- This presentation will explore the PICOT question related to the potential improvements in the quality of life of a target population.
- The question calls for research on the best method of reducing fall-related injuries in adults 65 years old and older.
- The answer to this question is synthesized by examining the evidence from several peer-reviewed articles regarding the alleviation of fall-related injuries among older people.
- Additional details will be provided to prove the importance of the issue, the necessity of the comparison of selected methods of its solution, and the recommendations that stem from it.
- The primary issue in practice is the determination of the most suitable source of improvement of fall rates for an individual over 65 years old.
- In practice, the reason behind falls can include both decreased bone density and side effects of drugs, making additional prescriptions potentially unviable as a method for issue resolution.
Practice Issue Importance
- Falls constitute a high amount of reasons for traumas in older adults, leading to n excessive yet preventable healthcare expenses.
- Further examination of this issue can reveal the most optimal set of recommendations for the target population that would reduce its severity.
- In adults older than 65 with the risk of falls (P), does the use of vitamin D (I), compare with equipment used to help movements (C), improve bone density and independence (O), in 6 months’ time?
- P-Population and problem – The issue is prevalent in the older population, having the most prominent adverse effect on people of age 65 and older (Mansouri & Goher, 2016).
- I–Intervention – Vitamin D is proven to alleviate the rate of fall incidents among older adults (Mansouri & Goher, 2016).
- C–Comparison – Equipment that assists with maintaining static balance and movement possesses similar positive effects on the quality of life (Sampaio et al., 2017).
- O–Outcome – Vitamin D supplements increase bone density and strength, reducing the chance of fractures in case of a fall (Hill & Aspray, 2017). Fall prevention measures examined in the articles are proven to increase independence in older adults (Moncada & Mire, 2017).
- T–Time frame – The researchers have documented that positive changes occur after three months of treatment, although the recommended length of the fall prevention treatment is six months (Park et al., 2017).
- The issue raised by the PICOT question leads to a significant decrease in the quality of life of older people (Cheema & Chaudhry, 2016).
- Literature review shows a prominent positive effect of Vitamin D and calcium supplements on bone density of older adults, which decreases the number of traumas from falls (Hill & Aspray, 2018).
Literature themes and concerns
- All papers examine people of the age of 65 as the most susceptible to fall-related injuries.
- Many of the articles explore the efficiency of Vitamin D, while several studies aim to compare various methods of alleviation of the issue.
- Controlled trials of the effects of Vitamin D on falls have revealed that the number of incidents after a 3-month treatment period has been reduced by approximately 50% (Cheema & Chaudhry, 2016).
- Moreover, it has been determined that the use of assistive devices is less efficient due to its technical limitations (Sharif et al., 2018).
- It is essential to combine all the suitable methods of fall reduction to achieve the best possible outcome.
- Physical exercise is recommended for older people to keep muscle strength in addition to keeping high bone density with Vitamin D intake (Mansouri & Goher, 2018).
- Nurses are encouraged to explore the topic to be able to determine the optimal dose of Vitamin D (Hill & Aspray, 2017).
Impact of Recommendations
- Patients who have osteoporosis and use assistive devices are prone to chronic diseases related to gait and posture changes and would benefit significantly from Vitamin D supplements (Cruz et al., 2020).
- Nurses and healthcare facilities will experience less strain due to the lower number of fall-related injuries.
Feasibility of Recommendations
- The necessity of the optimal dosage comes from the adverse effects of inappropriate Vitamin D intake (Hill & Aspray, 2017).
- A combination of suitable prevention measures can help a patient to avoid the adverse impact of a treatment that is non-vital for that individual (Cruz et al., 2020).
- Patients will be able to have a higher level of independence (Mansouri & Goher, 2018).
- Nurse practitioners are encouraged to include Vitamin D supplements as their primary recommendations for older people.
- Studies reveal that it has the highest potential among potential solutions to the high rates of fall-related traumas.
- Cheema, M. R., & Chaudhry, A. Y. (2016). Quality-of-life indicators and falls due to vitamin D deficiency. International Journal of General Medicine, 9, 21-25. Web.
- Cruz, A. D. O., Santana, S. M. M., Costa, C. M., Gomes da Costa, L. V., & Ferraz, D. D. (2020). Prevalence of falls in frail elderly users of ambulatory assistive devices: A comparative study. Disability and Rehabilitation: Assistive Technology, 15(5), 510-514. Web.
- Hill, T. R., & Aspray, T. J. (2017). The role of vitamin D in maintaining bone health in older people. Therapeutic Advances in Musculoskeletal Disease, 9(4), 89–95. Web.
- Mansouri, N., & Goher, K. (2016). Walking aids for older adults: Review of end-user needs. Asian Social Science, 12(12), 109-119. Web.
- Moncada, L. V. V., & Mire, L. G. (2017). Preventing falls in older persons. American Family Physician, 96(4), 240-247. Web.
- Park, K.-S., Yoo, J.-I., Kim, H.-Y., Jang, S., Park, Y., & Ha, Y.-C. (2017). Education and exercise program improves osteoporosis knowledge and changes calcium and vitamin D dietary intake in community dwelling elderly. BMC Public Health, 17(1). Web.
- Sampaio, L. V. P., Castilho, L. B., & Carvalho, G. de A. (2017). Development of an application for mobile devices to evaluate the balance and risk of falls of the elderly. Revista Brasileira de Geriatria e Gerontologia, 20(6), 805–813. Web.
- Sharif, S. I., Al-Harbi, A. B., Al-Shihabi, A. M., Al-Daour, D. S., & Sharif, R. S. (2018). Falls in the elderly: Assessment of prevalence and risk factors. Pharmacy Practice, 16(3). Web.