Nursing interventions for fall prevention in hospitalized aged people: an integrative review
DOI:
https://doi.org/10.15253/2175-6783.20232488610Keywords:
Aged; Hospitalization; Accidental Falls; Accident Prevention; Nursing.Abstract
Objective: to identify nursing interventions for fall prevention in hospitalized aged people. Methods: integrative review developed on the Web of Science, MEDLINE/PubMed, SCOPUS, CINAHL and LILACS databases using the PICo strategy with controlled descriptors and their combinations using the Boolean operators AND and OR. Studies addressing interventions to prevent falls in aged people in the hospital setting were included, without geographical or language limitation, from 2004 with the creation of The World Alliance for Patient Safety. Three reviewers worked on the citations, using EndNote basic and Rayyan, reaching a final sample of 20 studies. Results: 202 nursing interventions were identified for fall prevention in hospitalized aged people, categorized into six domains of the Nursing Interventions Classification (Physiological: basic; Physiological: complex; Behavioral; Safety; Family; Health Systems). Conclusion: nursing interventions were identified for the prevention of falls in hospitalized aged people, which provides subsidies for the construction of care protocols and improvements in care. Contributions to practice: the results allow nurses to prevent the occurrence of falls, putting into practice consistent scientific findings from the planning of actions to the execution and reassessment of results with the team.
References
Instituto Brasileiro de Geografia e Estatística. Projeção da população do Brasil por sexo e idade para o período 2000-2060 [Internet]. 2018 [cited Apr 13, 2023]. Available from: https://ftp.ibge.gov.br/Projecao_da_Populacao/Projecao_da_Populacao_2013/nota_metodologica_2013.pdf
Mendes JLV, Silva SC, Silva GR, Santos NAR. O aumento da população idosa no Brasil e o envelhecimento nas últimas décadas: uma revisão da literatura. Rev Educ Meio Amb Saúde [Internet]. 2018 [cited Mar 10, 2023];8(113):13-26. Available from: https://1library.org/document/y9rl1nry-o-aumento-da-populacao-idosa-no-brasil-e-o-envelhecimento-nas-ultimas-decadas-uma-revisao-da-literatura.html
Veras RP, Oliveira M. Aging in Brazil: the building of a healthcare model. Ciênc Saúde Coletiva. 2018;23(6):1929-36. doi: https://doi.org/10.1590/1413-81232018236.04722018
Danis K, Fonteneau L, Georges S, Daniau C, Bernard-Stoecklin S, Domegan L, et al. High impact of COVID-19 in long-term care facilities, suggestion for monitoring in the EU/EEA. Euro Surveill. 2020;25(22). doi: https://doi.org/10.2807/1560-7917.ES.2020.25.22.20009565
Kazazi L, Foroughan M, Nejati V, Shati M. Association between age associated cognitive decline and health related quality of life among Iranian older individuals. Electr Phys. 2018;10(4):6663-71. doi: https://doi.org/10.19082/6663
World Health Organization. Ageing and health [Internet]. 2021 [cited Mar 15, 2023]. Available from: http://www.who.int/news-room/fact-sheets/detail/ageing-and-health
Medeiros CB, Alves MSCF, Moura LKB, Souza RK, da Silva EM. A perspectiva do usuário na atenção básica sobre o acolhimento ao idoso. Rev Ciênc Plural. 2019;4(3):43-56. doi: https://doi.org/10.21680/2446-7286.2018v4n3ID17290
World Health Organization. Falls [Internet]. 2018 [cited Mar 15, 2023]. Available from: http://www.who.int/news-room/fact-sheets/detail/falls
Garcia TR. Classificação Internacional para a Prática de Enfermagem (CIPE®): versão 2019/2020. Porto Alegre: Artmed; 2020.
Agência Nacional de Vigilância Sanitária. Boletim segurança do paciente e qualidade em serviços de saúde – incidentes relacionados à assistência à saúde [Internet]. 2018 [cited Mar 10, 2023]. Available from: https://www.gov.br/anvisa/pt-br/centraisdeconteudo/publicacoes/servicosdesaude/publicacoes/boletim-seguranca-do-paciente/boletim-seguranca-do-paciente-e-qualidade-em-servicos-de-saude-n-20-incidentes-relacionados-a-assistencia-a-saude-2018.pdf/view
Souza AB, Röhsig V, Maestri RN, Mutlaq MFP, Lorenzini E, Marin BA, et al. In hospital falls of a large hospital. BMC Res Notes. 2019;12(1):284. doi: https://doi.org/10.1186/s13104-019-4318-9
Severo IM, Kuchenbecker R, Vieira DFVB, Lucena AF, Almeida MA. Risk factors for fall occurrence in hospitalized adult patients: a case-control study. Rev Latino-Am Enfermagem. 2018;26:e3016. doi: https://doi.org/10.1590/1518-8345.2460.3016
Ang GC, Low SL, How CH. Approach to falls among the elderly in the community. Singapore Med J. 2020;61(3):116-21. doi: https://dx.doi.org/10.11622/smedj.2020029
Lelaurin JH, Shorr RI. Preventing falls in hospitalized patients: state of the science. Clin Geriatr Med. 2019;35(2):273-83. doi: https://dx.doi.org/10.1016/j.cger.2019.01.007
Silva AKM, Costa DCM, Reis AMM. Risk factors associated with in-hospital falls reported to the Patient Safety Commitee of a teaching hospital. Einstein. 2019;17(1):eAO4432. doi: https://doi.org/10.31744/einstein_journal/2019AO4432
Oliveira DU, Ercole FF, Melo LS, Matos SS, Campos CC, Fonseca EAM. Evaluation of falls in hospitalized elderly. Rev Enferm UFPE On Line. 2017;11(Suppl 11):4589-97. doi: https://dx.doi.org/10.5205/reuol.11138-99362-1-SM.1111sup201707
Hill A, Etherton-Beer C, McPhail SM, Morris ME, Flicker L, Shorr R, et al. Reducing falls after hospital discharge: a protocol for a randomised controlled trial evaluating an individualised multimodal falls education programme for older adults. BMJ Open. 2017;7:e013931. doi: https://doi.org/10.1136/bmjopen-2016-013931
Oliveira ADG, Sousa ANB, Galdino SDAV. Nursing actions in the prevention of falls in the elderly: a narrative review of the literature. Braz J Health Rev. 2020;3(6):16260-9. doi: https://doi.org/10.34119/bjhrv3n6-050
Bulechek GM, Butcher HK, Dochterman JM. Classificação das intervenções de enfermagem (NIC). Rio de Janeiro: Guanabara Koogan; 2020.
Mendes KDS, Silveira RCCP, Galvão CM. Use of the bibliographic reference manager in the selection of primary studies in integrative reviews. Texto Contexto Enferm. 2019;28:e20170204. doi: https://doi.org/10.1590/1980-265X-TCE-2017-020415
World Health Organization (WHO). World alliance for patient safety: forward programme [Internet]. 2005 [cited Jun. 13, 2023]. Available from: https://apps.who.int/iris/bitstream/handle/10665/43072/9241592443.pdf
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:71. doi: https://doi.org/10.1136/bmj.n71
Joanna Briggs Institute. Levels of evidence [Internet]. 2013 [cited Apr 13, 2023]. Available from: https://jbi.global/sites/default/files/2019-05/JBI-Levels-of-evidence_2014_0.pdf
Healey F, Monro A, Cockram A, Adams V, Heseltine D. Using targeted risk factor reduction to prevent falls in older in-patients: a randomised controlled trial. Age Ageing. 2004;33(4):390-95. doi: https://doi.org/10.1093/ageing/afh130
Mcfarlane-Kolb H. Falls risk assessment, multitargeted interventions and the impact on hospital falls. Int J Nurs Pract. 2004;10(5):199-206. doi: http://doi.org/10.1111/j.1440-172x.2004.00482.x
Jeske L, Kolmer V, Muth M, Cerns S, Moldenhaur S, Hook ML. Partnering with patients and families in designing visual cues to prevent falls in hospitalized elders. J Nurs Care Qual. 2006;21(3):236-41. doi: https://doi.org/10.1097/00001786-200607000-00008
Fonda D, Cook J, Sandler V, Bailey M. Sustained reduction in serious fall-related injuries in older people in hospital. Med J Aust. 2006;184:379-82. doi: https://doi.org/10.5694/j.1326-5377.2006.tb00286.x
Koh SSL, Manias E, Hutchinson AM, Johnston L. Fall incidence and fall prevention practices at acute care hospitals in Singapore: a retrospective audit. J Eval Clin Pract. 2007;13(5):722-7. doi: https://doi.org/10.1111/j.1365-2753.2006.00743.x
Murphy TH, Labonte P, Klock M, Houser L. Falls prevention for elders in acute care: an evidence-based nursing practice initiative. Crit Care Nurs Q. 2008;31(1):33-9. doi: https://doi.org/10.1097/01.cnq.0000306394.79282.95
Krauss MJ, Tutlam N, Costantinou E, Johnson S, Jackson D, Fraser VJ. Intervention to prevent falls on the medical service in a teaching hospital. Infect Control Hosp Epidemiol. 2008;29(6):539–45. doi: https://doi.org/10.1086/588222
Tzeng H, Yin CY. Heights of occupied patient beds: a possible risk factor for inpatient falls. J Clin Nurs. 2008;17(11):1503-9. doi: https://doi.org/10.1111/j.1365-2702.2007.02086.x
Koh SLS, Hafizah N, Lee JY, Loo YL, Muthu R. Impact of a fall prevention programme in acute hospital settings in Singapore. Singapore Med J [Internet]. 2009 [cited Apr 4, 2023];50(4):425-32. Available from: http://smj.sma.org.sg/5004/5004a15.pdf
Dykes PC, Carroll DL, Hurley A, Lipsitz S, Benoit A, Chang F, et al. Fall prevention in acute care hospitals: a randomized trial. JAMA. 2010;304(17):1912-8. doi: https://doi.org/10.1001/jama.2010.1567
Ireland S, Kirkpatrick H, Boblin S, Robertson K. The real world journey of implementing fall prevention best practices in three acute care hospitals: a case study. Worldviews Evid Based Nurs. 2013;10(2):95-103. doi: https://dx.doi.org/10.1111/j.1741-6787.2012.00258.x
Hefner JL, McAlearney AS, Mansfield J, Knupp AM, Moffatt-Bruce SD. A falls wheel in a large academic medical center: an intervention to reduce patient falls with harm. J Healthc Qual. 2015;37(6):374-80. doi: https://doi.org/10.1097/jhq.0000000000000011
Esparza-Bohórquez M, Granados OLM, Serrano SME, Peñaloza JS. Prevención de caídas y lesiones derivadas en adultos mayores hospitalizados: experiencia de cuidado de enfermería de la aplicación de una guía de buenas prácticas en la Fundación Oftalmológica de Santander (FOSCAL). MedUNAB. 2017;20(2):174-81. doi: https://doi.org/10.29375/01237047.3246
Comino-Sanz IM, Sánchez-Pablo C, Albornos-Muñoz L, Beistegui IA, Jiménez VMM, Uribesalgo PL, et al. Falls prevention strategies for patients over 65 years in a neurology ward: a best practice implementation project. JBI Database System Rev Implement Rep. 2018;16(7):1582-9. doi: https://doi.org/10.11124/JBISRIR-2017-003628
Maia FOM, Cruz DALM, Shimoda GT, Sichieri K, Iida LIS. Falls prevention strategies for adult inpatients in a university hospital of São Paulo, Brazil: a best practice implementation project. JBI Database System Rev Implement Rep. 2018;16(8):1720-36. doi: https://doi.org/10.11124/jbisrir-2017-003556
Walsh CM, Liang LJ, Grogan T, Coles C, McNair N, Nuckols TK. Temporal trends in fall rates with the implementation of a multifaceted fall prevention program: persistence pays off. J Comm J Qual Patient Saf. 2018;44(2):75-83. doi: https://doi.org/10.1016/j.jcjq.2017.08.009
Ximenes MAM, Fontenele NAO, Bastos IB, Macêdo TS, Galindo Neto NM, Caetano JA, et al. Construction and validation of educational booklet content for fall prevention in hospitals. Acta Paul Enferm. 2019;32(4):433-41. doi: https://dx.doi.org/10.1590/1982-0194201900059
Fridman V. Redesigning a fall prevention program in acute care: building on evidence. Clin Geriatr Med. 2019;35(2):265-71. doi: https://doi.org/10.1016/j.cger.2019.01.006
Alcañiz-Mesas AI, García-González M, Zúñiga-Blanco L, Barrio-Pintado MB, Íñigo-Cruces L, Folguera-Arnau M, et al. Implementation experience of a guideline on fall prevention in Centres Committed to Excellence in Care®. Enferm Clin. 2020;30(3):185-97. doi: https://doi.org/10.1016/j.enfcli.2020.03.015
Coltters MC, Belmar VA. Experiencia de implementación de una guía para la prevención de caídas como trabajo interdisciplinar en una unidad de cuidados del adulto mayor. Med UNAB. 2020;23(1):95-106. doi: https://dx.doi.org/10.29375/01237047.3610
World Health Organization. Step safely: strategies for preventing and managing falls across the life-course [Internet]. 2021 [cited Mar 20, 2023]. Available from: https://www.who.int/publications/i/item/978924002191-4
Miller CA. Nursing for wellness in older adults. Philadelphia: Wolters Kluwer; 2019.
Carochinho ARP, Caldeira E, Jacob S. Quedas dos idosos no domicílio. Rev Ibero-Am Hum Ciênc Educ. 2022;8(3):58-71. doi: https://dx.doi.org/10.51891/rease.v8i3.4537
Ximenes MAM, Brandão MGSA, Macêdo TS, Costa MMF, Galindo Neto NM, Caetano J, et al. Effectiveness of educational technology for preventing falls in a hospital environment. Acta Paul Enferm. 2022;35:eAPE01372. doi: https://doi.org/10.37689/acta-ape/2022AO01372
Correia W, Teston, APM. Aspectos relacionados à polifarmácia em idosos: um estudo de revisão. Braz J Dev. 2020;6(11):93454-69. doi: https://doi.org/10.34117/bjdv6n11-674
Miranda AP, Athayde IF, Barbosa MEI. Risk factors contributing to falls in the elderly. Nursing [Internet]. 2018 [cited Apr 12, 2023];21(238):2063-67. Available from: http://www.revistanursing.com.br/revistas/238-Marco2018/fatores_de_risco.pdf
Luzia MF, Prates CG, Bombardelli CF, Adorna JB, Moura GMSS. Characteristics of falls with damage to hospitalized patients. Rev Gaúcha Enferm. 2019;40(spe):e20180307. doi: https://doi.org/10.1590/1983-1447.2019.20180307
