Medicine and Health Sciences Commons^™

Effectiveness Of An Instructional Program On Decreasing Fall Incidents In Geriatric Patients With Psychiatric Disorders, Maurice Washington

DNP Scholarly Projects

Falls occur in 25% of older adults, resulting in over 8 million fatal and nonfatal injuries. In addition to the human suffering, associated medical and legal costs amount to over 50 billion dollars a year. This study examines the impact on fall rates of an evidence-based fall prevention program provided to a multidisciplinary staff on a psycho geriatric unit in Philadelphia, Pennsylvania. Staff knowledge of effective fall prevention interventions was measured before and after their participation in an evidence-based instructional workshop provided by the Project Director using the Falls Prevention Knowledge Test by Dykes et al. (2019). While there were …

Implementing The Timed Up And Go Test To Prevent Falls, Shamika Allen

Doctor of Nursing Practice Projects

Falls are the most reported injury within the geriatric population. Behavioral health patients have the most injurious falls, with falls impacting multiple things such as staffing, cost, injury, and quality of life for the patient (Ocker et al., 2020). Currently, the standardized fall assessment for new patients upon admission is the Morse Fall Scale (MFS). This fall assessment was intended to assess the level of fall risk for patients who are on an acute medical floor during their hospital stay. The Timed Up and Go test (TUG) is a fall assessment that has been used in geriatric patients to assess …

The Psychometric Properties Of The Modified Fear Of Falling Avoidance Behavior Questionnaire In Parkinson’S Disease And Older Adults, Billy La, Arturo Aldaco, Ashley Haller

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background/purpose: The Fear of Falling Avoidance Behavior Questionnaire (FFABQ), developed in 2011 to measure fear of falling avoidance behavior, has good evidence for reliability and validity. However, a recently modified version (mFFABQ) is theorized to be easier to understand for those completing the questionnaire because the Likert responses are more logical in completing the item stem. The purpose of this study was to examine the test-retest reliability and construct validity of the mFFABQ in adults with Parkinson’s Disease (PD) and older adults aged 60-90 years. Methods: Thirty-nine participants (age 72.21 ± 9.5; 29 men, 10 women) diagnosed with PD (diagnosis …

Cost Analysis Of Implementing An Exercise Program For Fall And Fracture Prevention In Older Adults On Proton Pump Inhibitor Therapy, Thomas Adam Wichelmann, Nhan Dang, David H. Kruchko, Sufyan Abdulmujeeb, Eli D. Ehrenpreis

Journal of Patient-Centered Research and Reviews

Purpose: Falls have significant financial impact. Proton pump inhibitor (PPI) therapy is associated with an increased risk of falls and fractures. Exercise programs have been shown to decrease risk of falls in the elderly population and are recommended by the U.S. Preventive Services Task Force for patients over age 65 to reduce falls. Our study aimed to explore the potential financial benefit of implementing three different Centers for Disease Control and Prevention-recommended exercise-based interventions for fall prevention (Tai Chi, Stepping On, and Otago Exercise Program) in ≥ 65-year-old patients on PPI therapy.

Methods: A Markov model was developed to predict …

Decreasing Falls On A Locked Inpatient Psychiatric Unit, Terri Fitzpatrick

Doctor of Nursing Practice Final Manuscripts

Purpose: The purpose of this project was to implement an RN nursing staff education on the fall risk assessment tool in effort to decrease falls on one adult locked inpatient psychiatric unit. The assumption was that an educational review of the fall risk variables for inpatient psychiatric patients and subsequent initiation of a fall risk care plan would lead to decreased falls.

Background: A fall can be defined as a sudden unintentional change in position causing an individual to descend to a lower level or onto an object, the floor or ground, or another surface with or without injury. Review …

Skeletal Muscle Index And Its Association With Mobility Among Community‐Dwelling Older Women, Zbigniew M. Ossowski

Baltic Journal of Health and Physical Activity

Conclusions: The study findings highlight the complaints of people with moderate myopia compared to people without myopia concerning both their quality of life and musculoskeletal problems.

Evidence-Based Change Benchmark: Implementing Intervention Strategies Aimed At Reducing Patient Falls, Victoria Nix

MSN Capstone Projects

This paper provides an overview of an evidence-based change project that arose from the following PICOT: In patients at risk for falls [P], how does implementing fall risk prevention [I] compared to no fall risk prevention [C] affect fall rates [O] within 3 months of implementation [T]? A comprehensive review of primary sources dealing in clinical studies was found to support the case that fall prevention measures, specifically patient-specific bedside tools, have shown to be instrumental in reducing patient falls. The development and implementation of a robust Fall Prevention Program designed around the latest research was the goal; however, the …

The Use Of Video Monitoring To Decrease Falls, Marie Elizabeth Mo

Doctoral Dissertations and Projects

Fall prevention is a constant challenge for inpatient nursing staff. The purpose of this project is to demonstrate that falls in hospitalized patients will decrease with the initiation of video monitoring. A fall while in the hospital can lead to increased length of stay, increased cost to the organization, lack of reimbursement from Medicare, and the worst outcome is the patient never returning to baseline. Nursing staff struggle with fall prevention daily and are often unsuccessful. One to one sitters are often utilized as a fall prevention measure; this can be draining to hospital resources. Identified best practices of one-to-one …

A Pilot Study: The Effects Of Modified Tummy Time With Posterior Chain Strength Training On Sagittal Imbalances In Parkinson's Disease, Rhonda R. Boeckman

Health and Kinesiology Theses

Pathophysiological mechanisms of postural changes leading to sagittal imbalances in PD remain unknown and problematic, contributing to falls through all stages of PD. Research is needed regarding tummy time across the lifespan as a countermeasure for sagittal imbalances and as an optimal position for gravity-resisted exercise interventions for the posterior chain.

The purpose of this pilot study was to explore the impact of modified tummy time (MTT) with posterior chain strength training (PCST) on sagittal imbalances, postural instability, strength, falls, and QOL in individuals with PD. Six individuals with PD were recruited and randomly assigned to a treatment group (N=3) …

A Vicious Cycle Of Fear Of Falling Avoidance Behavior In Parkinson’S Disease: A Path Analysis, Kameron Jacobson, Nicole Matsunami, Hannah Mccarl, Michelle Regis

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Postural instability (PI) in Parkinson’s disease (PD) is associated with several negative down- stream consequences. Objective: The purpose was to explore the validity of a theoretical model of these downstream consequences arranged in a vicious cycle wherein PI leads to decreased balance con!dence, which in turn leads to increased fear of falling (FOF) avoidance behavior, which in turn leads to decreased physical conditioning, which then feeds back and negatively affects PI. Methods: A path analysis of cross!sectional data from 55 participants with PD was conducted. The four con- structs in the model connected in succession were: 1. PI (principal …

Response Inhibition Deficits In Women With The Fmr1 Premutation Are Associated With Age And Fall Risk, Carly Moser, Lyndsay Schmitt, Joseph Schmidt, Amanda Fairchild, Jessica Klusek

Faculty Publications

One in 113-178 females worldwide carry a premutation allele on the FMR1 gene. The FMR1 premutation is linked to neurocognitive and neuromotor impairments, although the phenotype is not fully understood, particularly with respect to age effects. This study sought to define oculomotor response inhibition skills in women with the FMR1 premutation and their association with age and fall risk. We employed an antisaccade eye-tracking paradigm to index oculomotor inhibition skills in 35 women with the FMR1 premutation and 28 control women. The FMR1 premutation group exhibited longer antisaccade latency and reduced accuracy relative to controls, indicating deficient response inhibition skills. …

Impact Of The Hester Davis Fall Risk Scale On Inpatient Falls, Amelia Payne

Dissertations

Problem: During a three month period in 2018, a rural acute care facility experienced a fall rate of 3.4 falls per 1,000 patient days. The aim of this clinical scholarship project was to implement the Hester Davis Fall Risk Scale (HDFRS) for adult inpatients in a rural acute care facility.

Methods: Utilizing the Find, Organize, Clarify, Understand, Select- Plan, Do, Study, Act (FOCUS-PDSA) model, the HDFRS was implemented and evaluated using a pre and post design to determine its impact on falls per 1,000 patient days and falls with injury per 1,000 patient days. The method of evaluation was a …

Association Between Patient Ability In Activities Of Daily Living At Hospital Admission And Key Indicators, Stephanie Rosen, Amber Steele

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Illness and inactivity in the hospital frequently leads to disability that can reduce quality of life and increase costs. Early identification of people with limitations in activities of daily living (ADL) who are at risk for poor outcomes such as increased length of stay (LOS), hospital acquired conditions (i.e., falls and pressure injuries (PIs)), and discharge away from home can facilitate appropriate intervention. The Activity Measure for Post-Acute Care Inpatient Activity Short Form (AM-PAC IASF), a reliable and valid tool to measure ADL limitations, is scored at admission for all patients in our hospital. The purpose of this study …

Hospital To Home: Fall Prevention Interventions For The Discharging Patient, Joy Bridewell

Nursing Masters Papers

Falls is a major public health problem globally, with an estimated 646,000 fatal falls per year. This makes falls the second leading cause of unintentional injury death. Falls are very costly with non-fatal fall injuries costing about $50 billion per year and fatal falls with an estimated $754 million. Many risk factors contribute to a person’s risk of falling. Risk factors include age, gender, muscle strength, underlying medical or disabling conditions, and unsafe environments. Patients who have been hospitalized are also among those at risk. Most hospitalized patients are assessed frequently to determine their risk of falling so that care …

The Impact Of Fall Prevention Education For Individuals With Parkinson's Disease, Missy Ziegler

Occupational Therapy: Student Scholarship & Creative Works

Abstract Objective: The purpose of this study is to explore the relationship between an individual with Parkinson’s Disease (PD) perceptions of why falls happen and if receiving fall prevention education is beneficial to reducing falls. Methods: An anonymous survey was developed by the researcher in order to learn more about individuals’ personal experiences relating to falls, fear of falling, and fall prevention education. Surveys were used to identify if participants have ever experienced a fall and subsequently examine the relationships between falls and fall education. Semi-structured interviews were conducted to supplement survey results and gain greater insight into the experiences …

Evaluating Knowledge Of Falls Risk Factors And Falls Prevention Strategies Among Lower Extremity Amputees After Inpatient Prosthetic Rehabilitation: A Prospective Study, Susan W. Hunter, Jordan Higa, Courtney Frengopoulos, Ricardo Viana, Michael Payne

Physical Therapy Publications

Purpose: Falls are prevalent among people with lower extremity amputations. A knowledge of risk factors is important in preventing falls, though no research has evaluated patient understanding of falls in this population. The study objective was to evaluate knowledge of falls risk factors and falls prevention strategies at discharge and 4-months after inpatient prosthetic rehabilitation.

Methods: Participants completed a falls questionnaires with four sections: (1) falls during rehabilitation and after discharge, (2) falls self-efficacy using the Activities-specific Balance Confidence scale, (3) knowledge of falls risk factors, and (4) falls prevention strategies. Questionnaire responses were quantified using means and standard deviations …

The Turkish Version Of The Modified Falls Efficacy Scale: Reliability And Validity From The Viewpoint Of Balance, Ni̇lüfer Çeti̇şli̇ Korkmaz, Mehmet Duray, Esra Doğru Hüzmeli̇, Hande Şenol

Turkish Journal of Medical Sciences

Background/aim: The factors associated with fall-related self-efficacy should be addressed, especially in the elderly. The Modified Falls Efficacy Scale (MFES) is a simple instrument with good scaling properties and reliability. The aim of the present study was to determine the reliability and the validity of the Turkish version of the MFES from the viewpoint of balance.Materials and methods: In this study, 164 participants aged >65 years were included. The use of walking aids and assistive devices, history and frequency of falls in the previous year, living environment, and exercise habits were noted. Balance and risk of falling were assessed with …

Strategies And Challenges Associated With Recruiting Retirement Village Communities And Residents Into A Group Exercise Intervention, Rachel L. Duckham, Jamie L. Tait, Caryl A. Nowson, Kerrie M. Sanders, Dennis R. Taaffe, Keith D. Hill, Robin M. Daly

Research outputs 2014 to 2021

BACKGROUND: Randomized controlled trials (RCTs) provide the highest level of scientific evidence, but successful participant recruitment is critical to ensure the external and internal validity of results. This study describes the strategies associated with recruiting older adults at increased falls risk residing in retirement villages into an 18-month cluster RCT designed to evaluate the effects of a dual-task exercise program on falls and physical and cognitive function.

METHODS: Recruitment of adults aged ≥65 at increased falls risk residing within retirement villages (size 60-350 residents) was initially designed to occur over 12 months using two distinct cohorts (C). Recruitment occurred via …

Assessing The Risk Of Falling In Adults One-Year After Total Hip Arthroplasty, William Janes

Electronic Thesis and Dissertation Repository

The purpose of this study was to examine falls prevalence, falls risk factors and knowledge of falls in individuals who have undergone a total hip arthroplasty. There were 135 patients examined at their one-year follow-up appointment for total hip arthroplasty. Our primary outcome, falls prevalence and falls circumstances, found a falls prevalence of 21.5% with identical circumstances to that of average community-dwelling older adults. Female sex, number of prescription medications and multiple joint replacements were found to be significantly associated with the occurrence of falls in the previous year. The Falls Risk for Older People in a Community Setting Questionnaire …

Baseline Prevalence Study Of Hendrich Ii Fall-Risk Assessment Tool At A Local Community Hospital, Emanuelle Vasconcelos Barbosa Borba Pontual

Master's Projects and Capstones

Each year, 700,000 to 1,000,000 people in the United States fall in hospitals; 30%–35% of those sustain injuries, and 20% of falls will cause serious traumatic injuries. Yet, research shows that close to one-third of these falls could be prevented. This paper presents the analyses of two fall-risk tools, Hendrich II fall risk model (HFRM II) and PMAT, in a local community hospital. Extensive review of literature and statistical analysis of 106 patients’ assessments practices were used to determine the current assessment skills for falls and PMAT. The aim was to understand if RNs are using the tools appropriately and …

Using The Medication Cabinet To Predict Fall Risk In Elderly Adults, Jessica Lopez

University of the Pacific Theses and Dissertations

Background: In the United States, 30-60% of older adults fall each year; 10-20% of these falls result in injury, hospitalization, or even death. Better prevention of falls in this population may be facilitated by broader identification of risk factors. The use of statins has emerged as a potential risk factor, but the data provide conflicted results.

Purpose: To examine the relationship between statin use and falls among community-dwelling older adults.

Methods: We evaluated the patient registry of a Level 1 trauma center. All patients aged > 50 years who were admitted for falls in 2015 were included (n=615). Many of these …

Incidence And Prevalence Of Falls In Adults Living With An Intellectual Disability Living In The Community: A Systematic Review, Portia Ho, Shane Patman, Caroline Bulsara, Jenny Downs, Max Bulsara, Anne-Marie Hill

Physiotherapy Papers and Journal Articles

Review question/objective: The objective of this review is to synthesize the best available evidence to determine the incidence and prevalence of falls in adults with intellectual disability living in the community.

Falls Program On An Acute Psychiatric Unit, Joseph Hunter Rose

Master's Projects and Capstones

In the metropolitan hospital’s acute psychiatric unit there has been an increase in falls incidence as well as need for evaluation of the effectiveness of Schmid Fall Risk Assessment tool in its ability to properly identify those at risk. In the last fiscal year there were 45 falls among 28 patients on the acute psychiatric unit.Falls are harmful to the patients and can cause prolonged hospital stays with non-reimbursable costs to the hospital. Falls amongst psychiatric patients is an even greater challenge to address due to the nature of the mental health disease process. This project addresses general costs of …

The Role Of Postural Stability And Other Factors In Distal Radius Fracture, Sheena Saju Philip

Electronic Thesis and Dissertation Repository

The objective of the thesis was to describe the factors leading to falls in distal radius fracture (DRF) events, explore patient perceived risk of falls, and postural stability. A mixed method study described the type of fall in DRF patients (n= 1454) and patient perceived contributing factors (n=29). A prospective cohort study examined the postural stability and related fall risk of DRF participants (n=137) in Biodex Balance System (BBS) and compared to normative values. Environmental factors were a major contributor to DRF events. Older adults (44 to 65 years) had the highest rate of DRF (female: male ratio of 2:1). …

Walking-Induced Fatigue Leads To Increased Risk In Older Adults, S. Morrison, S. R. Colberg, H. K. Parson, S. Neumann, R. Handel, E. J. Vinik, J. Paulson, A. I. Vinik

Rehabilitation Sciences Faculty Publications

Background- For older adults, falls are a serious health problem, with more than 30% of people older than 65 suffering a fall at least once a year. One element often overlooked in the assessment of falls is whether a person's balance, walking ability, and overall falls risk is affected by performing activities of daily living such as walking.

Objective- This study assessed the immediate impact of incline walking at a moderate pace on falls risk, leg strength, reaction time, gait, and balance in 75 healthy adults from 30 to 79 years of age. Subjects were subdivided into 5 equal groups …

My Independent Streak May Get In The Way': How Older Adults Respond To Falls Prevention Education In Hospital, Anne-Marie Hill, Jacqui Francis-Coad, Terry P. Haines, Nicholas Waldron, Christopher Etherton-Beer, Leon Ricker, Katharine Ingram, Steven Mcphail

Physiotherapy Papers and Journal Articles

Objectives: The aim of the study was to determine how providing individualised falls prevention education facilitated behaviour change from the perspective of older hospital patients on rehabilitation wards and what barriers they identified to engaging in preventive strategies.

Design: A prospective qualitative survey.

Methods: Older patients (n=757) who were eligible (mini-mental state examination score>23/30) received falls prevention education while admitted to eight rehabilitation hospital wards in Western Australia. Subsequently, 610 participants were surveyed using a semistructured questionnaire to gain their response to the in-hospital education and their identified barriers to engaging in falls prevention strategies. Deductive content analysis …

Incidence, Risk Factors And The Healthcare Cost Of Falls Postdischarge After Elective Total Hip And Total Knee Replacement Surgery: Protocol For A Prospective Observational Cohort Study, Anne-Marie Hill, Gail Ross-Adjie, Steven M. Mcphail, Leanne Monterosso, Max Bulsara, Christopher Etherton-Beer, Sarah-Jayne Powell, Gerard Hardisty

Research outputs 2014 to 2021

Introduction:

The number of major joint replacement procedures continues to increase in Australia. The primary aim of this study is to determine the incidence of falls in the first 12 months after discharge from hospital in a cohort of older patients who undergo elective total hip or total knee replacement.

Method and analyses:

A prospective longitudinal observational cohort study starting in July 2015, enrolling patients aged ≥ 60 years who are admitted for elective major joint replacement (n = 267 total hip replacement, n = 267 total knee replacement) and are to be discharged to the community. Participants are followed …

Brachial Plexus Injury And Benign Paroxysmal Positional Vertigo Following A Fall: A Case Report, Przemyslaw Ilczyk

All Capstone Projects

Background: In the elderly population, research has shown that impairments of balance and strength are common reasons for falls. Falls constitute one of the main reasons for emergency department and hospital admissions, and are the second most common reason for brachial plexus injury. Another common symptom, after a fall and head trauma incident, is Benign Paroxysmal Positional Vertigo (BPPV). Approximately 50% of subjects with traumatic brain injury complain about positional vertigo. Research shows that traumatic BPPV is commonly misdiagnosed in clinical practice.

Purpose: The purpose of this case report is to present interventions that were used to treat a patient …

Identification Of Functional Parameters For The Classification Of Older Female Fallers And Prediction Of ‘First-Time’ Fallers, Niklas König Ignasiak

Physical Therapy Faculty Articles and Research

Falls remain a challenge for ageing societies. Strong evidence indicates that a previous fall is the strongest single screening indicator for a subsequent fall and the need for assessing fall risk without accounting for fall history is therefore imperative. Testing in three functional domains (using a total 92 measures) were completed in 84 older women (60–85 years of age), including muscular control, standing balance, and mean and variability of gait. Participants were retrospectively classified as fallers (n = 38) or non-fallers (n = 42) and additionally in a prospective manner to identify first-time fallers (FTFs) (n = 6) within a …

Understanding And Preventing Falls: Perspectives Of First Responders And Older Adults, Monica Fernandez, Anita Diep Hin, Chelsea C. Prado

Dissertations, Masters Theses, Capstones, and Culminating Projects

OBJECTIVE. The objectives of this study were to identify characteristics of older adult fallers in a local community in Marin County, California, examine the perceptions of older adults who contacted a local fire district after a fall, examine the perceptions of first responders from a local fire district regarding falls and fall prevention, explore the degree of depression in older adult fallers, and identify strategies to prevent falls in older adults.

METHODS. This research study was an exploratory and retrospective descriptive study that utilized a mixed-method design. The researchers coded narratives from Patient Care Report (PCRs) provided by the fire …