Studying the problem of falls among the population of elderly patients is necessary due to the high risks of mortality and morbidity associated with them. Injuries related to falls in older adults are common and represent one of the major causes of long-term pain and functional impairment among the target population. The increased occurrence of falls has been attributed to the changing anatomic characteristics of individuals as they age, behavioral, environmental, biological, and socio-economic challenges, the development of musculoskeletal, cardiovascular, and other pathologies, as well as the lack of care and attention to the changing needs of older adults (McPhee et al., 2016). The problem is significant in the current context of nursing due to the range of complications that develop as a result of falls, including fractures, long-term pain, and post-traumatic stress.
Researchers have explored multiple methods of fall prevention to identify the most effective ones, as well as those that older patients will be able to implement with minimum supervision from healthcare providers. Thus, exercise programs targeted at reducing the occurrence of falls in the elderly have been chosen for further exploration because of their widespread use in the medical practice as well as the overall benefits to the health of older patients (Burton et al., 2015). The purpose of the current study is to determine the impact of exercises, training on gait balance, and behavioral modification on the reduction of falls among the elderly population. The range of available interventions on fall prevention can be used as best practice examples and help researchers in the present study make conclusions regarding the effectiveness of behavioral changes, the improvement of gait balance, and exercises.
In the current study, the key research question is the following: does elderly education on the issue of fall prevention using exercises, gait balance, and behavioral modification reduce the rate of falls among older adults? There may be a further gradation of research questions to reaching the desired level of specifics. These questions are the following:
- Which educational interventions are usually implemented to reduce falls in the elderly?
- What is the effect of regular exercise on reducing fall occurrence?
- What is the effect of balance modification efforts on reducing fall occurrence?
- Which behavioral procedures are the most effective in fall reduction?
Based on the previous research on the reduction of falls among older patients, it can be hypothesized that elderly education in the form of the abovementioned strategies will reduce the occurrence of falls. The null hypothesis for the study implies that there will be no significant statistical relationship between the education of older adults and the reduction of falls. Key study variables will include the level of education on falls within the target population, the rate of falls among older adults, patients’ age, family status, the availability of daily support, living conditions, and previous experiences with implementing fall prevention interventions. In the study, important operational variables include the level of education on falls, previous experiences with prevention interventions, and the rate of falls. The level of education refers to the extent to which the subjects understand the procedures associated with the reduction of falls, while previous experience relates to the exposure of patients to interventional procedures of fall prevention. The rate of falls is defined as the number of accidents in the form of falling as proportionate to the total number of older individuals.
References
Burton, E., Cavalheri, V., Adams, R., Browne, C. O., Bovery-Spencer, P., Fenton, A. M., … Hill, K. D. (2015). Effectiveness of exercise programs to reduce falls in older people with dementia living in the community: a systematic review and meta-analysis. Clinical interventions in aging, 10, 421-434.
McPhee, J. S., French, D. P., Jackson, D., Nazroo, J., Pendleton, N., & Degens, H. (2016). Physical activity in older age: perspectives for healthy ageing and frailty. Biogerontology, 17(3), 567-580.
Follow-Up Calls Reducing Readmission Rates: Design
Introduction
Due to the importance of improving the transitional care model through follow-up calls to reduce patient readmission rates, the nursing practice should be based on a special methodology involving a comprehensive assessment of the problem. Since the work is aimed at the direct interaction of medical personnel with patients, any calculations and correlations are to be based on the information received from the target audience. For a proposed topic, a mixed research method can be a valuable and effective analysis strategy to evaluate the role of follow-up calls for older adults. Obtaining data from patients with the subsequent interpretation of this information in statistical correlations may help to accurately assess the significance of work and its importance in the context of transitional care.
Literature Review
Despite the fact that such a parameter as hospital readmission is dynamic and depends on various factors, including the type of disease, patient age, and other criteria, some common features are characteristic of this problem. According to Jones et al. (2016), this issue is acute since, in 2014, more than half of hospitals faced the problem of an increased number of readmissions, which was also associated with low-quality transitional care. Van Spall et al. (2017) support this point of view and note that about 40% of readmissions are caused by the incorrect interaction of medical providers in healthcare settings (p. 1428). As a result, as Lewis, Samperi, and Boyd-Skinner (2017) state, the practice of follow-up calls to minimize the number of re-hospitalizations is seen as “a potentially cost-effective strategy” with positive health outcomes for older adults (p. 544). This strategy is taken as the basis for the research.
The considered practice is designed to solve a number of essential tasks that arise after patients are discharged from the hospital. Both physical and psychological support are incentives for recovery and a successful rehabilitation period (Lewis et al., 2017; Miller & Schaper, 2015). According to Lee, Yang, Hernandez, Steimle, and Go (2016), studies confirm a reduction in the number of readmissions when the follow-up call strategy is implemented within 72 hours of patient discharge. As a result, as Rennke and Ranji (2015) argue, the quality of transitional care directly depends on how efficiently providers organize their interaction with the target audience and what measures are taken to prevent re-hospitalization.
Methodology and Design
As a methodology for researching and proving the theory of follow-up calls for reducing readmissions among older adults, a mixed type of study may be applied. This strategy involves obtaining data from the target audience through interviews and surveys, as well as compiling statistical correlations based on this activity. The design of the study involves receiving valid information through the collection of data with their subsequent interpretation. The reliability and accuracy of the results may be achieved by engaging one category of the population (older adults) and the correlation principle of assessment, eliminating bias or ambiguity in the calculations.
Sampling Methodology
The sample methodology is based on the involvement of the older population discharged from the hospital within 72 hours. The age criterion is a priority, and other variables, for instance, the nature of the disease, gender, and other characteristics are not taken into account and are considered concomitant factors. As stakeholders, not only patients but also medical providers are engaged since the solution to the problem of a high level of readmission affects employees’ activities negatively. As Lee et al. (2016) note, for such a study, two groups may be involved. One group will receive standard treatment and care, while for the other one, the follow-up call strategy will be utilized. Based on the results of a 30-day intervention, the results will be compared, and conclusions will be drawn.
Necessary Tools
Such tools and are necessary as computing equipment that will help to conduct all calculations as accurately as possible, as well as relevant accounting programs. Also, to establish uninterrupted calls and contact between providers and patients, two-way communication should be maintained by using standard telephone equipment. Digital calling tools are not mandatory, but if desired, the parties can exchange video calls. Online tables may be needed to conveniently store all the research data and make changes in the research process.
Research Algorithms
The practice of the intervention may be based on three main steps. In the beginning, a telephone connection between the responsible medical staff and the patient is established. Further, for 72 hours, regular calls with a frequency of 6 hours in the daytime can be made. The third phase involves evaluating the results of patient surveys with the preparation of the necessary calculations. These actions will be carried out for one month with different patients, and at the end of this period, the results of the control group will be compared with the health outcomes of patients not involved in the research.
Conclusion
A mixed methodology based on the review of data from the control group is the technique that can provide relevant data on the value of follow-up calls to reduce readmission rates among older patients. The age criterion is the key, and as necessary tools, standard telephone equipment may be applied, as well as programs for statistical calculations. The three-phase intervention over a period of one month can make it possible to determine the effectiveness of the proposed assistance strategy and its significance for reducing readmission rates.
References
Jones, C. E., Hollis, R. H., Wahl, T. S., Oriel, B. S., Itani, K. M., Morris, M. S., & Hawn, M. T. (2016). Transitional care interventions and hospital readmissions in surgical populations: A systematic review. The American Journal of Surgery, 212(2), 327-335. Web.
Lee, K. K., Yang, J., Hernandez, A. F., Steimle, A. E., & Go, A. S. (2016). Post-discharge follow-up characteristics associated with 30-day readmission after heart failure hospitalization. Medical Care, 54(4), 365-372. Web.
Lewis, E., Samperi, S., & Boyd-Skinner, C. (2017). Telephone follow-up calls for older patients after hospital discharge. Age and Ageing, 46(4), 544-546. Web.
Miller, D. A., & Schaper, A. M. (2015). Implementation of a follow-up telephone call process for patients at high risk for readmission. Journal of Nursing Care Quality, 30(1), 63-70. Web.
Rennke, S., & Ranji, S. R. (2015). Transitional care strategies from hospital to home: A review for the neurohospitalist. The Neurohospitalist, 5(1), 35-42. Web.
Van Spall, H. G., Rahman, T., Mytton, O., Ramasundarahettige, C., Ibrahim, Q., Kabali, C.,… Connolly, S. (2017). Comparative effectiveness of transitional care services in patients discharged from the hospital with heart failure: A systematic review and network meta-analysis. European Journal of Heart Failure, 19(11), 1427-1443. Web.
Family History Of The Tynes And Lemane
The history of my family is always an interesting topic for me as it is a good chance to find out something new and improve my understanding of our traditions and the chosen culture. My parents came from two different families, Tynes and Lemane. Within the frames of this week personal family genealogical study, I was able to trace their history and investigate the early origins of Tynes and Lemane using a credible Internet source.
Both Tynes and Lemane are the representatives of the British tribes. During migration caused by the Norman Conquest in the middle of the 1000s, Tynes were firstly brought to Shropshire, England (“Tynes History, Family Crest & Coast of Arms”). This family included the representatives of the Lords of the Manor of Church Stretton (“Tynes History, Family Crest & Coast of Arms”). No information was possible to find about the living conditions of this family in England. The only true fact that could be used in this analysis included the necessity to move from England to the United States because of the political chaos and the desire to follow the American Dream. Unfortunately, traveling was not a successful experience of the Tynes, and many family members died because of unknown diseases and poor hygiene conditions on ships. Still, several family representatives were lucky to reach the goal and come to America. They became good farmers and laborers, proving their rights for existence in a new country. Buford Cleveland Tynes and Bonnie Powell Tynes became well-known American politicians, and Andrew Tynes is a famous sprinter.
Lemane history was not as bright as the one of the Tynes was. However, its origins and movements matter to my family and me. For example, it is known that first Lemane were the representatives of the Anglo-Saxon tribes with baptismal roots (“Lemane History, Family Crest & Coast of Arms”). No evidence was available to explain the reasons for their migration to the United States. Political and economic challenges could be defined as possible causes. In the middle of the 17th century, notable names included Sir John Leman and Sir William Leman, and both of them were politicians. As soon as the first Lemane came to the United States, they demonstrated good skills in cooking and housekeeping. Men preferred to work on farms and developed strong business and trade intentions. Because of different social and health conditions, the life expectancy of the Lemane was not high, and my ancestors had to work hard in order to survive and strive for better living conditions. The period before the 20th century was not an easy one for this family, as well as for other migrants from Europe.
In general, the stories of my possible ancestors are unique and educative. On the one hand, they show how persistent and goal-oriented people from not rich families could be. On the other hand, both Tynes and Lemane did not have great opportunities in the United States, and they had to survive, using their knowledge and gained skills. Our history is not rich in images or remarkable events, and someone can find it predictable and boring. However, the list of notable names, the migration history from England to the New World, and the conditions under which I have to live today make me proud and respect all the attempts made.
Works Cited
“Lemane History, Family Crest & Coast of Arms.” House of Names, Web.
“Tynes History, Family Crest & Coast of Arms.” House of Names, Web.