For adults on the medical-surgical unit in a hospital, will the use of bed alarms reduce the number of falls per year, compared to usual care, as defined by fall risk protocol by nursing staff?
P: Falls; Adult patients aged 18 years of age and older; Medical-surgical unit
I: Use of bed alarms
C: Usual care, as defined by fall risk protocol by nursing
O: To reduce the number of falls
CPG: https://www.guideline.gov/content.aspx?id=36906&search=falls+medical+surgical+and+fall+prevention
All group members need to do a literature review/crituqe on 2 articles. 1/2 page per article is suggested. Please post your 2 articles again this week – it was suggested to avoid any meta analysis or meta synthesis – look back at the 2 articles previously posted and your article was one of these, please look for another article – hint: this can be the articles previously critiqued and submitted but must pertain to our project – when you post your 2 articles, please list your reference for your article as it should be listed on the reference page – In with your literature review/critique you need to make sure you list the following:
Review of evidence for or against our recommended practice i.e. bed alarms or usual care, summative statement on evidence, practice implication from your finding and recommendations for practice.
Lastly, we all need to do a 1 page part for the paper regarding recommended practice interventions. I reviewed our clinical practice guideline and here are the assignments I have made for this part:
Ngozi – performing risk assessments to identify risk factors –
– Communicating risk factors i.e. patient education, visual cues
– establish a process for evaluation of the hospitalized patient for risk of falling
– performing environmental risk factor interventions
– falls prevention program for organization
– observation/surveillance – sitters, time rounding
The above information came from the interventions listed under our clinical practice guideline. Click on the link above to open the page and scroll down and you will see these interventions listed. If you continue looking through the guideline you will see additional information for each intervention
Please write only on � performing risk assessments to identify risk factors, the one that bears my name.( 1 page)
Literature review/critique on 2 articles � page per article.
Effectiveness of Intervention Programs In Preventing Falls: A Systematic Review of Recent 10 Years and Meta-Analysis.
Authors:
Choi, Myunghan; Hector, Melvin
Abstract:
Abstract: Objective: To examine the reported effectiveness of fall-prevention programs for older adults by reviewing randomized controlled trials from 2000 to 2009. Design: Systematic review and meta-analysis of randomized controlled trials. Data Sources: A systematic literature search of articles was conducted using 5 electronic databases (Medline, PubMed, PsycINFO, CINAHL, and RefWorks), including articles describing interventions designed to prevent falls, in English with full text availability, from 2000 through 2009. Review Methods: Of a potential 227 studies, we identified 17 randomized controlled trials with a duration of intervention of at least 5 months of follow-up. Inclusion and exclusion criteria were used to assess the methodological qualities of the studies. We excluded unidentified study design, quasi-experimental studies, and/or studies that were nonspecific regarding inclusion criteria. Data Extraction: Primary outcome measures were number of falls and fall rate. Methodological quality assessment included internal and external validity, reporting, and power. Data were extracted independently by 2 investigators and analyzed using a random-effects model. We analyzed the effectiveness of these fall intervention programs using their risk ratios (RR) in 2 single-intervention versus 15 multifactorial intervention trials, 3 nursing homes versus 14 community randomized controlled trials, and 8 Model 1 (initial intervention with subsequent follow up) versus 9 Model II (ongoing intervention throughout the follow-up) studies. Results: The combined RR for the number of falls among 17 studies was 0.855 (z = �2.168; p = .030; 95% CI = 0.742�0.985; Q = 196.204, df = 16, P = .000, I <sup>2</sup> = 91.845), demonstrating that fall-prevention programs across the studies were effective by reducing fall rates by 14%, but with substantial heterogeneity. Subgroup analysis indicated that there was a significant fall reduction of 14% in multifactorial intervention (RR = 0.856, z = �2.039, P = .041) with no variation between multifactorial and single-intervention groups (Q = 0.002, P = .961), 55% in the nursing home setting (RR = 0.453, z = �9.366, P = .000) with significant variation between nursing home and community groups (Q = 62.788, P = .000), and no significant effect was gained by dividing studies into either in Model I or II. Sensitivity analysis found homogeneity (Q = 18.582, df = 12, P = .099, I <sup>2</sup> = 35.423) across studies with a 9% overall fall reduction (RR = 0.906, 95% CI = 0.853�0.963, z = �3.179, P = .001), including a fall-reduction rate of 10% in multifactorial intervention (RR = 0.904, z = �3.036, P = .002), 9% in community (RR = 0.909, z = �3.179, P = .001), and 12% in Model I (RR = 0.876, z = �3.534, P = .000) with no variations among all the groups. Meta regression suggested that the model fit explained 68.6% of the relevant variance. Conclusions: The meta-sensitivity analysis indicates that randomized controlled trials of fall-prevention programs conducted within the past 10 years (2000�2009) are effective in overall reduction of fall rates of 9% with a reduction of fall rates of 10% in multifactorial interventions, 9% in community settings, and 12% in Model I interventions (initial intervention efforts and then subsequent follow-up).
The 6-PACK programme to decrease fall-related injuries in acute hospitals: protocol for a cluster randomised controlled trial.
Authors:
Barker, Anna; Brand, Caroline; Haines, Terry; Hill, Keith; Brauer, Sandy; Jolley, Damien; Botti, Mari; Cumming, Robert; Livingston, Patricia M.; Sherrington, Cathie; Zavarsek, Silva; Morello, Renata; Kamar, Jeannette
Abstract:
Background and aims In-hospital fall-related injuries are a source of personal harm, preventable hospitalisation costs, and access block through increased length of stay. Despite increased fall prevention awareness and activity over the last decade, rates of reported fall-related fractures in hospitals appear not to have decreased. This cluster randomised controlled trial (RCT) aims to determine the efficacy of the 6-PACK programme for preventing fall-related injuries, and its generalisability to other acute hospitals. Methods 24 acute medical and surgical wards from six to eight hospitals throughout Australia will be recruited for the study. Wards will be matched by type and fall-related injury rates, then randomly allocated to the 6-PACK intervention (12 wards) or usual care control group (12 wards). The 6-PACK programme includes a nine-item fall risk assessment and six nursing interventions: ‘falls alert’ sign; supervision of patients in the bathroom; ensuring patient’s walking aids are within reach; establishment of a toileting regime; use of a low-low bed; and use of bed/chair alarm. Intervention wards will be supported by a structured implementation strategy. The primary outcomes are fall and fall-related injury rates 12 months following 6-PACK implementation. Discussion This study will involve approximately 16 000 patients, and as such is planned to be the largest hospital fall prevention RCT to be undertaken and the first to be powered for the important outcome of fall-related injuries. If effective, there is potential to implement the programme widely as part of daily patient care in acute hospital wards where fall-related injuries are a problem.
You may use these articles or find another articles that are in comparison with bed alarm for fall interventions.
Please, write 1/2 page on per one article critique, then one page on my own share of work; that is ;Performing risk assessments to identify risk factors
Please call me for more explanations. Thanks
