NURS3046 Nursing Project



The prevention of falls among older adults is an urgent public health issue in Australia and internationally (Nyman & Skelton 2017; Gillespie et al. 2012).  The proportion of Australians aged 65 years and over is predicted to increase from 14% (3 million people) in 2010 to 23% (8.1 million people) by 2050 (Intergenerational Report 2010). By 2051, the Australian total annual health costs from fall-related injury are predicted to increase almost threefold to $1.4 billion (Moller 2003). Approximately 30% of adults aged 60 and older will fall during the period of a year (Tinetti 2003; Resnick 1999). Falls by older adults are a common occurrence and a leading cause of dependence (Stevens et al. 2006). Falls can result in injuries, reduced confidence, isolating social consequences, and a reluctance to continue physical activity that, not surprisingly, can be a precursor to other health-related complications. Nearly 30% of people over the age of 65 will sustain a fall every year in residential care facilities, and fall-related injuries are the leading cause of mortality and morbidity (Cakar et al. 2010). Notably, three quarters of injuries to older adults that require hospitalization are the result of falls (AIHW: Bradley 2013) The rate of falls by older adults in residential aged care facilities is nearly three times higher than the rate of falls in other settings (Shi 2014).

There is compelling evidence that physical activities to enhance balance and strength are among the most promising exercise-based interventions to prevent falls and fall-related injuries in older adults (Gillespie et al. 2012). Moreover, ‘widespread implementation of exercise as a single intervention seems to be the best approach to falls prevention’ (Sherrington et al. 2011, p. 78). Balance and strength training and lower limb resistance training is known to reduce falls in older adults (Sherrington et al. 2008). However, less than 10% of older people routinely engage in strength training and even less in activities that strengthen their balance (Clemson et al. 2012).

Research Question: What is the effectiveness of exercise-based interventions in reducing falls in older adults living in residential care facilities?

This research question is relevant for evidence-based clinical practice and professional knowledge.  If exercise-based intervention programs have positive effects on reducing falls among older people, then this approach could change the way older adults are cared for in residential care facilities. This research question could generate evidence to inform person-centred care planning regarding effective exercise-based interventions for falls prevention and targeted education for older adults living in residential care facilities (NMBA 2016). Findings could inform strategies that target audiences such as managers, nurses and families could implement to improve holistic care for older adults living in residential care facilities. Nurse educators could also use the evidence to teach effective strategies in the undergraduate nursing curriculum. The research question is therefore highly relevant to clinical practice and has wider implications for the provision of quality care and encouraging older adults to adopt effective self-care practices.

Select four (4) primary research articles (from the 8 articles provided) that provide relevant evidence to answer the research question. Write a 300 word summary of each primary research article using the three step format learned in Topic 2.

Paper 1

Paper 2

Paper 3

Paper 4

Compare and contrast the findings of the four (4) primary research articles using the approach learned in Topic 3. Ensure the analysis explains how the findings answer the research question. Identify any existing gaps in knowledge or practice. Discussion may be supported by additional relevant additional literature.

Summarise the major points in a non-repetitive manner, discuss future directions for research.

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