The Ability To Apply Principles Of Analysis Nursing Essay

This article clearly addresses major issues that happen within hospitals. The study is clearly defined to assess and improve the knowledge of fall preventions in Registered Nurses, so that proper implantation of strategies can occur. The aim of this trial is to explore the effects that will take place if educational interventions are utilised in hospitals and although there is ample amounts of literature on this particular area, this study is aiming for a different approach on fall prevention.

The participants for the trial were picked from four difference hospitals in Chong Qing which totalled 1468 participants, there was no evidence provided to show why these particular hospitals were picked for the study.1082 participants had to be excluded due to work related committees, 12 Registered Nurses refused to participate in the trial which resulted in a population of 374. Population is defined as a group of people that have common characterises of points of interest to the researcher. (Sansee Jirojwong, 2011) These participants were not randomly selected as randomised selection is defined as every sample having an equal opportunity in being selected in the study. (Sally Borbasi, 2012) As all the participants in the study are Registered Nurses this makes the selection process specific and only targeting nurses in those four hospitals. From this population they were randomly place into two groups by a computer generator, one group being the control group and the other being the intervention group. Though from initially reading it seems there may be some bias in the selection process as the participants were not part of a blind study and because the individuals within the groups were very different in age, educational background and social class this proves to be beneficial as this study can be applied across the general population, in terms of using the results from the outcome The researchers decided to use quantitative data collection which is data collected that is either categorical or numerical. (Sansee Jirojwong, 2011) They had also put together a questionnaire and knowledge test in relations to falls and fall prevention strategies to determine each group’s baseline knowledge. These questionnaires were undertaken by both the control group and the interventions group simultaneously, under exam condition and were only allocated thirty minutes to finish. Both groups were treated equally in terms of the questionnaire and survey and the time allocated for these. Both groups also received the teaching seminar in which they discuss questions on elderly care as the population from those four hospitals received these every three months already. The participates in the intervention group engaged in extensive education which covered aspects of the ageing population, risk factors of falls, the differences among each type of fall, the costs associated with falls and also fall related diseases. They learnt the methods and tools needed for a falls assessment and were given fall assessment problems.

Though the study goes into great detail the researchers could have addressed validity and reliability more specifically as there is no explanation about the nurses in terms of what ward they may have worked in and how long for, this may have changed the results if a large number of the population had worked in geriatric ward as they may have had more falls prevention training and awareness.

The follow up was performed in the ninth week after the education intervention had been completed. Both groups completed the knowledge test and the questionnaire that they had filled out previously, they were allocated into two different rooms and were still only allocated the thirty minutes time frame to complete it ensuring that both intervention group and control group were treated equally aside from the educational interventions provided. This set-up for the groups can ensure that the data collected can be trustworthy and liable, with no tented evidence from groups interacting with one another before tests were performed. The baseline scores for the knowledge test for the control group ranged between four and eleven leaving them with a median of seven whereas the intervention groups scored between four and twelve also leaving them with a median of seven. This shows that both groups also had similar knowledge before the intervention was put into place this ensures that the results are reliable.

The three month follow up indicated that the intervention group had a significant different in comparison to the control group in relation to their know knowledge tests. Suggesting that the education provided within the study has served its purpose and has increased Registered Nurses knowledge and understanding of the importance of falls prevention falls related diseases and risk factors in patients that can indicate their level of falls risks. The three month follow up results can be seen in the following along with the baseline results. Overall these results both baseline results and the three month follow up results show the effectiveness of this particular study and show logic and sense to why these results turned out the way they did.

Study Group

Study Phase

Range/Median

Intervention Group

Baseline

4-12 Median= 7

Control Group

Baseline

4-11 Median=7

Intervention Group

3 month follow up

13-19 Median= 16

Control Group

3 month follow up

4-12 Median= 7

Although knowledge test scores indicate that Registered Nurses now have a better understanding of management and implantation of falls, this study still has its limitations which still leaves a gap in the research of falls prevention. Although after the educational interventions were proven to be beneficial and even though the Registered Nurses maybe now be better equip with the knowledge and understanding of this particular area, there was no observational follow up to ensure that knowledge learnt was actually put into practice. It may be all well and good if hospitals run educational interventions for major problematic areas such as falls, but even though the right education has been provided how many nurses will actually implement the strategies learnt? How many registered nurses can actually pin point the risk factors in patients that may cause them to fall in a real life scenario? Is this theory able to be put into practice so that the falls rates in hospitals can be decreased in older people? In turn decreasing hospital stays and economic costs associated with fall related diseases and injuries. Though the study clearly addresses the question in terms of educational inventions it still does not cover all clinical outcomes in relation to falls prevention. A good indicator for this study would have been a focus group, a group where the participants could voice their opinions, believes and attributes (Sansee Jirojwong, 2011). This would have shown what the nurses themselves thought of this issue and might have been a good indicator to see if they thought was important enough to actually put into practice. The knowledge test contained very broad and generic questions and did not go into the depth thus it could not indicate whether participants understand the complexity associate with this topic and whether or not they were able to put it into practice. The results didn't indicate whether Nurses could differentiate the risk factors associated with the broad range of patients they would be taking care of from day to day. It has been illustrates that falls risk assessment tools should be used to form a plan on how to reduce fall risks in individuals according to their needs and this study does not show how nurses would create a plan that is strategically made for an individual (Anna Barker, 2010). Did the educational intervention give nurses the tools to evaluate the different needs from a patient who has dementia and is impulsive with transfers and always forgetting their gait aid versus those patients that have poor balance and coordination due to their routine medications? These issues still remain unclear from this study.

Falls happen in a large number of settings such as hospitals, aged care facilities and in elderly people homes (Ward, Fenton, & Maher, 2010) and although there is large numbers of studies and ample amounts of marketing related to this issue it seems that a falls are still occurring. Now maybe falls are inevitable, but reducing the amounts of fall is surely beneficial despite the costs. (Erin Cassell, 2008) States that the leading cause of hospital admissions were falls, reaching a staggering 61,486 alongside that the number of unintentional injuries due to falls which led to death which reached 1,192 between 2004 and 2006. The burden of injury due to falls puts a strain on everyone involved, but the burden really lies within the health care system. Where follow up care is put into place after a fall depending on the individual’s needs. These follow ups can range anywhere from orthopaedic follow up care to rehabilitation. (Bradley, 2009)

There are so many complications that relate to falls, such as decreased mobility, depression, fractures and breaks, neurological issues associated this head strikes during falls and incontinent. (Rebecca McCarthy, 2009) Some of these issues are unable to be reversed; many patients may never get full mobility back and may remain incontinent post fall. Not only do falls effect the patients themselves but their families who may need to take care of them when they return home, the nursing staff who may find when a patient falls stressful but also the economical aspect associated with falls such as longer hospital stays due to not only treating the initial problem they presented with but also the problems that they have now acquired due to a fall in a hospital (Emma Lea, 2012). Some patients can become so agitated and aggress post fall if they have a decrease in mobility causing them to have a greater chance of them falling again as they are unable to accept what has happened (Bedford, 2011), these patients at times need one on one specialised nursing care to ensure that they are safe and things to not become more problematic, this intervention is quite a costly one and we need to put intervention in place so that these issues aren't happening so frequently.

This study has highlighted the importance of educational training within the nursing field and depicts the importance of educational training in problematic areas. Though this study has some limitations and still has some gaps in the study as it does not cover all aspects of this particular area, it is a good baseline for further studies that may be done in the near future. With a more specific knowledge test and learning more about nurses and their opinions on this topic and also including a three month observational follow-up we would be able to articulate a more in depth study that will reveal interventions and strategies method that will help decrease the amount of falls that happen in hospitalised older people.