SIMILARITY LESS THAN 10%

Phase1, 2, and 3 attached

Phase 4 instructions

Phase 4-Results (Due by WEEK 11) – Please read carefully (Assignment worth 20 points)

Phase 4 is all about results, this part of the paper will be based on the hypothetical analysis. Meaning since we will not be implementing the process, the results described will be based on whatever the students would like the research results to be. You will need to provide results for all the statistical tools mentioned and provide descriptive data (demographics of the population, different descriptive data points, etc.). Make sure to also include research limitations to improve for future studies. Approximately 6 pages.

*** Please note I am more concerned with quality of your writing as opposed to the quantity of your composition.

Grading Rubric for Phase 4 – Before Writing Your Assignment Please read the Research Paper Rubric Carefully

Research Paper Rubric – Phase IV

Outstanding 20 points

Very Good 15 points

Good 10 Points

Unacceptable 5 points

Integration of Knowledge

12.5%

The paper demonstrates that the author understands and has applied concepts learned in the course.

Concepts are integrated into the writer’s own insights.

The writer provides concluding remarks that show analysis and synthesis of ideas

The paper demonstrates that the author, mostly, understands and has applied concepts learned in the course.

Some conclusions, however, are not supported in the body of the paper

The paper demonstrates that the author, to a certain extent, understands and has applied concepts learned in the course

The paper does not demonstrate that the author has understood, and applied concepts learned in the course.

Topic Focus

12.5%

The topic is focused narrowly enough for the scope of this assignment.

A thesis statement provides direction for the paper, either by statement of a position or hypothesis

The topic is focused but lacks direction.

The paper is about a specific topic, but the writer has not established a position.

The topic is too broad for the scope of this assignment.

The topic is not clearly defined

Depth of Discussion

12.5 %

In-depth discussion and elaboration in all sections of the paper.

In-depth discussion and elaboration in most sections of the paper.

The writer has omitted content.

Quotations from oth

Research Paper-Planning 2

Research Paper-Planning

The issue of falls in the long-term care settings

The issue of falls in the long-term care settings

The issue of falls is a common event for elderly patients who are living in acute care settings. This leads to the loss of independence, injuries, and even death if proper intervention and care are not taken. This, therefore, implies that the preventive approaches are the major concern for elderly patients and healthcare professionals. Reports reveal that about 700,000 to 1,000,000 fall-related cases are common within acute care settings (Panneman, et al., 2021).

The United States Centers for Disease Control and Prevention (CDC) reports that one in every four individuals of age 65 years and above falls every year. This is more than 2.8 million injuries that are being treated within the emergency departments every year. The reported annual rates of hospitalization and deaths are 800, 000 and over 27, 000 respectively not forgetting the financial burden associated with adult falls. The medical cost for the fall issue was anticipated to rise to $ 67.7 billion by 2020 (Panneman, et al., 2021). Most of the insurance firms are not reimbursing for these never events hence causing more financial burden to the healthcare organizations.

These burdens and the adverse impacts of fall rates require urgent interventions from healthcare professionals in acute care settings. The best practices must be put in place to help in the successful management of the falls thus enhancing the overall safety and the autonomy of the individuals in healthcare facilities. The purposeful, as well as timely hourly rounding, has been recommended to be an effective intervention that helps in meeting the needs of the clients, reduction of the fall rates in every department or units, improvement of the patients’ safety, and helping in the proactive approaches towards addressing the falls issues before they occur (Brewer, Carley, Benham-Hutchins, Effken, & Reminga, 2018).

Identification of the problem

Even though hourly rounding has proven to be one of the effective approaches that help reduce the burden and other adverse problems caused by the issue of patients, little attention has been given to such practices. There is an increased lack of accountability by the nurses when it comes to implementing hourly rounding. This, therefore, implies that however much the hourly rounding intervention or practice is made available, the reluctance in its implementation would still lead to an increase in the rates of falls.

The reluctance and

1

8

Falls in The Long-Term Care Settings

Nayaris Reyes

Florida National University

June 12, 2021

Brief Literature Review

The elderly in the long-term care facilities are typically predisposed to falling and might fall for various reasons. Some predisposing factors might be related to unsteady balance and gait, poor vision, weak muscles, dementia, and medications. In addition, various medical conditions, including stroke, low blood pressure, brain disorders, and poorly managed epilepsy, might increase older people’s risk for falls (Golmakani et al., 2014). Therefore, several studies have been conducted to evaluate the efficacy of multi-factorial interventions on the occurrence of falls in long-term care settings, including psycho-geriatric nursing home patients. Based on the clinical study, it was concluded that various multi-factorial interventions used in preventing falls such as a general medical assessment emphasizing falls, specific fall risk evaluation devices, assessing medication intake, fall history, and mobility, using protective and assistive aids play a significant role in reducing the incidence of falls among the elderly (Ungar et al., 2013). Accordingly, it was evident that fall prevention, usually geared towards psycho-geriatric patients in a long-term care facility, is possible and efficient in minimizing falls among older people.

Other researchers carried out a study in developing a fall prevention program for the aged patients in long-term care entities, especially those at risk of falling, by increasing caregiving expertise or skills and motivating staff members. From the analysis, exercise programs encompassing warm-up, muscle reinforcement, especially in the lower extremities, and proprioceptive neuromuscular expedition are used in increasing motivation and caregiving skills (Donath et al., 2016). Another research conducted to evaluate the statistics of falls among the elderly found out that falls are the leading cause of injury-interrelated visits to emergency facilities in the U.S. They are also the primary etiology of accidental deaths in persons aged 60 and above. From the analysis, falls might be markers of diminishing function and poor health and are significantly attributable to morbidity.

To assess the risk factors related with falls among the older people in the long-term care facilities, it was realized that more than 25% of facility-dwelling older individuals and 60% of nursing home residents fall yearly (Pfortmueller et al., 2014). Various risk factors linked to their falls are medication use, increasing age, sensory deficits, and cognitive impairment. Studies depict that older persons who have fallen must undergo a thorough clinical evaluation (within the facilities) to analyze the preven

8

Falls in Long Care Term Settings

The consequences of falls in among elderly population have resulted in pain, functional impairment, disability and death. Because of the expected increase in the elderly population and the known complications of falling populations, risk factors associated with falls need to be assessed. Prescribed medicines contribute significantly to falling conditions. Some of the medications well-known for increased drops in older people are such medicines as benzodiazepines, neuroleptic drugs, sedatives and anti-hypertensive drugs. Falls in older adults are not only due to extrinsic risk factors such as medications, but also due to intrinsic factors such as cognitive impairment, frailty, gender, and age. Internal factors such as cognitive impairment, frailty, sex, and age, as well as external dangers such as medicine, play a role in the decline of older people. Despite workers’ increasing understanding of how to care for the elderly, there is still a significant gap between what is known and what is regularly done. This article applies the techniques for investigating the risk variables and potential preventive strategies in long-term care facility residents in Phase 2.

Measures

During a six-month span, the number of falls should be calculated using charts. Falls should be characterized as: no falls reported, 1 fall, 2-4 falls and +5 falls in analyzes utilizing categorical variables and to distinguish between non-falling, rare falling and common falling. The number of falls is considered a continuous variable in regression analysis. Both the score of the Mini-Mind State Examination (MMSE) and the clinical dementia diagnostic, which should be documented in both LTC-CGA, should be used to evaluate cognition. Every 6 months and after any substantial health changes the LTC-CGA should be performed by family medical doctors. Medicines from the latest medication list should be recognized in the document, and clinical judgment should be used by researcher data abstractors to decide what medicines the resident should now be administered. The list of beers should be used to identify possibly inappropriate medications, often known as (PIMs). Drug counts should be used to assess polypharmacy. Clinical frailty should be measured using a modified Frailty Scale for use in LTC. Little weak persons rely on others to complete essential daily duties. Massively vulnerable persons need help in both constructive and non-constructive actions. Individuals who are Severely vulnerable are fully reliant on others for everyday tasks. Very fragile people are totally reliant and near the end of their lives. Terminally sick people who are not obviously fragile otherwise have a life expectation of less than 6 months. Another risk in

1

8

Falls in The Long-Term Care Settings

Nayaris Reyes

Florida National University

June 12, 2021

Brief Literature Review

The elderly in the long-term care facilities are typically predisposed to falling and might fall for various reasons. Some predisposing factors might be related to unsteady balance and gait, poor vision, weak muscles, dementia, and medications. In addition, various medical conditions, including stroke, low blood pressure, brain disorders, and poorly managed epilepsy, might increase older people’s risk for falls (Golmakani et al., 2014). Therefore, several studies have been conducted to evaluate the efficacy of multi-factorial interventions on the occurrence of falls in long-term care settings, including psycho-geriatric nursing home patients. Based on the clinical study, it was concluded that various multi-factorial interventions used in preventing falls such as a general medical assessment emphasizing falls, specific fall risk evaluation devices, assessing medication intake, fall history, and mobility, using protective and assistive aids play a significant role in reducing the incidence of falls among the elderly (Ungar et al., 2013). Accordingly, it was evident that fall prevention, usually geared towards psycho-geriatric patients in a long-term care facility, is possible and efficient in minimizing falls among older people.

Other researchers carried out a study in developing a fall prevention program for the aged patients in long-term care entities, especially those at risk of falling, by increasing caregiving expertise or skills and motivating staff members. From the analysis, exercise programs encompassing warm-up, muscle reinforcement, especially in the lower extremities, and proprioceptive neuromuscular expedition are used in increasing motivation and caregiving skills (Donath et al., 2016). Another research conducted to evaluate the statistics of falls among the elderly found out that falls are the leading cause of injury-interrelated visits to emergency facilities in the U.S. They are also the primary etiology of accidental deaths in persons aged 60 and above. From the analysis, falls might be markers of diminishing function and poor health and are significantly attributable to morbidity.

To assess the risk factors related with falls among the older people in the long-term care facilities, it was realized that more than 25% of facility-dwelling older individuals and 60% of nursing home residents fall yearly (Pfortmueller et al., 2014). Various risk factors linked to their falls are medication use, increasing age, sensory deficits, and cognitive impairment. Studies depict that older persons who have fallen must undergo a thorough clinical evaluation (within the facilities) to analyze the preven

8

Falls in Long Care Term Settings

The consequences of falls in among elderly population have resulted in pain, functional impairment, disability and death. Because of the expected increase in the elderly population and the known complications of falling populations, risk factors associated with falls need to be assessed. Prescribed medicines contribute significantly to falling conditions. Some of the medications well-known for increased drops in older people are such medicines as benzodiazepines, neuroleptic drugs, sedatives and anti-hypertensive drugs. Falls in older adults are not only due to extrinsic risk factors such as medications, but also due to intrinsic factors such as cognitive impairment, frailty, gender, and age. Internal factors such as cognitive impairment, frailty, sex, and age, as well as external dangers such as medicine, play a role in the decline of older people. Despite workers’ increasing understanding of how to care for the elderly, there is still a significant gap between what is known and what is regularly done. This article applies the techniques for investigating the risk variables and potential preventive strategies in long-term care facility residents in Phase 2.

Measures

During a six-month span, the number of falls should be calculated using charts. Falls should be characterized as: no falls reported, 1 fall, 2-4 falls and +5 falls in analyzes utilizing categorical variables and to distinguish between non-falling, rare falling and common falling. The number of falls is considered a continuous variable in regression analysis. Both the score of the Mini-Mind State Examination (MMSE) and the clinical dementia diagnostic, which should be documented in both LTC-CGA, should be used to evaluate cognition. Every 6 months and after any substantial health changes the LTC-CGA should be performed by family medical doctors. Medicines from the latest medication list should be recognized in the document, and clinical judgment should be used by researcher data abstractors to decide what medicines the resident should now be administered. The list of beers should be used to identify possibly inappropriate medications, often known as (PIMs). Drug counts should be used to assess polypharmacy. Clinical frailty should be measured using a modified Frailty Scale for use in LTC. Little weak persons rely on others to complete essential daily duties. Massively vulnerable persons need help in both constructive and non-constructive actions. Individuals who are Severely vulnerable are fully reliant on others for everyday tasks. Very fragile people are totally reliant and near the end of their lives. Terminally sick people who are not obviously fragile otherwise have a life expectation of less than 6 months. Another risk in