In a 1,000–1,250 word essay, summarize two QUANTITATIVE studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study.
Cameron, Bowles, Gard, & Andrew (2018), falls among older adults result in several complications that are detrimental to the health of nursing home residents including but not limited to injuries and death. The number of older adults in nursing homes that fall annually is rather alarming. In dementia patients living in nursing homes, falls are a cirtical issue especially because majority of the residents that fall do not tell their physicians. Additionally, a history of falls can worsen the complications if the individual falls again.
The method of study adopted by the authors is the cross-sectional study design, which was used to evaluate changes in healthcare and the outcome after the implementation of a new primary care model. The research utilized a sample population of 395 residents, which was divided between those with Emergency Health Services (EHS) 911 ambulance call and those without. The research timeline was six months during which the number of falls were recorded in a chart. Cognition impairement, one of the resulting complications of falls among nursing home residents, was measured using a clinical diagnosis for dementia and the MMSE (Mini Mental State Examination). The research also assessed prescribed medications that the residents were taking and their potential impact on falls.
The study discovered that the frequnecy of falls of the sample population was 52%. Some of the factors that were proven to increase the risk of the falling include the use of Selective Serotonin-Noreinephrine Reuptake Inhibitors (SSRN) (p=0.084), belonging to the male gender (p=0.009), suffering dementia (p=0.009). Further, the researchers found out that visual impairment and using potentially inappropriate medications (PIMS) was responsible for 95% of falls among the sample population (Cameron, Bowles, Gard, & Andrew, 2018). While the use of Benzodiazepine was thought to have a negative impact on falling, the research proved that the contrary was true – the medication was in fact found to be quite successful in reducing the incidence of falls. These findings may be used in nursing practice to reduce the risk and rate of falling especially in nursing homes. Nurse practitioners can identify the potentially inappropriate medications that increase the risk of falling among older adults and then substitute them with more appropriate medication. Additionally, there is a need to check on nursing home residents more frequently and provide assistance to those with visual impairment to reduce the number of falls (Cameron, Bowles, Gard, & Andrew, 2018). Further, nurses can develop a plan for regulating the older adults’ intake of Benzodiazepine as it has been proven to reduce the incidence of falls.
This research has observed ethical considerations to the maximum, beginning with beneficence. The sole aim of the research is to create a positive impact on the lives of their target study population and hence, no harm was done during the research or effected by the findings of the research. Another ethical issue strictly observed by this research is the respect for anonymity, confidentiality and privacy. The data obtained from the research steers clear of individual identities and only describes important information required for the study, thereby respecting the anonmity and confidentiality of the study group. Further, by including only the required data, the researchers adhere to the ethical issue of respecting the privacy of the participants.
Okeorji (2017) begins her research by mentioning that the safety and care of older adults living in skilled nursing facilities is dependent on the nursing staff. 70% of the time, the nursing practitioners have to provide direct care to these residents as they are unable to care for themsleves. The primary reason why older adults are taken to nursing homes is to receive the care and assistance that their families may not be able to provide either because of the lack of expertise or their busy schedules. However, the nursing staffing ratios may affect the care received by these residents, hence the frequency of falls, which most of them experience from time to time. The complications that may result from these falls are a critical issue in nursing care. Older adults can suffer injuries that may further complicate their health that has already deteriorated as a result of old age. Further, when these falls become so frequent, the residents may suffer death. While there are several interventions that have already been developed to prevent older adults in nursing homes from falling, the need for appropriate nursing staffing ratios need not be downplayed as they are responsible for implementing the said strategies. Some of these strategies as stated by Okeorji (2017) include the education of staff and resident about the significance of preventing and reporting falls respectively, use of alarm devices to monitor falls and use of restraints (can be physical or chemical).
The study by Okeorji (2017) compared the incidence of falls in four skilled nursing facilities and found varying results, with some being higher than others. However, the study did not find any correlation between the number of falls and the nursing staffing ratios as some of the skilled nursing facilities reported higher fall rates despite being more staffed than others. The researcher’s effort to determine the rate of falls during different shifts and provide a connection with staffing ratios also went unsubstantiated as no considerable change was noted. The researcher concluded that while the correlation between staffing ratios and incidence of falls was almost nonexisent, there was need for future researchers to determine other links to the problem – such as nurse attitudes toward their work or patients, variation of tasks between shifts or insufficient knowledge among the staff. These findings are essential in nursing practice as they redirect the focus back to the implementation of effective intervention measures including the use of technology (alarm devices, seatblets on wheelchairs, medical restraints) and the education of the staff and residents.
The ethical considerations associated with Okeorji’s (2017) research study include respect for confidentiality and anonymity, respect for privacy, informed consent and beneficence. Confidentiality and anonymity is observed through the researcher’s effort to keep the identities of the four skilled nursing facilities used in the study unknown throughout the study. Further, no identities of the study group (both the residents and nurses) has been revealed by the researcher, thereby extending the respect for privacy. More so, the reseacrh does not result in the harm of anyone involved – patients or nurses – fulfilling the requrement of beneficence. Informed consent is also an ethical issue that is apparent throughout the research conducted among multiple institutions (Okeorji, 2017).
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