Interventions to Prevent Fall Injury in Older Clients

This proposal aims to summarize the best interventions implemented to prevent fall injury in older clients. It discusses the high incidence of geriatric fall injury and the burden of care due to repeated hospitalization. The project design involves a systematic review to evaluate the effectiveness of various interventions such as exercise, medication review, fall assessment, environmental changes, and multi-factorial intervention. The outcomes of the research indicate that exercise intervention, including physical activity and balance training, is the most prevalent and effective intervention for fall prevention in elderly patients.

Running head: PROPOSAL
Proposal
Name of the student:
Name of the University:
Author’s note

1PROPOSAL
Problem statement:
The main aim of my project is to summarize best interventions implemented to prevent
fall injury in older client. The main rationale for research on this topic is the high incidence of
geriatric fall injury and increase in burden of care due to repeated hospitalization (Williams et
al., 2015). According to Australian Institute of Health and Welfare (2017), the rate of
hospitalization due to fall injury in elderly people has increased by 3% per year in Australia.
Apart from common injury such as abrasions, cuts and sprains due to fall, incidence of fall in
elderly are also associated with serious injuries like femoral neck fracture and hip fracture
(Florence et al., 2018). Hence, evaluating risk of fall particularly in elderly is critical because
ageing related changes such as cognitive impairment, poor balance and vision increase the risk of
fall in this population group. The benefit of identifying and analysing fall prevention
intervention for elderly is that these interventions are likely to be tailored made to address the
specific risk factor of fall in elderly and mitigate those risk factors. As ageing related factors
mobility limitation, cognitive decline and polypharmacy predispose elderly to high risk of fall,
the significance of the review of systematic review related to interventions to prevent fall in the
target population group is that it will help to evaluate how far intervention address ageing related
risk factors of fall and which interventions are most effective to be implemented in clinical
setting.
Project design:
To achieve the desired goals of my project, I have chosen systematic review as one of the
research design for my project. In clinical setting, variety of interventions for fall prevention in
elderly has been implemented such as exercise, medication review, fall assessment,

2PROPOSAL
environmental changes and multi-factorial intervention. The use of systematic review method
will define which intervention has been able to prevent fall related injuries and reduce length of
hospitalization for elderly. Systematic review papers are likely to provide high quality evidence
on the best interventions to treat fall in elderly patients. This will inform the key steps needed to
reduce fall injury among elderly patients.
As the main purpose of my project is to give a summary intervention related to fall
prevention for elderly, the eligibility criteria during search process was to select only papers
which used systematic review design. The search for relevant systematic review paper was done
from MEDLINE, CINAHL and PubMed and articles published between 2009 to 2019 were
analyzed. The gap of 10 years has been chosen to find both innovative as well as standard fall
prevention intervention that has been implemented so far to reduce fall injuries in elderly
patients. The key search terms included fall prevention’, ‘fall injury’, ‘elderly patients’,
‘prevention of fall’ and ‘older patients’. Key inclusion criteria for study selection included taking
those papers only which were published in the last ten years, which used systematic review as
research design, elderly patients as study subject (more than 60 years) and primary outcome of
reduction in fall injuries or hospital admissions. Elderly participants above 60 years have been
taken because prevalence of fall injury is mostly found in patients above 60 years (Sharif et al.,
2018).The methodological quality of each paper was analyzed using the Assessment of Multiple
Systemaatic Reviews (AMSTAR) tool and the scores obtained helped to categorize papers into
high quality or moderate or low quality research paper. Thematic analysis was used to present
the outcome of research.
Project outcomes:

3PROPOSAL
By the use of systematic review design, six papers were found relevant to the research
question. Based on the review of these systematic review papers, the key interventions that has
been found to be implemented in clinical setting includes fall prevention through different
exergaming system, basic fall risk assessment, flooring, social engagement, environment
assessment, exercise intervention and stepping intervention. The review indicates that exercise
intervention like physical activity and balance training is the most prevalent intervention that has
been implemented in clinical setting for elderly patient.
The significance of this outcome is that it will have implications for clinical leaders as the
findings will help to take action on implementing the best exerciseintervention to provide
adequate support to hospitalized elderly patient. This will lead to changes in clinical practice and
increasing training for nurses and other involved staffs so that exercise intervention is adequately
implemnetd to promote mobility in elderly patients. The research finding will be disseminated by
holding seminars in hospitals dealing with elderly population and in nursing college so that
practice changes in relation to fall prevention is adequately implemented in desired setting.

4PROPOSAL
References:
Florence, C. S., Bergen, G., Atherly, A., Burns, E., Stevens, J., & Drake, C. (2018). Medical
costs of fatal and nonfatal falls in older adults. Journal of the American Geriatrics
Society, 66(4), 693-698.
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).
Williams, J. S., Kowal, P., Hestekin, H., O’Driscoll, T., Peltzer, K., Yawson, A., ... & Wu, F.
(2015). Prevalence, risk factors and disability associated with fall-related injury in older
adults in low-and middle-incomecountries: results from the WHO Study on global
AGEing and adult health (SAGE). BMC medicine, 13(1), 147.