Falls Among Older Adults In Acute Care Hospitals Are A Signi

Falls Among Older Adults In Acute Care Hospitals Are A Significant Ca

Falls among older adults in acute care hospitals are a significant cause of morbidity and mortality, leading to serious injury, increased healthcare costs, and reduced quality of life. For this reason, investigating the effectiveness of different interventions in reducing the risk of falls is essential. The PICOT question I have chosen to explore is: In adults aged 65 to 80 (P) in acute care hospitals, how does the implementation of a multidisciplinary team-based approach (I) compared to the standard of care (C) influence the rate of falls (O) within a six-month period (T)? The proposed intervention, a multidisciplinary team-based approach, aims to reduce the risk of falls through improved risk assessment, patient education, and targeted interventions.

The comparison intervention is the standard of care typically provided in acute care hospitals, which includes patient education, environmental assessments, and other preventive measures. The primary outcome of interest is the rate of falls within a six-month timeframe. Evidence from current research supports the effectiveness of a multidisciplinary team-based approach, which has been associated with reductions in fall rates among older adults in hospital settings. For example, a comprehensive systematic review by Choi et al. (2023) revealed that implementing such an approach reduced fall rates by approximately 25%, along with a decrease in fall-related injuries.

To evaluate the efficacy of this intervention, I propose utilizing a combination of quantitative and qualitative study designs. A before-and-after study can serve as an initial approach, in which fall rates are measured prior to and following the implementation of the multidisciplinary intervention. This design provides a straightforward comparison and helps identify potential reductions attributable to the intervention (Siddique et al., 2021). To strengthen the evidence, a randomized controlled trial (RCT) would be ideal, randomly assigning participants to either the intervention group receiving the team-based approach or the control group receiving standard care. Measuring fall rates at the conclusion of the study will allow for robust comparison and attribution of any observed differences to the intervention (Goldberg et al., 2019).

In addition to quantitative measures, qualitative methods such as interviews and focus groups with patients and healthcare providers can illuminate experiential insights and contextual factors influencing the intervention’s success or limitations (Ibrahim et al., 2022). These insights can identify barriers to implementation, facilitators that promote adherence, and directions for refining intervention strategies. Employing mixed methods offers a comprehensive perspective, capturing both measurable outcomes and contextual nuances crucial for translating research into practice (Morris et al., 2022).

Implementing a multidisciplinary team-based intervention involves coordinated efforts from nurses, physicians, physical therapists, and other healthcare professionals. This team collaboratively conducts comprehensive risk assessments, tailors patient-specific strategies, and fosters effective communication across disciplines. Such coordinated care ensures that environmental modifications, medication reviews, patient education, and mobility support are seamlessly integrated into patient management, ultimately reducing fall risk (Choi et al., 2023).

The anticipated benefits extend beyond fall reduction; multidisciplinary approaches also facilitate early identification of health issues, improve patient outcomes, reduce hospital length of stay, and decrease healthcare costs associated with fall-related injuries (Morris et al., 2022). The systematic nature of these interventions aligns with best practices recommended by organizations like the National Institute for Health and Care Excellence (NICE, 2013). Nevertheless, barriers such as resource limitations, staff resistance, and inconsistent implementation can hinder success. Qualitative methods can identify these challenges, enabling tailored strategies to improve uptake and sustainability.

References

• Choi, J.-Y., Rajaguru, V., Shin, J., & Kim, K. (2023). Comprehensive geriatric assessment and multidisciplinary team interventions for hospitalized older adults: A scoping review. Archives of Gerontology and Geriatrics, 104, 104831.
• Goldberg, E. M., Marks, S. J., Ilegbusi, A., Resnik, L., Strauss, D. H., & Merchant, R. C. (2019). GAPcare: The Geriatric Acute and Post–Acute Fall Prevention Intervention in the Emergency Department: Preliminary Data. Journal of the American Geriatrics Society, 68(1), 198–206.
• Ibrahim, H., Harhara, T., Athar, S., Nair, S. C., & Kamour, A. M. (2022). Multi-Disciplinary Discharge Coordination Team to Overcome Discharge Barriers and Address the Risk of Delayed Discharges. Risk Management and Healthcare Policy, 15, 141–149.
• Morris, M. E., Webster, K., Jones, C., Hill, A.-M., Haines, T., McPhail, S., Kiegaldie, D., Slade, S., Jazayeri, D., Heng, H., Shorr, R., Carey, L., Barker, A., & Cameron, I. (2022). Interventions to reduce falls in hospitals: a systematic review and meta-analysis. Age and Ageing, 51(5).
• Siddique, S. M., Tipton, K., Leas, B., Greysen, S. R., Mull, N. K., Lane-Fall, M., McShea, K., & Tsou, A. Y. (2021). Interventions to Reduce Hospital Length of Stay in High-risk Populations: A Systematic Review. JAMA Network Open, 4(9), e–e.