Date of Conferral

2021

Degree

Doctor of Nursing Practice (DNP)

School

Nursing

Advisor

Maria M. Ojeda

Abstract

In the United States, the cost of treating a resident of a long-term care facility (LTC) after a fall with injury is between $10,000 and $26,000. Current nursing interventions for fall prevention among older adults aged 65 years and over at the local LTC do not address the risk of polypharmacy and are focused on environmental and intrinsic factors. The purpose of this systematic literature review was to find the nursing interventions that have been used to reduce falls in older adults aged 65 years and over in nursing homes and LTCs who are on polypharmaceutical therapy. Primary research articles and systematic reviews published between 2013 and 2020 were included. The Johns Hopkins Research Evidence Appraisal Tool was used to determine the level of evidence and quality of the studies. Out of 1,728 articles uncovered in the literature search, only four met the inclusion criteria. The studies provided Level I, II, and V evidence and all were high quality studies. None of the studies were conducted in the United States. The findings indicated that study designs and settings varied; staff education focusing on the adverse effects of medications, team changes to include nurses, improved communication among professionals using electronic platforms, and implementing the nurse practitioner role in LTCs decreased fall rates and polypharmacy. LTCs may reduce the risk for falls among older adults receiving polypharmaceutical therapy by implementing any one or more of the interventions uncovered in this systematic review. These organizations will benefit by reducing the cost of care related to polypharmacy-related falls and injuries. Positive social change will result from improving nursing practice and thus the safety of the care environment for vulnerable residents. More research is needed before best practices can be determined because of the scarcity of evidence and because existing studies did not provide detailed information on how nurses implemented their roles.

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