Effect of Bundled Interventions by Patient Type to Reduce Falls

Effect of Bundled Interventions by Patient Type to Reduce Falls by Celia Nurse MSN, South University, 2015 BS, University of the Virgin Islands, 2012 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Nursing Walden University February 2020 Abstract Despite consistent efforts in the healthcare field, 700,000 to 1 million patients fall in hospitals each year. There is a gap in the literature regarding identification of optimal bundles of fall prevention interventions (FPIs) for patients by type, and though patients of all ages fall in hospitals, older adults fall more, which may mean that the influence of FPIs may differ for patients by age. The purpose of this descriptive, retrospective, quantitative secondary data analysis study, guided by Virginia Henderson’s need theory, was to examine the differences in the influence of bundled FPIs in reducing the number of falls (NOF) in hospitalized older (60 years and older) and younger patients (59 years and younger). De-identified falls data from 2017-2019 of 1,963 cases were analyzed using an independent t-test and two-way ANOVA to examine the differences of mean NOF among hospitalized older (n = 258) and younger patients (n = 331) who were and were not on FPIs. There was no statistically significant difference between the mean NOF of older adults versus younger adults and or between the mean NOF of older adults on the FPI bundle versus younger adults on the FPI bundle. The greater number of younger adults who fell compared to older adults may suggest that the bundle of FPIs (non-skid socks, yellow wrist band, assessment/re-assessment of fall risk score using Morse Fall Scale, and bed alarms) are more efficient in reducing NOF in older adults. Future research could focus on examining what bundles of FPIs have the greatest reduction in falls in young adults and in the elderly population. The findings of this study can effect positive social change by demonstrating that FPI bundles are effective for older patients and that patients under 60 may need different strategies to prevent falls.Despite consistent efforts in the healthcare field, 700,000 to 1 million patients fall in hospitals each year. There is a gap in the literature regarding identification of optimal bundles of fall prevention interventions (FPIs) for patients by type, and though patients of all ages fall in hospitals, older adults fall more, which may mean that the influence of FPIs may differ for patients by age. The purpose of this descriptive, retrospective, quantitative secondary data analysis study, guided by Virginia Henderson’s need theory, was to examine the differences in the influence of bundled FPIs in reducing the number of falls (NOF) in hospitalized older (60 years and older) and younger patients (59 years and younger). De-identified falls data from 2017-2019 of 1,963 cases were analyzed using an independent t-test and two-way ANOVA to examine the differences of mean NOF among hospitalized older (n = 258) and younger patients (n = 331) who were and were not on FPIs. There was no statistically significant difference between the mean NOF of older adults versus younger adults and or between the mean NOF of older adults on the FPI bundle versus younger adults on the FPI bundle. The greater number of younger adults who fell compared to older adults may suggest that the bundle of FPIs (non-skid socks, yellow wrist band, assessment/re-assessment of fall risk score using Morse Fall Scale, and bed alarms) are more efficient in reducing NOF in older adults. Future research could focus on examining what bundles of FPIs have the greatest reduction in falls in young adults and in the elderly population. The findings of this study can effect positive social change by demonstrating that FPI bundles are effective for older patients and that patients under 60 may need different strategies to prevent falls. Effect of Bundled Interventions by Patient Type on Number of Falls by Celia Nurse MSN, South University, 2015 BS, University of the Virgin Islands, 2012 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Nursing Walden University February 2020 Dedication This dissertation is dedicated to my parents, Percival Nurse and Gwendolyn Todman, who have both been very instrumental in encouraging and supporting me in my endeavors. A very special thank you to my mother who has consistently been of tremendous assistance in helping me care for my three children, all the days of my college life. This dissertation is also dedicated to my wonderful children, Cynia King, Cynae King, and Michael Tavernier, whose smiles, brilliance and unique personalities have warmed my heart and refueled my engine every time I grew tired. Most importantly, this dissertation is dedicated to God, who gives me reason to persevere despite many difficult moments. Acknowledgments I extend a multitude of thanks to Drs. Leslie Hussey, Janice Long, and Francisca Farrar. Without them, this accomplishment would not have been possible.