Expert Answer:Risk of Falls in Geriatric Care: A Quantitative St

  

Solved by verified expert:Use the practice problem (Prevention of falls among Geriatric Patient) and a quantitative, peer-reviewed research article you identified in the PICOT Statement and Literature assignment to complete this assignment.In a 1,250-word essay, summarize the study, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.Refer to the resource “Research Critique Guidelines” for suggested headings and content for your paper.Prepare this assignment according to the guidelines found in the 6 APA Style GuideALL aspects of template meet APA 6th editionformat.This includes the running header,the header of the rest of the pages and thereference page.There should be 3 studies used in this assignment.1 is the study being critiqued and the other 2 studiesshould be used to support your conclusion statementswhen the initial study is not enough. There MUST beat least 3 studies in APA 6th edition format on the Reference page.NO PLAGIARISM, please follow the Research Critique method for the content of paper .
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Quantitative Study
Background of Study:

Identify the clinical problem and research problem that led to the study. What was not
known about the clinical problem that, if understood, could be used to improve health
care delivery or patient outcomes? This gap in knowledge is the research problem.

How did the author establish the significance of the study? In other words, why should
the reader care about this study? Look for statements about human suffering, costs of
treatment, or the number of people affected by the clinical problem.

Identify the purpose of the study. An author may clearly state the purpose of the study or
may describe the purpose as the study goals, objectives, or aims.

List research questions that the study was designed to answer. If the author does not
explicitly provide the questions, attempt to infer the questions from the answers.

Were the purpose and research questions related to the problem?
Methods of Study

Identify the benefits and risks of participation addressed by the authors. Were there
benefits or risks the authors do not identify?

Was informed consent obtained from the subjects or participants?

Did it seem that the subjects participated voluntarily in the study?

Was institutional review board approval obtained from the agency in which the study was
conducted?

Are the major variables (independent and dependent variables) identified and defined?
What were these variables?

How were data collected in this study?

What rationale did the author provide for using this data collection method?

Identify the time period for data collection of the study.

Describe the sequence of data collection events for a participant.

Describe the data management and analysis methods used in the study.

Did the author discuss how the rigor of the process was assured? For example, does the
author describe maintaining a paper trail of critical decisions that were made during the
analysis of the data? Was statistical software used to ensure accuracy of the analysis?

What measures were used to minimize the effects of researcher bias (their experiences
and perspectives)? For example, did two researchers independently analyze the data and
compare their analyses?
Results of Study

What is the researcher’s interpretation of findings?

Are the findings valid or an accurate reflection of reality? Do you have confidence in the
findings?

What limitations of the study were identified by researchers?

Was there a coherent logic to the presentation of findings?

What implications do the findings have for nursing practice? For example, can the
findings of the study be applied to general nursing practice, to a specific population, or to
a specific area of nursing?

What suggestions are made for further studies?
Ethical Considerations

Was the study approved by an Institutional Review Board?

Was patient privacy protected?

Were there ethical considerations regarding the treatment or lack of?
Conclusion

Emphasize the importance and congruity of the thesis statement.

Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting
impression and take-away points useful in nursing practice.

Incorporate a critical appraisal and a brief analysis of the utility and applicability of the
findings to nursing practice.

Integrate a summary of the knowledge learned.
Running head: PICOT STATEMENT AND LITERATURE SEARCH
PICOT Statement and Literature Search
Name
Institutional Affiliation
Date
1
PICOT STATEMENT AND LITERATURE SEARCH
2
The issue of falls among the geriatric patients has become common and is causing nearly
to 750,000 hospitalization as well as 25,000 deaths on a yearly basis in the United States. There
are a number of reasons which leads to the rise of the cases related to the geriatric patient falls.
Some of the factors leading to the increase in the falls among geriatric patients are related to the
practices within healthcare facilities. For example, there is a lack of effective equipment such as
hip protectors and exercise program to help in the prevention of fall. Other factors are related to
the poor healthcare environment which might be due to the overcrowding of the patients or the
small sizes of healthcare facilities; lack of risk factor screening; and lack of proper interventions
for the prevention of such falls.
Prevention and Management fall among Geriatric patient
The prevention and the management of fall among geriatric patients are necessary in a
healthcare facility to help in the reduction of the death cases caused by falls. The picot statement
on the prevention and management of fall among the geriatric patients is tackled through using
the picot questions below:

What role do exercise program and other interventions play towards the prevention of
fall?

Should modification of the physical environment be utilized for the prevention of the fallrelated injuries among geriatric patients?

What role does risk factor screening play towards the prevention of fall-related injuries
among geriatric patients?
Literature Review
PICOT STATEMENT AND LITERATURE SEARCH
3
Shier, V., Trieu, E., & Ganz, A. D. (2016). Implementing exercise programs to prevent falls: a
systematic descriptive review. Injury Epidemiology, 3(1), 16.
Authors of this article aimed at looking at the aspect of implementing the exercise
program for the prevention of the falls. It is a recommendation by the United States Preventive
Services Task Force for the exercise program to be utilized for the prevention of the falls within
the community. This was a qualitative approach study which involved reviewing of literature to
help in the determination of how exercise programs for the prevention of falls are being
implemented from the point of vantage of the healthcare setting. There was a synthesis of
descriptive information related to each program and data on those particular program features as
well as the implementation challenges and promoting factors.
The outcome of this study revealed that the programs which are under the sponsorship of
primary caregivers are helping in the recruitment for the exercise programs. The primary
caregivers have the opportunities of identifying individuals who are at risk and then encourage
their participation because the majority of these geriatric individuals regularly visits and make an
inquiry about the exercise from the doctors. Exercise programs related to the Home-based and
group-based ted to be operational in the prevention of the falls, nevertheless, there are limitations
and the advantages related to each program. The home-based program involves individuals who
are not willing to attend the group-based programs. Therefore this implies that they can be
tailored individually. However, this offers less opportunity when it comes to socialization with
other group members as well as for the supervision procedures.
Authors of this study concluded that despite the fact that there is an increased focus to the
population-based in managing health within the United States, physicians, and the healthcare
PICOT STATEMENT AND LITERATURE SEARCH
4
front-runners requires knowledge on the means of connecting patients to the healthcare systems
through the use of suitable community programs.
Nicklett, J. E., Lohman, C. M., & Lee, S. M. (2017). Neighborhood Environment and Falls
among Community-Dwelling Older Adults. International Journal of Environment Research and
Public Health, 14, 175
According to the World Health Organization (WHO), there are four types of risks for
falls among geriatric patients. These factors are related to the biological risk factors; behavioral
factors; social and economic risk factors; and the environmental risk factors. This study was
aimed at examining the link between the fall and the events at the neighborhood factors. The
collected data were analyzed from the 9259 participants of the study. The outcome of this study
revealed that an increase in the single unit in the community social interrelation which was
linked with the 4 percent lower odds of going through multiple falls. There is also an increase in
the physical environment scale. This was connected with 4 percent of the lower odds of being
subjected to a single fall with 5 percent lower odds of multiple falls within the adjusted models.
The conclusion in this study is that physical and the social community environment might
influence fall risk amongst the elderly patients.
Renfro, M., Maring, J., Brainbridge, D., & Balir, M. (2016). Fall Risk Among Older Adult HighRisk Populations: a Review Of Current Screening and Assessment Tools. Curr Geri Rep.
Falls is considered to be the leading cause of the injury as well as accidental deaths
among the older patients. This is common among high-risk populations like individuals who are
experiencing logical and developmental disabilities, and multiple sclerosis among others.
Authors of this article provided an outline of the concerns which are related to the falls belonging
PICOT STATEMENT AND LITERATURE SEARCH
5
to the population above. Authors of this article provides an illustration of the general fall risk
screening tools, as well as the fall risk tests and measurements, was made. Application of the risk
screening instruments to the high-risk populations was done. The study was concluded by
providing guidance on the mechanism through which healthcare providers can utilize the present
tools to carry out suitable fall risk prevention screening and the undertakings that are involved in
the assessment process resulting in the choice of the evidence-based fall preventive measures or
programs for the geriatric patients.
Spears, G. V., Roth, C. P., Mike-Lye, I. M., Saliba, D., Shekelle, P. G., & Ganz, D. A. (2013).
Redesign of an electronic clinical reminder to prevent falls in older adults. Med Care, 51(3), S37S43.
According to this study, falls are considered to be the leading unintentional injury among
the older patients of the United States. There are guidelines which recommend for the screening
of the individuals who are risk of falling and promotion of the exercise programs for patients
suffering from gait and the balance issues. In this study, electronic clinical reminder was
designed to help in improving the process of identifying and managing the veterans at high risk
for falls.
A review of the clinical reminder reports were also done followed by the processes of
interviewing the nurses, the primary care providers, and a direct observation of the clinic
activities while watching the nurses and the primary care providers using the clinical reminder
with the bogus patient record to help in the determination of the areas which needed urgent
improvements. The outcome of this study reveals that out of 162 veterans who were having gait,
balance, and the problems related to strength on evaluation, 39 of them were offered physical
PICOT STATEMENT AND LITERATURE SEARCH
6
therapy, the primary care providers and nurses were of different opinions concerning the clinical
reminder ad the project. Primary caregivers were more negative as compared to nurses. The
conclusion of this study was that it is possible to incorporate a fall prevention clinical reminder
into normal operations of healthcare. A low referral rate to the exercise programs is an indication
for the need to make quality improvement cycles.
Clemson, L., Singh, F., Cumming, R. G., Manollaras, K., O’Loughlin, P., & Black, D. (2012).
Integration of balance and strength training into daily life activity to reduce the rate of falls in
older people (the LiFE study): randomized parallel trial. BMJ, 345, e4547.
The goal of this research work was to find out whether a lifestyle incorporated
approaches to the balance and strength training is in effect in the reduction on the f falls among
high-risk individuals staying at home. The design of this research involved the use of three arms,
a randomized parallel trial for the evaluation at baseline and after six and 12 months. The
randomization was performed through the use of computer-generated random block which is
stratified by sex and the history of the fall then obscured by an autonomous protected website.
The study was carried out in metropolitan Sydney in Australia. Individuals aged 70 years
and above were used as the subjects of the study. These participants had experienced two or
more falls and injuries for the past year. The exclusion criteria were moderate to serious
cognitive challenges, lacking the ability to ambulate independently, gait, and the mobility which
influenced neurological conditions. The interventions in this study included three home-based
interventions. There was a substantial decrease in falls rate (31 percent) for the LiFE program in
comparison to the controls. The conclusion of the study was that the LiFE program is capable of
providing an alternative to the customary exercise for fall prevention. It is also important to
PICOT STATEMENT AND LITERATURE SEARCH
7
consider the functional based exercise for the protection of the older and high-risk individuals
from falling and improve as well as help in the maintenance of the functional therapy.
Renfro, M. O., & Fehrer, S. (2011). Multifactorial screening for fall risk in community-dwelling
older adults in the primary care office: development of the fall risk assessment & screening tool.
J Geriatr Phys Ther, 34(4), 174-183.
The article was aimed at giving a description on the content choice and the process of
developing a simple administer, multifactorial, Fall Risk Assessment and Screening Tool
(FRAST) which is particularly designed to be applied within the primary care settings for the
identification of the geriatric patient who are at risk of fall. Authors of this article developed a
multifactorial FRAST to be used in the 5-part process i.e. identification of the risk factors to fall;
reviewing of the perfect proof, choosing of the items, development of the scoring grid, and the
process of developing a proposed action plan. The outcome of this study shows that Fall Risk
Assessment and Screening Tool is has been and is still being developed in many healthcare
facilities to help in the assessment of the risk of fall. The conclusion of the study is that fall risk
among the geriatric individuals within the community is imperative, multifactorial, and still
remains a public health issue of concern. Primary caregivers can use the screening tool to help
the situation. This tool is important in allowing for the safer, speedy, and cheaper for the
administration of the trained office staff with the understanding as well as the follow-up process
by the primary caregivers.
PICOT STATEMENT AND LITERATURE SEARCH
8
References
Clemson, L., Singh, F., Cumming, R. G., Manollaras, K., O’Loughlin, P., & Black, D. (2012).
Integration of balance and strength training into daily life activity to reduce the rate of
falls in older people (the LiFE study): randomized parallel trial. BMJ, 345, e4547.
Nicklett, J. E., Lohman, C. M., & Lee, S. M. (2017). Neighborhood Environment and Falls
among Community-Dwelling Older Adults. International Journal ofEnvironment
Research and Public Health, 14, 175.
Renfro, M. O., & Fehrer, S. (2011). Multifactorial screening for fall risk in community-dwelling
older adults in the primary care office: development of the fall risk assessment &
screening tool. J Geriatr Phys Ther, 34(4), 174-183.
Renfro, M., Maring, J., Brainbridge, D., & Balir, M. (2016). Fall Risk Among Older Adult HighRisk Populations: a Review Of Current Screening and Assessment Tools. Curr Geri Rep.
Shier, V., Trieu, E., & Ganz, A. D. (2016). Implementing exercise programs to prevent falls: a
systematic descriptive review. Injury Epidemiology, 3(1), 16.
Spears, G. V., Roth, C. P., Mike-Lye, I. M., Saliba, D., Shekelle, P. G., & Ganz, D. A. (2013).
Redesign of an electronic clinical reminder to prevent falls in older adults. Med Care,
51(3), S37-S43.
Research Critique Method
Quantitative Study
Background of Study:

Identify the clinical problem and research problem that led to the study. What was not
known about the clinical problem that, if understood, could be used to improve health
care delivery or patient outcomes? This gap in knowledge is the research problem.

How did the author establish the significance of the study? In other words, why should
the reader care about this study? Look for statements about human suffering, costs of
treatment, or the number of people affected by the clinical problem.

Identify the purpose of the study. An author may clearly state the purpose of the study or
may describe the purpose as the study goals, objectives, or aims.

List research questions that the study was designed to answer. If the author does not
explicitly provide the questions, attempt to infer the questions from the answers.

Were the purpose and research questions related to the problem?
Methods of Study

Identify the benefits and risks of participation addressed by the authors. Were there
benefits or risks the authors do not identify?

Was informed consent obtained from the subjects or participants?

Did it seem that the subjects participated voluntarily in the study?

Was institutional review board approval obtained from the agency in which the study was
conducted?

Are the major variables (independent and dependent variables) identified and defined?
What were these variables?

How were data collected in this study?

What rationale did the author provide for using this data collection method?

Identify the time period for data collection of the study.

Describe the sequence of data collection events for a participant.

Describe the data management and analysis methods used in the study.

Did the author discuss how the rigor of the process was assured? For example, does the
author describe maintaining a paper trail of critical decisions that were made during the
analysis of the data? Was statistical software used to ensure accuracy of the analysis?

What measures were used to minimize the effects of researcher bias (their experiences
and perspectives)? For example, did two researchers independently analyze the data and
compare their analyses?
Results of Study

What is the researcher’s interpretation of findings?

Are the findings valid or an accurate reflection of reality? Do you have confidence in the
findings?

What limitations of the study were identified by researchers?

Was there a coherent logic to the presentation of findings?

What implications do the findings have for nursing practice? For example, can the
findings of the study be applied to general nursing practice, to a specific population, or to
a specific area of nursing?

What suggestions are made for further studies?
Ethical Considerations

Was the study approved by an Institutional Review Board?

Was patient privacy protected?

Were there ethical considerations regarding the treatment or lack of?
Conclusion

Emphasize the importance and congruity of the thesis statement.

Provide a logical wrap-up to bring the appraisal to completion and to leave a lasting
impression and take-away points useful in nursing practice.

Incorporate a critical appraisal and a brief analysis of the utility and applicability of the
findings to nursing practice.

Integrate a summary of the knowledge learned.

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