Nursing care related to fall prevention among hospitalized elderly people: an integrative review

Sena, Adnairdes Cabral de; Alvarez, Angela Maria; Nunes, Simony Fabíola Lopes; Costa, Nadia Pinheiro da

doi:10.1590/0034-7167-2020-0904

home Sumário navigate_before Anterior Atual Seguinte navigate_next

home Sumário

REVIEW • Rev. Bras. Enferm. 74 (Suppl 2) • 2021 • https://doi.org/10.1590/0034-7167-2020-0904 linkcopy

Nursing care related to fall prevention among hospitalized elderly people: an integrative review

Atención de enfermería relacionada con la prevención del riesgo de caídas en ancianos hospitalizados: una revisión integradora

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective: to identify scientific productions on nursing care related to fall risk prevention among hospitalized elderly people.

Methods: an integrative literature review from 2015 to 2019 in the PubMed/MEDLINE, Scopus, Web of Science, LILACS, BDENF, SciELO and CINAHL databases, in Portuguese, English and Spanish. The keywords were elderly, hospitalization, accidents due to falls, nursing care.

Results: thirty-three publications were analyzed. The synthesis of the studies resulted in the categories: Clinical nursing assessments to prevent falls among hospitalized elderly people; Fall risk factors for elderly people; Fall risk prevention strategies for elderly people.

Final considerations: it was found that the scientific knowledge produced on nursing care related to fall risk prevention for hospitalized elderly people evidences the clinical assessment, risk factors and strategies such as nursing care, contributing to foster self-care behavior and promotion security for elderly people.

Descriptors:
Aged; Hospitalization; Accidental Falls; Nursing Care; Review

Authors year/ country	Design	Objective	Main results	Thematic content
Royset et al. 2019⁽¹⁰⁾ Norway	Quantitative study n= 3,143	To assess the effects of fall prevention program on reducing its rate on patient safety culture.	The fall prevention program showed no significant effect on the rate of falls.	Fall risk factors.
Fridman 2019⁽¹¹⁾ United States of America	Qualitative study	To decrease falls and promote patient safety, health and comfort.	Current practices should be redesigned to ensure that fall prevention and acute care initiatives are consistent and transformational.	Clinical assessment and fall prevention.
Yamashita et al. 2019⁽¹²⁾ Japan	Quantitative study n=180	To investigate changes in the strength of the feet, knees and the distribution of pressure in the feet.	Care for feet and toenails can improve lower limbs muscle strength, decrease fall risk and distribute foot pressure.	Fall risk factors.
Bolton 2019⁽¹³⁾ United States of America	Quantitative study n= 401	To determine the cost-effectiveness of a hospital fall prevention program.	At least 4% of cognitively intact patients fell into the ward under the normal conditions of care.	Fall risk factors.
Toye et al 2019⁽¹⁴⁾ Australia	Quantitative and qualitative study n=486	To investigate the association between multiple movements and bed falls during hospitalization of elderly patients.	Patients with high fall risk admitted to the hospital are at increased risk of fall.	Fall risk factors.
Souza et al. 2019⁽¹⁵⁾ Brazil	Quantitative study n=1,071	To describe in-hospital falls reported in a large hospital in southern Brazil.	Fall prevention strategies focus on patients hospitalized patients in hospitalization units aged 60 years or older, assessed as high risk for falls.	Fall prevention strategies.
Ferreira et al. 2019⁽¹⁶⁾ Brazil	Integrative review	To identify the instruments for evaluating the use of siderails in hospitalized patients.	Four articles using the same instrument, Assessment of Siderail Use, were selected, with a detailed approach to the assessment of patients regarding the use of siderails, discussing alternative interventions for the use of siderails that should be adapted to individual needs.	Fall prevention strategies.
Cunha et al. 2019⁽¹⁷⁾ Portugal	Quantitative-qualitative study n=18	To design and validate a team intervention.	It allowed to validate the intervention of the team by panel of experts, so that the teams can manage the fall risk in hospitalized elderly patients.	Fall risk factors.
Wong and Pang 2019⁽¹⁸⁾ China	Quantitative study n=123	To investigate factors associated with falls in psychogeriatric patients.	Patients with dementia and women had higher fall risk.	Fall prevention strategies.
Dolan and Taylor-Piliae 2019⁽¹⁹⁾ United States of America	Theoretical reflection study	To describe the process of selecting a theoretical framework.	The Health Belief Model was selected as the theoretical framework.	Fall risk factors.
Falcão et al. 2019⁽²⁰⁾ Brazil	Quantitative study n= 284	To assess fall risk in hospitalized elderly people.	The use of specific tools in fall prevention allows the improvement of the quality of care based on scientific evidence.	Clinical assessment and fall prevention.
LeLaurin and Shorr 2019⁽²¹⁾ United States of America	Literature review	To analyze the drawings of common studies and the evidence of various hospital interventions of fall prevention.	There is an urgent need for well-designed research on the theme of hospital fall prevention.	Clinical assessment and fall prevention.
Chan et al. 2019⁽²²⁾ Singapore	Qualitative study n=30	To explore the perceptions of nurses about their participation in the physical activity of elderly patients.	Culturally appropriate strategies at the organizational and individual levels are necessary to reinvigorate nurses and optimize participation in physical activity.	Fall risk factors.
Kiyoshi-Teo et al. 2019⁽²³⁾ United States of America	Documentary research	To identify associations between risk factors, perceptions and daily activities of patients.	Address measures, include validated tools, and modified fall behavioral scale in a patient-centered way, such as daily perceptions and activities. These actions prevent patients from falls.	Fall prevention strategies.
Grealish et al. 2019⁽²⁴⁾ Australia	Qualitative study n=17	To explore reflections of nurses and nursing assistants about the care of elderly patients with cognitive impairment who suffered a fall.	Participants knew the policy and techniques available to prevent falls, but their implementation was challenging due to the complexity of care required by elderly people with cognitive impairment.	Clinical assessment and fall prevention.
Smith et al. 2018⁽²⁵⁾ Australia	Quantitative study n=653	To determine whether patients' time in care resulted in lower adverse events and incidents when compared to patients admitted to mental health wards of elderly people.	The characteristics of the reported adverse events appeared similar and there seems to be no substantial difference between the wards that entered the study.	Fall prevention strategies.
Shyu et al. 2018⁽²⁶⁾ China	Quantitative study n=600	To develop the Self-Awareness scale of Falls in the Elderly (SAFE) and test its reliability.	Combining the SAFE scale with other fall assessment tools can help the care team effectively assess the self-awareness of fall risk.	Fall prevention strategies.
Oliveira et al. 2018⁽²⁷⁾ Brazil	Quantitative study n= 424	To identify extrinsic factors favorable to the occurrence of falls of hospitalized elderly patients.	Knowing the profile of elderly people and extrinsic factors will enable health professionals to identify the risks and provide safe care.	Fall risk factors.
Oliveira et al. 2017⁽²⁸⁾ Brazil	Quantitative study n=96	To assess the occurrence of fall in hospitalized patients who presented high risk for the event.	Falls are directly linked to patient safety indicators, and a multidisciplinary and interdisciplinary approach is necessary.	Clinical assessment and fall prevention.
Victor et al. 2017⁽²⁹⁾ Brazil	Quantitative study n=70	To describe the adverse fall event in patients hospitalized in surgical units.	Nurses should be aware of risk factors to intervene and prevent events.	Fall risk factors.
Durán et al. 2017⁽³⁰⁾ Spain	Descriptive, observational and retrospective study n=99	To determine the incidence and characteristics of falls in elderly hospitalized.	Nursing interventions in the HSPV were oriented towards strengthening fall prevention in patients with cardiovascular pathology and in polymedicated patients.	Clinical assessment and fall prevention.
Kobayashi et al. 2017⁽³¹⁾ Japan	Quantitative study n=212,617	To examine fall prevention due to fall work group intervention established in hospital.	The decrease in patients at risk of grade 3 did not decrease, but increased; on the other hand, the decrease in grade 1 and 2 patients decreased, suggesting that better information sharing is needed for patients with high fall risk.	Clinical assessment and fall prevention.
Esparza-Bohórquez et al. 2017⁽³²⁾ Colombia	Quantitative study N=2,387	To reduce falls in the old people in hospitalization services.	The implementation of evidence-based nursing guides generates a positive effect on the quality of care, obtaining results that affect the health and well-being of patients.	Clinical assessment and fall prevention.
Hill et al. 2016⁽³³⁾ Australia	Qualitative study n=30	To understand how the team responded to individualized education for fall prevention of patients.	Providing individualized education to elderly patients with good levels of cognition can empower the team.	Clinical assessment and fall prevention.
Mazur et al. 2016⁽³⁴⁾ Poland	Quantitative study n=788	To assess the factors associated with falls in geriatric patients after the implementation of the fall prevention program.	Delirium, history of falls and advanced age seem to be the main risk factors for geriatric falls.	Clinical assessment and fall prevention.
Meuleners et al. 2016⁽³⁵⁾ Australia	Quantitative study n=32,519	To identify risk factors for recurrent harmful falls that require hospitalization in adults over 60 years of age with dementia.	Screening those with dementia for the history of harmful falls could help identify those with higher fall risk.	Fall risk factors.
Oliveira et al. 2016⁽³⁶⁾ Brazil	Qualitative study	To develop an instrument to assess the vulnerability of hospitalized elderly people in relation to falls.	The instrument for assessing falls in hospitalized elderly people is additional in the work process.	Clinical assessment and fall prevention.
Latt et al. 2016⁽³⁷⁾ Australia	Quantitative study n=217	To examine the validity of Ontario Modified STRATIFY (OM).	Screening tools have limited accuracy in identifying patients with high fall risk.	Clinical assessment and fall prevention.
Said et al. 2016⁽³⁸⁾ Australia	Quantitative study n= 121	To determine whether patients hospitalized in rehabilitation with high fall risk receive adequate assessment, management and care.	There was little evidence that people with high fall risk received systematic assessment of fall risk during rehabilitation.	Clinical assessment and fall prevention.
Fernandes et al. 2015⁽³⁹⁾ Brazil	Quantitative study n=59	To characterize the fall risk in elderly men hospitalized in a hospital environment.	Risk factors for fall related to clinical, physiological, environmental, cognitive and drug conditions were identified.	Fall risk factors.
Vass et al. 2015⁽⁴⁰⁾ England	Qualitative study n= 675	Assessment of the service to examine and describe the style and quality of footwear used by elderly patients in the hospital.	It was found that 46% of hospitalized elderly people use slippers and 60% of the shoes have moderate to excessive wear, not promoting stability or ideal gait for elderly people.	Fall risk factors.
Abreu et al. 2015⁽⁴¹⁾ Brazil	Quantitative study n=221	To estimate the incidence and predictors associated with falls in elderly patients.	Predictors such as educational level, polypharmacy, visual impairment, gait and balance impairment, urinary incontinence and use of laxatives and antipsychotics predispose to fall.	Fall risk factors.
Hill et al. 2015⁽⁴²⁾ Australia	Qualitative study n=10	To explore educators' perspectives of providing education.	Individualized fall prevention education effectively provides patients who receive the ability and motivation to develop and undertake behavioral strategies that reduce their falls.	Fall risk factors.

vertical_align_top show_chart

more_horiz close
- image
- translate
- link
- article
- vertical_align_top
- file_download
- show_chart
- image
- translate
- link
- article

location_on

Associação Brasileira de Enfermagem SGA Norte Quadra 603 Conj. "B" - Av. L2 Norte 70830-102 Brasília, DF, Brasil, Tel.: (55 61) 3226-0653, Fax: (55 61) 3225-4473 - Brasília - DF - Brazil
E-mail: reben@abennacional.org.br

rss_feed Acompanhe os números deste periódico no seu leitor de RSS