-related fractures.

Apart from the physical effects of falls, they may also have a psychological effect. After the falls, the victims may experience fear of falling and a reduction in their confidence. Consequently, they may have a restricted movement where they reduce the extent of activities that they previously engaged in to prevent another fall. A reduction of activity will set back the physical function and social interactions (Hitcho, 2004). Fear of falling can also result in a higher risk of falling in the future.

Assistive technology is increasing being used to prevent falls. Numerous studies have been done on the role and efficiency of assistive technologies. Carswell et al. (2009) that assistive technology could help in reducing falls even during nighttime.  Bateni & Maki (2005) studied the impact of using canes and walkers as assistive technology. The results indicated that canes and walkers can reduce falls by increasing balance. However, they can also impede attainment of balance in certain situations and the strength, and metabolic demands can be excessive on an old body. Frank (2001) explored the available assistive technology and discussed their applications and limitations. Karmarkar (2009) state that although the use of the wheelchair is common in nursing homes and community dwellings, the wheelchair users in community dwellings were more satisfied with their technology compared to those in the nursing homes.

Struksnes et al. (2011) conducted research on the opinion of falls among the elderly with dementia while focusing on the causes of the falls; interventions used to prevent the falls, documentation and reporting on the falls and their reaction and expectations after an incident. Rush et al. (2009) focused their study on the nurses’ experience with patient falls. Other studies focus on the role of a nurse in prevention and causing falls. Tzeng (2008) established how nurses use sitters to prevent falls.

Although numerous studies have been done on assistive technology and the risk and prevalence of falls, there are limited studies that explore the effectiveness and acceptability of assistive technology in hospitals in both the nurses and the patients. With the extent and effect of falls in the hospital, there is a need to quantify the satisfaction levels of the patients and nurses in using assistive technologies in the hospitals.

Research Questions

1. How are the available assistive technologies in the selected hospitals rate regarding satisfaction in both the elderly inpatients and the nurses concerned with taking care of them?
2. What are the available assistive technologies in the selected hospitals?
3. What are the factors that affect the acceptability of these technologies?

Hypothesis

Alternative hypothesis H₁

Both nurses and inpatient elderly people experience the same level of satisfaction to assistive technology.

Null hypothesis H₀

There is a difference in the acceptability levels of nurses and elderly inpatients to assistive technology.

Definition of Variables

Fall: for the purpose of this study, fall will be defined as a sudden and unexpected descent from a sitting, a horizontal or standing position with or without injury. It will include both witnessed and not seen fall.

Assistive technology: this is any device or software that allows an elderly person to operate in a manner that is not possible on the removal of the technology. It will include both the simple and complex technology.

Elderly/older: any person with 65 or more years.