“Predicting Injurious Falls in the Hospital Setting” by Hester

Research Problem

The selected study revolves around the problem of falls among hospitalized adults as one of the primary causes for the emergence of undesired outcomes, development of complications, and deterioration of the quality of patients’ lives. For this reason, there is a need for the investigation of factors that might precondition these fails to create appropriate preventive measures. In such a way, the article delves into the given problem and follows the pivotal aim of analyzing and determining patient factors that might be associated with injurious falls in hospitalized adults. The given purpose is preconditioned by the scope of the problem and its influence on treatment outcomes.

Analyzing the article, it should be noted that investigators link the study problem to the context of exiting healthcare knowledge. They state that there is a significant body of evidence devoted to the analysis and evaluation of falls in general. However, there is a certain gap in knowledge related to injurious falls, which means that there is a need for additional studies to analyze this component. In this regard, the study tries to solve a problem relevant to existing nursing practice as falls remain one of the most common and frequent complications in acute settings. Moreover, adults and older individuals might need specific nursing care and interventions to prevent falls and injuries. In such a way, investigation of the given problem plays a vital role in enhancing the nursing practice and provision of knowledge needed to improve outcomes.

Review of Literature

To create a theoretical background for their study, researchers conduct a literature review. The use of this method can be viewed as a beneficial solution as it helps to improve the overall understanding of the topic and, at the same time, create the basis for the discussion and justify the relevance of the question by outlining its significance for practice. The basic concepts explored in the review section included the variables selected for the study. The authors introduce the terms that were used to search for sources: fall injury risk, fall injury predictor, accidental fall and injury, injury in hospitals (Hester et al., 2016). The given concepts are relevant for the study, for this reason, their inclusion is reasonable for the creation of the basis for the investigation. The selected references range from the most current to older sources published in the 1990s (Hester et al., 2016). It is preconditioned by the universal character of the selected problem as the reasons for falls remain similar regardless of date. For this reason, the literature review remains relevant and provides credible information about the issue.

Theoretical Framework

In such a way, the authors form the theoretical framework by using information from the literature review and their own assumptions regarding the major causes of injurious falls in adult patients in the hospital setting. Additionally, they offer the conceptual framework that is utilized for the paper. The authors admit that Nelson’s Data-to-Wisdom Continuum guides the development of the study and transformation of information into knowledge and wisdom (Hester et al., 2016). In such a way, the offer appropriate assumptions that data collected about injurious falls within the study will help nurses to generate wisdom and experience needed to improve outcomes and guarantee the high quality of patients’ lives. The adherence to the given conceptual framework also presupposes the integration of nursing informatics as the method to manage acquired information and process it to improve the vision of a particular problem or aspect of nursing practice. The application of the given paradigm is useful for the research as it helps to process data more effectively.

The authors of the study do not identify the formal nursing theory that can be associated with their findings. However, considering the importance of their results for the improvement of nursing practice and the achievement of positive outcomes, the article can be analyzed regarding Pender’s health promotion model. It states that the work of specialists and the provision of care should be focused on increasing patients’ level of well-being and outcomes. Better knowledge of the basic causes of falls will help patients to benefit from a higher quality of life, which is critically important for patients.


Investigating the selected problem, the authors also introduce some variables and assumptions that are needed to cover the topic and guide their study. The researchers revolve around the idea that falls in the hospital setting are one of the major causes of the emergence and development of complications. For this reason, the choice of variables comes from this assumption. The study does not have a clearly stated research question or hypothesis. However, from the purpose of the article and the background of the research, it is possible to understand that the research question is to answer what factors are associated with injurious falls in hospitalized patients.

The researchers clearly outline the dependent variable, which is the injurious falls, as it is vital to investigate this issue and aspects linked to it. As for the independent variables, the review of literature helped to outline the following ones: “age, sex, fall history, use of cardiovascular medications, use of CNS medications, cognitive impairment, primary discharge diagnoses, abnormal laboratory values, impaired mobility, and BMI” (Hester et al., 2016). The selection of these aspects for the investigation preconditions the credibility of findings as the dependent variable is concrete and can be measured by using tools introduced by researchers. In such a way, the study benefits from the appropriate selection of concepts needed to provide conclusions.


The article also has the methodology section that is devoted to the detailed description of the research design, methods, and approaches employed by the authors to avoid bias and use only credible data to support their assumptions. The given part contributes to a better understanding of the paper and its major purpose. Thus, the investigators conduct a retrospective correlational study presupposing the analysis of existing medical reports of patients belonging to the interest group. For this reason, it is possible to conclude that they use quantitative measures to collect and process data vital for their project and conclusions. The researchers also use inductive reasoning as it seems relevant for the given research. They consider different factors and instances to acquire a specific and generalized conclusion about the primary causes of injurious falls among patients in hospital settings. The employment of this perspective helps to transform information into knowledge that can be used by nurses in their practice to acquire improved outcomes and help patients to recover.

The analyzed article rests on data acquired from electronic medical records of patients at an academic medical center in South Central USA (Hester et al., 2016). It serves as the trauma center with 450 patient bends and records over 25,000 discharges a year (Hester et al., 2016). The participants ranged from 18 years and older and had experience of falls during their stay in the hospital (Hester et al., 2016). The data was collected in the period from January 1, 2006, to October 31, 2013 (Hester et al., 2016). In such a way, the non-probability sampling was selected as the way to choose patients as it was necessary to ensure that they have needed experiences and their information can be used to conclude about the major reasons for falls.

The independent variable was tested by using the information acquired from the literature review and existing medical records that contained data about sex, gender, BMI, and all other factors indicated as potential predictor variables. As for the dependent variable, it was measured regarding the impact of factors mentioned above and their ability to contribute to falls among different patients. The authors do not mention ethical considerations; however, this type of study demands the preservation of the anonymity of data related to patients’ records.

Data Analysis

The authors employed the bivariate analyses to outline whether there is a statistically significant correlation between the dependent and independent variables selected for the research. Moreover, the tests of the association are also employed to compare factors that are chosen as possible causes and conclude about their impact on the outcomes and how they can precondition falls in the discussed setting. The results of data procession are presented using tables and a specific section devoted to the discussion of all findings and their importance for the paper. The use of visual appeals contributes to a better understanding of how the authors manage to acquire their statistics and use them to prove their assumptions. One of the central findings states that patients with a primary discharge diagnosis of symptoms and ill-defined conditions are more likely to be injured when they fall (Hester et al., 2016). In such a way, this result can be directly linked to the dependent variable as there are specific factors that impact falls in patients and the emergence of injuries among them.

Summary, Conclusions, and Implications

In such a way, the given paper delves into the question of falls in hospital settings. The relevance of the selected issue is proved by the fact that multiple patients suffer from negative outcomes caused by this very factor. In such a way, investigation of aspects that might precondition injuries is vital for the achievement of better results and reduction of incidence. The major strengths of the paper include the use of effective methods to collect data, the implementation of several independent variables, and the employment of information collected during a long period. It helps to formulate appropriate conclusions. At the same time, there are some limitations that are associated with the inability to consider all factors that might reduce falls and collect relevant data about them.

At the same time, the given findings can be generalized to different populations, excluding children and individuals under 18. It can be explained by the fact that data were collected from participants belonging to different groups, regardless of their age, sex, and other conditions. In such a way, the findings become vital for nursing practice as they help to understand the reasons for injurious falls and try to avoid them. For me, the information provided in the article is also significant as it helps to enhance my skills and contribute to the generation of knowledge of how to work with patients to avoid falls.


Hester, A. L., Tsai, P.-F., Rettiganti, M., & Mitchell, A. (2016). CE: Original research: Predicting injurious falls in the hospital setting: Implications for practice. American Journal of Nursing, 116(9), 24–31.