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Topic: Prevention of fall in the elderly in the healthcare settings

(Question 1: PICOT Question)

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PICOT QUESTION: In Adult patients older than 65 years of age, how can both clinicians and the community prevent falls when providing primary care within six months times

The population

Individuals older than 65 years of age are the most affected among the inpatient population in healthcare. According to the CDC (2019), more than one million older individuals experience falls annually across the globe. One in every four older patients experience falls annually though almost half of these patients tell their doctors about falling. One in every five falls makes the patient experience serious injuries such as fractured bones. There are more than 3 million older patients receiving care services in emergency departments due to fall injuries annually (CDC, 2019). The CDC analysis also shows that older adults falling sideways contributes to over 95% of hip fractures and traumatic brain injuries among the elderly. This makes falls among elderly patients a common challenge in the clinical and community-based environment.

The interventions

Fortunately, there are different approaches that an individual implements to prevent falls and related risks both in the community and clinical environment. Some of the most applicable prevention interventions include functional training, physical activities such as Tai Chi, home assessment/modifications, reduction of psychotropic drugs, multifactorial interventions, and vitamin supplements (Dellinger, 2017). A health care provider can further prevent by implementing patient education and improving patients-clinician communication (Morris, 2017). Education program allow the community and the patient to become more aware to the risk related to falls. It also helps an individual to identify the best ways to prevent fall among the elderly when providing or receiving primary care.

The control

Although an individual should consider a healthcare facility, it is not uncommon to find the community, such as family members been part of the people who provide health care to the elderly. Sometimes people find it difficult to decide whether to take their elderly family members to a home nursing facility or commit to taking care of them on their own. Despite the variability, it is importance to prevent fall among the elderly in both environments and minimize the risk related to this issue.

The objective and outcome

The objective for preventing fall among the elder is to increase safety and reduce the risk related to falls such as injuries, bone fractures and disabilities. Preventing fall among the elderly can also reduce the cost involved in providing primary care (Dellinger, 2017). This PICOT question focuses on identifying how both the clinicians and the community can prevent falls among the elderly patient more effectively (Coe, 2017). It focuses on identifying the cause and risk related to fall and determining the best prevention interventions that both the community, that is family members and friends and the clinicians can use when implement primary care to elderly patients.

The time for testing the intervention

The result of the prevention interventions is tested within a time frame of six months. The test focus on determining whether linking clinical and community-based prevention measures has any positive impact or safety and well begin of the elderly populations that need primary care services (Kulinski et al., 2017).

References

CDC. (2019, February 1). Important facts about falls. Centers for Disease Control and Prevention. https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html

Coe, L. J., St John, J. A., Hariprasad, S., Shankar, K. N., MacCulloch, P. A., Bettano, A. L., & Zotter, J. (2017). An integrated approach to falls prevention: a model for linking clinical and community interventions through the Massachusetts Prevention and Wellness Trust Fund. Frontiers in public health, 5, 38.

Dellinger, A. (2017). Older adult falls: Effective approaches to prevention. Current trauma reports, 3(2), 118-123.

Donelan, K., Chang, Y., Berrett-Abebe, J., Spetz, J., Auerbach, D. I., Norman, L., & Buerhaus, P. I. (2019). Care management for older adults: The roles of nurses, social workers, and physicians. Health Affairs, 38(6), 941-949.

Grossman, D. C., Curry, S. J., Owens, D. K., Barry, M. J., Caughey, A. B., Davidson, K. W., ... & US Preventive Services Task Force. (2018). Interventions to prevent falls in community-dwelling older adults: US Preventive Services Task Force recommendation statement. Jama, 319(16), 1696-1704.

Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A. M., & Morris, M. E. (2020). Hospital falls prevention with patient education: a scoping review. BMC geriatrics, 20(1), 1-12.

Kulinski, K., DiCocco, C., Skowronski, S., & Sprowls, P. (2017). Advancing community-based falls prevention programs for older adults—the work of the Administration for Community Living/Administration on Aging. Frontiers in public health, 5, 4.

Moncada, L. V. V., & Mire, L. G. (2017). Preventing falls in older persons. American family physician, 96(4), 240-247.