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Gibbs reflection Cycle

Introduction 

The essay has aimed to review an article on risk factors associated with fall incidents in elderlies. As reported by gov. uk (2019), falls resulted in more than 100,000 hip fractures in the elderly in the year 2017-2018. Hence, there is a need to identify the risks and develop care plans to prevent such incidents. For this purpose, the essay has reviewed an article by Gale et al., (2018) on the mentioned topic, analysed how the article relates to future nursing practices, and a reflection on the experience of the review. 

Discussion

Article Review

The chosen research article discusses the risk factor for fall incidents in older men and women. Gale et al. (2018) aims to assess the sex-specific risk factors. For this purpose, the data from Wave 4, 5, 6 of the Health Survey for England was obtained and analysed. The analysis revealed that the only common factor associated with increased fall risks is old age for both sexes. However, sex-specific factors for both genders were different. For women, factors like depressive symptoms, being unmarried for their entire life, and incontinence increase the risk of incidents. While, for men, higher pain levels, more significant comorbidity, and inability to maintain balance to obtain a full-tandem stand are the factors associated with increased fall risks. 

Gale et al. (2018) revealed that out of 3298 participants selected for the study, 863 women and 633 men experienced a fall incident. The study conducted by Welmer et al. (2017) revealed that a higher degree of pain is strongly associated with increased fall risks. However, unlike Gale et al. (2018), Keefe et al. (2000) revealed that women experience more severe pain than men and react by being less physically active. Also, Sibley et al. (2014) supported the current study findings that increased comorbidities increase the risk of falls. At the same time, Gale et al. (2018) argued that confounding variables, including the perception of pain and depressive symptoms, could have affected the relationship between variables. Like Gale et al. (2018), Coyne et al. (2013) also suggested that urinary continence increases the risk of falls. However, Coyne et al. (2013) argued that the risk is not associated with a specific gender.

Similarly, Kvelde et al. (2013) also supported the findings of Gale et al. (2018) and discussed that depressive symptoms are consistently associated with a greater risk of falls. Likewise, the study conducted by Stel et al. (2003) supported the findings of Gale et al. (2018) that the inability to maintain a Tandem stands for the desired amount of time increases chances for fall; however, Stel et al. (2003) also argued that the effect is consistent for both the sexes and is not sex-specific. In summary, Gale et al. (2018) successfully elaborated on the risk factor associated with falls in the elderly; however, the questionnaire did not define pain and fall, making it difficult to compare the findings. 

Relation to Health Care Practice

According to age.uk (2021), falls are considered to be a significant cause of injury-related deaths in older women and men. For nurses, preventing patients from falling is critical for providing safety. NMC code (2018) recognises that to display professionalism, nurses must preserve the safety of their patients. Also, according to the Safeguarding Vulnerable Act (2006), the healthcare providers and other local and national authorities must ensure that they protect the vulnerable population, including the elderly and children, from the risk of harm or harm (Schrems, 2014). 

Hence, nurses must practice in a way that promotes the patient's safety. As a future nurse, one must be more cautious while working with the elderly and assist them as they engage in any physical activity to reduce the chances for falls (Thomas et al., 2016). Also, as future nurses, one should constantly engage in evidence-based learning to know more about the causative factors of falls and risk associated with falls and keep one informed about the latest strategies and techniques used by the nurses to prevent falls in older women and men. Following the NICE (2013) guidelines, the nurse must regard all patients above age 65 as at risk of falling and ensure that lighting, furniture, fittings, and flooring that could increase patients' fall risk are systemically addressed and identified. At the same time, future nurses must consider multifactorial assessment and multifactorial intervention for the patient identified at risk for falls (NICE guidelines, 2013). 

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Reflection

For developing a systematic reflection on the experience of undertaking an article review, Gibb's reflective model was used. 

Description

As part of my course, I was asked to review an article on the risk factors associated with falls in the elderly. Therefore, I selected an article on the module and conducted the review. 

Feeling 

Being honest, I was apprehensive and nervous as I started with the assignment. However, as I studied and explored, I realised that it was not difficult, making me feel confident.

Evaluation

The review of the article has provided me with the knowledge of emerging trends and ideas within nursing. It has made me well-informed about the risks of falls in the elderly and has offered me advice on how I, as a future nurse, can develop my working practices and care plan to reduce these risks in elderlies. However, as I started searching the literature, I realised that it was time-consuming.

Analysis 

As Bettany (2016), reviewing articles help nurses advance in their field, stay well informed of the latest information and trends, and provide patients with better care. As I researched the mentioned topic, I realised the importance of adhering to professional guidelines. NMC (2018) code has stressed on the practice of professional standards and ethical guidelines of beneficence and non-maleficence. If nurses adhere to these guidelines, I think we would be able to decrease these fall risks by being extra cautious of patients' safety to maximise benefit and minimise harm.

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Conclusion

The literature search has helped me be well-informed about how can I improve my practices to provide high quality care for elderlies. 

Action Plan

As a future nurse, I have decided to strictly adhere to the professional guidelines of NMC and engage myself in literature and research to inform my practices and to provide my patients with quality care to maximise their health and wellbeing.

Conclusion 

To conclude, as reported by NHS Digital (2019), falls resulted in more than 100,000 hip fractures in the elderly in the year 2017-2018. The reviewed article discusses that old age is the only common factor associated with increased fall risks; however, certain risk factors are sex-specific. In addition, the essay has added how this article informs the future practice of nurses and a reflection on the experience of conducting a literature review. 

References

Primary Source

Gale, C.R., Westbury, L.D., Cooper, C. and Dennison, E.M., 2018. Risk factors for incident falls in older men and women: the English longitudinal study of ageing. BMC geriatrics, 18(1), pp.1-9.

Secondary Source

Age UK. 2021. [online] Available at: <https://www.ageuk.org.uk/latest-press/articles/2019/may/falls-in-later-life-a-huge-concern-for-older-people/> [Accessed 26 November 2021].

Bettany-Saltikov, J., 2016. EBOOK: How to do a Systematic Literature Review in Nursing: A step-by-step guide.

Coyne, K.S., Wein, A., Nicholson, S., Kvasz, M., Chen, C.I. and Milsom, I., 2013. Comorbidities and personal burden of urgency urinary incontinence: a systematic review. International journal of clinical practice, 67(10), pp.1015-1033.

Gale, C.R., Westbury, L.D., Cooper, C. and Dennison, E.M., 2018. Risk factors for incident falls in older men and women: the English longitudinal study of ageing. BMC geriatrics, 18(1), pp.1-9.

GOV.UK. 2021. Falls: applying All Our Health. [online] Available at: <https://www.gov.uk/government/publications/falls-applying-all-our-health/falls-applying-all-our-health> [Accessed 26 November 2021].

Keefe, F.J., Lefebvre, J.C., Egert, J.R., Affleck, G., Sullivan, M.J. and Caldwell, D.S., 2000. The relationship of gender to pain, pain behaviour, and disability in osteoarthritis patients: the role of catastrophising. Pain, 87(3), pp.325-334.

Kvelde, T., McVeigh, C., Toson, B., Greenaway, M., Lord, S.R., Delbaere, K. and Close, J.C., 2013. Depressive symptomatology as a risk factor for falls in older people: systematic review and meta‐analysis. Journal of the American Geriatrics Society, 61(5), pp.694-706.

Nice.org.uk. 2021. Overview | Falls in older people: assessing risk and prevention | Guidance | NICE. [online] Available at: <https://www.nice.org.uk/guidance/cg161> [Accessed 26 November 2021].

Nmc.org.uk. 2021. The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates - The Nursing and Midwifery Council. [online] Available at: <https://www.nmc.org.uk/standards/code/> [Accessed 26 November 2021].

Schrems, B.M., 2014. Informed consent, vulnerability and the risks of group-specific attribution. Nursing Ethics, 21(7), pp.829-843.

Sibley, K.M., Voth, J., Munce, S.E., Straus, S.E. and Jaglal, S.B., 2014. Chronic disease and falls in community-dwelling Canadians over 65 years old: a population-based study exploring associations with number and pattern of chronic conditions. BMC geriatrics, 14(1), pp.1-11.

Stel, V.S., Smit, J.H., Pluijm, S.M. and Lips, P., 2003. Balance and mobility performance as treatable risk factors for recurrent falling in older persons. Journal of clinical epidemiology, 56(7), pp.659-668.

Thomas, P., Chandès, G., Couegnas, N. and Hazif-Thomas, C., 2016. Nursing Home and Elderlies' Family: Questions about Semiospheres. Journal of Nursing & Patient Care.

Wei, F. and Hester, A.L., 2014. Gender difference in falls among adults treated in emergency departments and outpatient clinics. Journal of gerontology & geriatric research, 3, p.152.

Welmer, A.K., Rizzuto, D., Calderón-Larrañaga, A. and Johnell, K., 2017. Sex differences in the association between pain and injurious falls in older adults: a population-based longitudinal study. American journal of epidemiology, 186(9), pp.1049-1056.

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