Question

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1Graded.docx

LITERATURE EVALUATION TABLE

Student Name:

Summary of Clinical Issue.

The clinical issue of interest is falling among the elderly population living in a long-term care facility. High fall rates are experienced in long-term care facilities by older adults, which brings about mortality and a broad scope of morbidities, for example, fractures and injuries. As revealed by Baixinho et al. (2017), one out of three older people falls every year, leading to increased health care costs. For instance, it is approximated that 30 billion dollars Medicare cost is spent in treating injuries identified with fall in the U.S. (Agashivala & Wu, 2009). The risk of falling in older people is high in long-term care facility because of risk factors like, visual disability, dementia, a few prescriptions, and gait imbalance. Different interventions have been recommended to minimize the risk of falling among geriatric. Such interventions include but not limited to the supplementation of vitamin D, physiotherapy, drugs, and cataract surgery because of falls resulting from poor vision (Valcarenghi et al., 2014). Just as for the victims, fall among older people can pose significant cost implications even for the healthcare systems. In 2015 alone, (Annweiler et al., 2010) states that the United States healthcare system incurred an extra $50 billion in healthcare expenses for managing fall-related injuries and accidents. The bad news is that the elderly gap in the U.S is expected to continue rising in future this raising the cost of treating fall-related injuries (Neyens et al., 2006).

If this is your clinical issue, then why aren’t you focusing your intervention on one of these highlighted in blue?

PICOT Question:

In older people aged above 65 years (P), how effective is the use of walking aids and appropriate footwear (I) compared to the use of vitamin D enhancements (C) in reducing the number of falls and fatalities and injuries resulting from the same falls (0) over six-months (T)? Comment by Microsoft Office User: PICOT - not approved Where did this come from? It is not any one of the PICOTs you submitted in our Private Forum exchanges.

P - elderly adults aged 65 and older

I - choose one, either walking aids (be specific) or appropriate footwear

C - what does Vitamin D have to do with walking aids or footwear? this would have to be just, compared to current practice

O - choose one, either reduction in the number of incidence of falls (not fatalities!!) or injuries

T - you will want to use only over 4 weeks.

Article 1 :

APA-Formatted with Permalink

Valcarenghi, R. V., Santos, S. S. C., Hammerschmidt, K. S. D. A., Barlem, E. L. D., Gomes, G. C., & Silva, B. T. D. (2014). Institutional actions based on nursing diagnoses for preventing falls in the elderly. Northeast Network Nursing Journal15(2). Retrieves from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103968179&site=eds-live&scope=site

Study page numbers are missing; you provide a retrieval source but not the Permalink. Refer to W1 DQ1 on how to extract Permalinks. The words Retrieved from are no longer necessary per the APA Manual 7th edition.

How does the Article relate to the PICOT question?

The PICOT question is identified with the study as it exhibits how elderly falls could be reduced by standardized approaches based on nursing diagnoses.

You need to find studies that would focus on your intervention - use of walking aid or footwear.

Quantitative or Qualitative?

(how do you know?)

Authors used a qualitative method because human subjects were used in studying the correlation of cognitive status and falls among elderly residents. No, that’s not why it’s qualitative - what was the method?

Purpose Statement

The research tries to determine if the proposed nursing care intervention actions based on nursing diagnoses could be used to prevent elderly falls.

What intervention?

Research Question

Does the proposed diagnostic examination and planning of Nursing care focused on Long-term Care Facilities (LTCF) lessen fatalities and injuries related to elderly falls?

Walking aid? footwear?

Outcome

The overall outcome was recognized in LTCFs hospitals, whether the consolidated theory, practice, and knowledge development activities knowledge falls in older people.

Setting

(Where was the study conducted?)

The study was performed in a long-term care facility in the Rio Grande do Sul, Brazil.

Sample

It involved 30 seniors who live in an institutionalized LTCF facility.

Method

Exploratory, descriptive, observational study.

Key Findings

Authors were able to propose nursing care strategies identified with nursing diagnoses at reducing elderly fall rates who reside in long-stay facilities.

Recommendations

of the Researcher (s)

The future study ought to consider deepening the intercessions with nursing prescriptions suitable to every older fall circumstance so as to decrease the results of this incident and adding to the support of the ageing process.

Use single spacing in the Table not 1-1/2 line spacing.

Article 2 :

APA-Formatted Citation

with Permalink

Baixinho, C. R. S. L., Dixe, M. D. A. C. R., & Henriques, M. A. P. (2017). Falls in long-term care institutions for elderly people: protocol validation. Revista brasileira de enfermagem70(4), 740-746. Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=124636955&site=eds-live&scope=site Permalink is missing. Journal name should be in Title Case.

How does the Article relate to the PICOT question?

The PICOT question is identified with the study as it tries to authenticate how fall management risk protocol within healthcare could be used in long-term institutions to reduce elderly fall-related accidents.

How does it relate to your proposed intervention?

Quantitative or Qualitative?

(how do you know?)

It is a qualitative study because data was collected using the quanti-qualitative method. No

Purpose Statement

Authors intend to assess the impact of implementing fall management risk protocol in LTC institutions.

Research Question

Can the safety of elderly population be maintained by reducing fall-associated fatalities when management risk protocol identified with single and multiple sets of interventions are implemented?

Outcome

The high prevalence of elderly falls has decreased on the implementation of risk management protocols in LTC hospitals, ensuring that the fall risk is surveyed guaranteeing the wellbeing of the institutionalized older people.

Setting

(Where was the study conducted?)

The study took place in the Catholic University of Portugal.

Sample

The intentional sample consisted of 14 female experts.

Method

The consensus from the selected female experts was obtained using Delphi technique.

Key Findings

Protocols can be utilized to meet the expected objective of promoting the introduction of research evidence in nursing clinical practice and decision making, just as to offer conditions to a healthy change in institutionalized older people.

Recommendations

of the Researcher (s)

Future research should concentrate on clinical intervention and incorporation since most casualties of falls much of the time visit medical care centre.

Article 3 :

APA-Formatted Citation

with Permalink

Neyens, J. C., Dijcks, B. P., van Haastregt, J. C., de Witte, L. P., van den Heuvel, W. J., Crebolder, H. F., & Schols, J. M. (2006). The development of a multidisciplinary fall risk evaluation tool for demented nursing home patients in the Netherlands. BMC Public Health6(1), 74. Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edsdoj&AN=edsdoj.24d7890b34a848168e31874af2327ad5&site=eds-live&scope=site

Page range? Permalink missing

How does the Article relate to the PICOT question?

The PICOT question is identified with the study as it demonstrates the improvement of a specialized fall preventive program for demented nursing home patients, possible for the nursing home staff.

Program? how does it relate to walking aids or footwear?

Quantitative or Qualitative?

(how do you know?)

The study used a qualitative research design because authors consulted a group of Dutch experts to collect data that will judge whether the use of multidisciplinary fall risk evaluation tool in nursing care homes will reduce falls rate from demented patients. No

Purpose Statement

The study was directed to measure and evaluate the feasibility of evidence-based, multidisciplinary fall risk evaluation tool used to provide preventive interventions tailored towards demented patients

Research Question

Can fall rates among demented patients in nursing homes reduce upon implementation of multidisciplinary fall risk evaluation tool?

Outcome

Nursing home demented patients managed with a multidisciplinary fall risk evaluation tool showed positive results since they were managed explicitly with interventions tailored to their needs.

Setting (Where was the study conducted?)

Nursing homes in the Netherlands

Sample

The sample included 276 people, ages 65 and older.

Method

Randomized controlled trial

Key Findings

Authors found that both multidisciplinary and multifactorial interventions coined with interdisciplinary fall risk evaluation tool reduced falls as well as their associated adversaries in demented nursing home patients.

Recommendations

of the Researcher (s)

Future research should concentrate on actualizing specific standards or designed programs for the reduction of fall events ailing in Netherland nursing home for demented clients.

Article 4 :

APA-Formatted Citation

with Permalink

Annweiler, C., Montero-Odasso, M., Schott, A. M., Berrut, G., Fantino, B., & Beauchet, O. (2010). Fall prevention and vitamin D in the elderly: an overview of the key role of the non-bone effects. Journal of neuroengineering and rehabilitation7(1), 50. Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=conedsqd8&AN=edsdoj.421e8232c344b3928b94d43598ab01&site=eds-live&scope=site

Permalink is missing. Journal name should be in Title Case.

How does the Article relate to the PICOT question?

The PICOT question is identified with the study as authors summarize the evidence around fall reduction and vitamin D supplementation since they found out that most elderly-related fatalities are due to vitamin D deficiency.

Quantitative or Qualitative?

(how do you know?)

The study used is quantitative design because authors analyzed collected clinical data in humans that appeared to support the hypothesis of a favorable action of vitamin D on cognitive function, No

What type of experimental study was it?

Purpose Statement

The study is showing the benefits associated with prescribing vitamin D supplementation to elderly patients during primary and secondary fall prevention management strategies.

Research Question

Do the use of replacement therapy or vitamin D, and calcium status relate to age-associated alteration of the older people postural adaption?

Outcome

It is evidenced that, even in patients with no vitamin D deficiency, there is an improvement in muscular strength and prevention of falls upon giving vitamin D supplementation.

Setting

(Where was the study conducted?

Residents nursing homes.

Sample

Elderly subjects above 65 years of age.

Method

Semi-structured interviews.

Key Findings

Not only does vitamin D supplementation prevents the occurrence of falls and their complications, but also it determines gait performance among older adults.

Recommendations

of the Researcher (s)

The likelihood that future data changes the primary inferences of this study is low because of the assurance of the evidence.

Article 5 :

APA-Formatted Citation

with Permalink

Agashivala, N., & Wu, W. K. (2009). Effects of potentially inappropriate psychoactive medications on falls in US nursing home residents. Drugs & aging26(10), 853-860. Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=105327592&site=eds-live&scope=site

Permalink missing. Journal name should be in Title Case.

How does the Article relate to the PICOT question?

The PICOT is identified with the study as authors try to determine the negative side effects of using other psychoactive drugs as compared to PIPMs when managing fall rates in older people.

This does not support the PICOT.

Quantitative or Qualitative?

(how do you know?)

The study used a quantitative method since the authors assessed multicollinearity variables of the study. No

Purpose Statement

Authors intend to compare the effects of psychoactive medications (PIPMs) with other psychoactive drugs among older residents in the U.S nursing homes.

Research Question

Should physicians avoid prescribing PIPMs medication to elderly nursing home residents to other alternative psychoactive intervention approaches?

Outcome

Beer’s criteria showed that the falling rate of nursing home residents continued to increase significantly after taking PIPMs.

Setting

(Where was the study conducted?)

U.S. nursing home residents.

Sample

The 2004 National Nursing Home Survey (NNHS) database was used.

Method

A linear regression model

Key Findings

To prevent subsequent falls, researchers found that patients with a history of falls should be provided with necessary precautionary measures as well as specialized medical attention.

Recommendations

of the Researcher (s)

Further research ought to be conducted to assess the effect on falls of possibly inappropriate drugs in other remedial categories.

Article 6 :

APA-Formatted Citation

with Permalink

Chacko, T. V., Thangaraj, P., & Muhammad, G. M. (2017). How Fall-Safe is the Housing for the Elderly in Rural Areas? A Cross Sectional Study using Fall Prevention Screening Checklist. Journal of the Indian Academy of Geriatrics13(3). Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=127993988&site=eds-live&scope=site

Permalink is missing

How does the Article relate to the PICOT question?

The PICOT question relates with the article as authors try to assess the effectiveness of prevention screening checklist used to measure the proportion of elder people houses that adhere to housing guidelines in preventing falls.

Quantitative or Qualitative?

(how do you know?)

The study used a quantitative method as data was statistically analyzed with SPSS-19 using Microsoft Excel software. No

SPSS is a statistical software program. What type of quantitative study was it?

Purpose Statement

Authors use fall prevention screening checklist used in developed countries to determine the risk of fall among older adults living in unsafe housing rural areas.

Research Question

How Fall-Safe is the Housing for the Elderly in Rural Areas?

Outcome

Results of the study were about creating awareness among older adults living in unsafe housing conditions since it was perceived to be a thorough approach in reducing the number of falls.

Setting

(Where was the study conducted?)

The study was conducted in a rural area of Coimbatore in India.

Sample

The study screened a total of 655 houses.

Method

Cross-sectional study

Key Findings

It was discovered that implementing a fall-prevention program coordinated at screening the places of the older to distinguish and correct the fall risk housing conditions decreased stumbling and, in this manner, preventing falls among the older population.

Recommendations

of the Researcher (s)

Further research must be done to set up the validity of the observational checklist device to suggest new measures for peculiar conditions that add to fall.

References

Agashivala, N., & Wu, W. K. (2009). Effects of potentially inappropriate psychoactive medications on falls in US nursing home residents. Drugs&aging26(10),853-860. https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=105327592&site=eds-live&scope=site

Annweiler, C., Montero-Odasso, M., Schott, A. M., Berrut, G., Fantino, B., & Beauchet, O. (2010). Fall prevention and vitamin D in the elderly: an overview of the key role of the non-bone effects. Journal of neuroengineering and rehabilitation7(1), 5 https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=conedsqd8&AN=edsdoj.421e8232c344b3928b94d43598ab01&site=eds-live&scope=site.

Baixinho, C. R. S. L., Dixe, M. D. A. C. R., & Henriques, M. A. P. (2017). Falls in long-term care institutions for elderly people: protocol validation. Revista brasileira de enfermagem70(4), 740-746. Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=124636955&site=eds-live&scope=site.

Chacko, T. V., Thangaraj, P., & Muhammad, G. M. (2017). How Fall-Safe is the Housing for the Elderly in Rural Areas? A Cross Sectional Study using Fall Prevention Screening Checklist. Journal of the Indian Academy of Geriatrics13(3). Retrieved from https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=127993988&site=eds-live&scope=site

Neyens, J. C., Dijcks, B. P., van Haastregt, J. C., de Witte, L. P., van den Heuvel, W. J., Crebolder, H. F., & Schols, J. M. (2006). The development of a multidisciplinary fall risk evaluation tool for demented nursing home patients in the Netherlands. BMC Public Health6(1),74. https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=edsdoj&AN=edsdoj.24d7890b34a848168e31874af2327ad5&site=eds-live&scope=site.

Valcarenghi, R. V., Santos, S. S. C., Hammerschmidt, K. S. D. A., Barlem, E. L. D., Gomes, G. C., & Silva, B. T. D. (2014). Institutional actions based on nursing diagnoses for preventing falls in the elderly. Northeast Network Nursing Journal15(2).

https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103968179&site=eds-live&scope=site

Comment - I thought we had found a PICOT that could work for you. I’m rather confused that you have taken an entirely different approach. Review my comments on your PICOT above and resubmit it in the Private Forum for approval. Without a well-structured PICOT, it is difficult to determine if the selected studies are supportive. It appears that they offer some indirect support, but do not support a clearly defined evidence-based intervention. What about using a fall protocol? There are several. \\