What are the extrinsic risk factors that influence the incidence of hospital falls and fall-related injuries within psychiatric inpatient units caring for the elderly?

Hospital Falls and Fall-Related Injuries

Introduction to the Problem

One area of nursing research that has impacted practice is the prevention of bone fractures- especially in the elderly. Even when elderly patients come into the Emergency Department for complaints besides falls or fractures, we must be aware of their risks and attempt to prevent injury at the hospital and at home. I have a practice of talking with the family of elderly patients to be sure they have thought through showers, stairs, rugs and other tripping hazards. The twin topics of hospital falls and fall-related injuries continue to be the mainstream focus of many scholars and nursing theorists interested in understanding the risk factors involved. However, despite the abundance of research studies focused on investigating the risk factors associated with hospital falls and fall-related injuries among the elderly (Pi et al., 2016), only a few studies have focused attention to understanding the specific risk factors that affect inpatients in mental health settings (Quigley, Barnett, & Friedman, 2014).

Problem Description

Available nursing scholarship demonstrates that, although falls and fall injury are a foremost cause of mortality and morbidity among the elderly, the risk of falling is often aggravated when these members of the population have an existing mental health condition (Quigley et al., 2014). Indeed, it is evident that older people affected by mental or psychiatric health conditions are at a greater risk of falling upon admission in hospital due to an assortment of factors associated with their mental competency and the drugs that are often administered to cure or manage these conditions (Lam et al., 2016). For example, a patient receiving psychotropic medications or experiencing overactivity due to mania-related deficits is at a greater risk of falling or having fall-related injuries than a patient in acute care setting. However, “despite much research on falls occurring on medical-surgical units and in long-term care settings, falls on inpatient psychiatry units are understudied” (Quigley et al., 2014, p. 51). This predisposition has occasioned a paucity of evidence-based research studies that could be used by nursing professionals to understand the risk factors for hospital falls and fall-related injuries among elderly psychiatric patients admitted in mental health settings. The proposed study aims to fill this gap in the literature by empirically investigating the risk factors that influence the incidence of falls within psychiatric inpatient units caring for the elderly.

Significance of the Problem to Nursing

The described problem is significant to nursing practice as it is only by identifying the risk factors involved in hospital falls that evidence-based falls prevention processes can be designed and implemented with the view to preventing the development of secondary comorbidities among the selected group of the population (Quigley et al., 2014). Having adequate knowledge on the risk factors involved, in the view of the researcher, will go a long way in ensuring that nursing professionals are able to provide quality care as well as reduce exposure to costly lawsuits and other hospital costs associated with falls and fall-related injuries (Meuleners, Fraser, Bulsara, Chow, & Ng, 2016).

Purpose of the Research

The main purpose of the proposed study is to undertake an empirical investigation of the risk factors that influence the incidence of hospital falls and fall-related injuries in mental inpatient units caring for older people suffering from psychiatric health conditions.

Research Questions

The following research questions will guide the research process:

RQ1: What are the intrinsic risk factors that influence the incidence of hospital falls and fall-related injuries within psychiatric inpatient units caring for the elderly?

RQ2: What are the extrinsic risk factors that influence the incidence of hospital falls and fall-related injuries within psychiatric inpatient units caring for the elderly?

RQ3: Which fall prevention processes could be implemented in these units to enhance the quality of care and minimize hospital-associated costs?

Master’s Essentials that Aligned with your Topic

It is important to note that only a few studies aligns with the proposed topic as most of the existing scholarship addresses hospital falls and fall-related injury among the elderly without going into the specifics. Although a number of studies have investigated the relationship between hospital falls and degenerative conditions such as dementia and Parkinson’s disease, only a few have focused attention to mental health conditions and the risk factors involved.

References

Lam, C., Kang, J.H., Lin, H.Y., Huang, H.C., Wu, C.C., & Chen, P.L. (2016). First fall-related injuries requiring hospitalization increase the risk of recurrent injurious falls: A nationwide cohort study in Taiwan. PLoS ONE, 11(2), 1-15. doi: 10.1371/journal.pone.0149887

Meuleners, L.B., Fraser, M.L., Bulsara, M.K., Chow, K., & Ng, J.Q. (2016). Risk factors for recurrent injurious falls that require hospitalization for older patients with dementia: A population based study. BMC Neurology, 16(1), 1-8. doi: 10.1186/s12883-016-0711-3

Pi, H.Y., Gao, Y., Wang, J., Hu, M.M., Nie, D., & Peng, P.P. (2016). Risk factors for in-hospital complications of fall-related fractures among older Chinese: A retrospective Study. BioMed Research International, 28(1), 1-11. doi: 10.1155/2016/8612143

Quigley, P.A., Barnett, S.D., & Friedman, Y. (2014). Reducing falls and fall-related injuries in mental health: A 1-year multihospital falls collaborative. Journal of Nursing Care Quality, 29(1), 51-59. Retrieved from https://healthinsight.org/Internal/docs/hen/Reducing_Falls_and_Fall-Related_Injuries_in_Mental_Health_-_A_1-Year_Multihospital_Falls_Collaborative.pdf