The PICOT question must be relevant to a nursing practice( Falls with elderly adults)
1. create a clinical guiding question know as a PICOT question. Select a nursing practice problem of interest to use as the focus of your research. ( falls and elderly adults )
Use the “Literature Evaluation Table” to complete this assignment.
Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200 words, provide a summary of the clinical issue.
Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest.
Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest.
This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem < 5 years old and able to easily reference. Include article reference
systematic Reviews, Literature Reviews, and Metanalysis articles- SHOULD NOT BE USED .
ANSWER
Literature Evaluation Table
Student Name:
Summary of Clinical Issue:
A fall is considered as unintentionally, accidental and unexpected coming to rest on the ground without losing consciousness. Falls have been increasing among hospitalized elderly adults which has become an issue of concern in both developing and developed countries. Falls among the elderly may hasten adverse medical, physical, social, psychological; and economic consequences. Falls among the elderly are still an increasing problem. Age relate factors such as diseases and changes both have influence on the older individual’s ability to balance. Additionally, various medications, cognitive impairment and changes in an individual’s environment contributes to the risk of falling. They have also been associated with frequent admissions in hospitals due to the underlying chronic diseases such as heart problems, cancers and hypertension. During hospitalization the elderly adults admitted in the hospital have a high risk of falling thus increasing their length of stay in the hospital. This has exposed them to morbidities, hospital related infections, mortalities as well as high cost of healthcare. Studies have indicated that falls among the elderly have been the main cause of morbidities and mortalities. They have constituted to the second highest number of unintentional deaths after car accidents. Comprehensive research and review have been conducted to evaluate the most effective practices to reduce fall prevention among the elderly. Exercise intervention has been considered as one of the ways to prevent fall associated injuries among the elderly.
PICOT Question: Among elderly adults, how will exercise intervention and programs prevent fall associated injuries in twelve months?
| Criteria | Article 1 | Article 2 | Article 3 |
| APA-Formatted Article Citation with Permalink |
Lee, S. H., & Kim, H. S. (2017). Exercise interventions for preventing falls among older people in care facilities: A meta‐analysis. Worldviews on Evidence‐Based Nursing, 14(1), 74-80. |
Zhao, R., Bu, W., & Chen, X. (2019). The efficacy and safety of exercise for prevention of fall-related injuries in older people with different health conditions, and differing intervention protocols: a meta-analysis of randomized controlled trials. BMC geriatrics, 19(1), 1-12. | Ng, C. A., Fairhall, N., Wallbank, G., Tiedemann, A., Michaleff, Z. A., & Sherrington, C. (2019). Exercise for falls prevention in community-dwelling older adults: trial and participant characteristics, interventions and bias in clinical trials from a systematic review. BMJ open sport & exercise medicine, 5(1), e000663. |
| How Does the Article Relate to the PICOT Question? | The article centers on utilization of exercise to lower falls among elderly adults in care amenities. | The article focuses on the effectiveness of exercise on preventing fall associated injuries with divergent exercise protocols. | The article focuses on exercises as an intervention for fall prevention. |
| Quantitative, Qualitative (How do you know?) | Quantitative- Meta analysis is a quantitative method for systematically evaluating the outcomes of previous researches. | Quantitative- The researcher conducted a meta-analysis of randomized controlled trials. | Qualitative- The systematic reviews derives data from observations, interpretations and meanings. |
| Purpose Statement | The purpose of the research is to evaluate how exercise may prevent falls among older adults such as improving their balance, strength and endurance. | The drive of the study is to examine the efficiency of exercises related to fall injuries in reducing falls among elderly. | The drive of the study is to examine the result of exercise for fall preventions among community dwelling older adults. |
| Research Question | Do exercise programs focused on preventing falls actually lower falls among elderly adults in care facilities. | What is the influence of exercise on fall associated injuries among the older people. | Does exercise as a single approach and intervention for fall prevention in community dwelling elderly adults reduce the number of falls. |
| Outcome | Exercise programs that focus on fall prevention strategies are effective in lowering falls among adults in care facilities. | Balance training and combined exercise protocols were considered as the most suitable exercise techniques in lowering fall connected injuries. | Effective exercise interventions involving functional and balance exercises are suitable for reducing falls amid the community dwelling elderly individuals. |
| Setting
(Where did the study take place?) |
The meta-analysis reviewed 21 randomized controlled trials. | The meta analysis reviewed 25 randomized controlled trials. | The study was conducted using Cochran review. |
| Sample | 21 randomized control trials | 25 randomized controlled trials | 108 randomized clinical trials |
| Method | Meta-analysis | Meta-analysis | Systematic review |
| Key Findings of the Study | The fall prevention exercise programs lower the rate of falls among participants. | Exercise is significant in lowering fall induced injuries since it has the ability of restoring balance, muscle strength, bone mass, posture control and performance of activities. | Most of the trials indicated that exercises involving functional and balance exercises are common interventions that have great effect to reduced falls. |
| Recommendations of the Researcher | The researcher needs to focus on the cost of the exercise programs and examine whether they are cost effective and how they should be applied in the care environments. | The researcher needs to focus on the effectiveness of walking as an exercise to manage the danger of fall associated damages. | The researcher should ensure that the study has also covered middle income and low income countries. |
| Criteria | Article 4 | Article 5 | Article 6 |
| APA-Formatted Article Citation with Permalink |
Hager, A. G. M., Mathieu, N., Lenoble-Hoskovec, C., Swanenburg, J., de Bie, R., & Hilfiker, R. (2019). Effects of three home-based exercise programmes regarding falls, quality of life and exercise-adherence in older adults at risk of falling: protocol for a randomized controlled trial. BMC geriatrics, 19(1), 1-11. |
Sherrington, C., Michaleff, Z. A., Fairhall, N., Paul, S. S., Tiedemann, A., Whitney, J., … & Lord, S. R. (2017). Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. British journal of sports medicine, 51(24), 1750-1758. | Senderovich, H., & Tsai, P. M. (2020). Do exercises prevent falls among older adults: where are we now? A systematic review. Journal of the American Medical Directors Association. |
| How Does the Article Relate to the PICOT Question? | The article attentions on home-based exercise programs to lower the number of falls through lowering the risk factors. | The article has focused on prevention of falls in older adults through exercise which is similar to the Picot question. | The article has examined whether multifactorial mediations, single interventions and multiple interventions are essential in avoiding incidence falls in long term care facilities. |
| Quantitative, Qualitative (How do you know?) | Qualitative- Randomized controlled trials are used to examine the complexity of interventions. | Quantitative- The study relies on meta regression and meta-analysis. | Qualitative- The systematic review has searched for evidence through qualitative studies and brought together findings. |
| Purpose Statement | The purpose of the research is to compare the home-based exercise program regarding incidence fall. | The purpose of the study is to examine the efficiency of exercise as a single mediation in reducing falls among the elderly. | The drive of the study was to scrutinize how exercises that are discretely tailored to participants’ risks and capabilities could be the most effective in preventing falls. |
| Research Question | What are the impacts of home-based exercise programs in reducing incidence falls among the elderly population. | What is the impact of exercise as a single approach for preventing falls in community dwelling older individuals. | Does multifactorial interventions, and single interventions including supplementation of Vitamin D effective in preventing fall risks in long term care facilities? |
| Outcome | Home based exercise programs have positive influence in fall prevention among the elderly. | Exercise has a great impact as a single mediation to lower falls in community dwelling older individuals. | The reported outcomes indicate that fall rates reduced significantly. |
| Setting
(Where did the study take place?) |
The study was conducted in four Swiss regions: Vaud, Haurt-valais, Bas-Valais and Zurich. | The study was conducted through systematic review with meta regression and meta-analysis. | The study was conducted through a systematic review design. |
| Sample | 405 participants | 88 trials | 21 systematic reviews |
| Method | Multi-center randomized controlled trial. | Meta-analysis and meta-regression | Systematic review |
| Key Findings of the Study | The severity of falls reduces among the elderly due to increased physical function. | Exercises show strong evidence and great intervention effects to the reduction of falls among the elderly. | Fifteen out of twenty studies indicated that there is a significant reduction in fall as a result of single and multi-factorial interventions. |
| Recommendations of the Researcher | The research has only relied on three home based exercise programs to reduce the incidence falls. | The researcher should gather enough evidence that suggest that exercise as a single intervention for elderly people with chronic disease can prevent falls. | There is low evidence that multifactorial interventions can reduce the number of falls. Therefore, the researcher should focus on providing more evidence on multi-factorial interventions. |
