Fall Prevention in a Long Term Facility
QUESTION
Revise the PICOT question you wrote in the Topic 1 assignment using the feedback you received from your instructor.
The final PICOT question will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).
Research Critiques
In the Topic 2 and Topic 3 assignments, you completed a qualitative and quantitative research critique on two articles for each type of study (4 articles total). Use the feedback you received from your instructor on these assignments to finalize the critical analysis of each study by making appropriate revisions.
The completed analysis should connect to your identified practice problem of interest that is the basis for your PICOT question.
Refer to “Research Critiques and PICOT Guidelines – Final Draft.” Questions under each heading should be addressed as a narrative in the structure of a formal paper.
Proposed Evidence-Based Practice Change
Discuss the link between the PICOT question, the research articles, and the nursing practice problem you identified. Include relevant details and supporting explanation and use that information to propose evidence-based practice changes.
General Requirements
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Research Critiques and PICOT Question Guidelines –
Final Draft
Use this document to organize the content from your four studies into your final draft.
Quantitative and Quantitative Studies
Nursing Practice Problem and PICOT Question
1. What is your identified nursing practice problem?
2. List your PICOT question, following one of the templated formats reviewed in the course.
Background
1. Summary of studies. Include problem, significance to nursing, purpose, objective, and research question.
How do these four articles support the nurse practice issue you chose?
1. Discuss how these articles will be used to answer your PICOT question.
2. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question.
Method of Study:
1. State the methods of the articles you are comparing and describe how they are different.
2. Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method.
Results of Study
1. Summarize the key findings of each of the studies into a comprehensive summary.
2. What are the implications of the four studies you chose in nursing practice?
Ethical Considerations
1. Discuss two ethical consideration in conducting research.
2. Describe how the researchers in the four articles you choose took these ethical considerations into account while performing their research.
Outcomes Comparison
1. What are the anticipated outcomes for your PICOT question?
2. How do the outcomes of the four articles you chose compare to your anticipated outcomes?
Proposed Evidence-Based Practice Change
1. What is the link between the PICOT question, the research articles, and the nursing practice problem you identified?
2. Based on this information, propose an evidence-based practice change for your identified setting.
Fall Prevention in a Long Term Facility
ANSWER
Fall Prevention in a Long Term Facility
Student’s Name
Institutional Affiliation
Course Name and Number
Instructor’s name
Date
Fall Prevention in a Long Term Facility
Nursing Practice Problem and PICOT Question
Introduction
Quality and safe care is an essential need for patients to help them in having better health outcomes. However, various challenges exist, which hinders the ability of healthcare providers to offer such quality and safe care to their patients. This leads to poor health outcomes of the patients, which result in prolonged hospital stay, high healthcare costs and poor quality of life. The incidences of falls among hospitalized have remained high, despite extensive information from researchers on how to address significant nursing practice problems (Taylor & Hignett, 2016). Certain factors have been implicated in the increased occurrences of falls, with the most outstanding being long term hospitalization of the elderly, the majority of battles chronic conditions.
Falls during hospitalization are associated with devastating impacts, including fractures, physical disabilities, internal organs injuries, increased hospital stays, and increased healthcare costs as more resources are required to manage the various complications that develop after a fall. (Taylor & Hignett, 2016)These devastating impacts associated with falls, together with the fact that fall incidences remain high despite measures to prevent them, emphasize the need to develop appropriate and more aggressive strategies that will effectively prevent them. A PICOT statement surrounding this healthcare issue to enhance awareness together with analysis of research articles and lastly, discussion of how different pieces of evidence obtained are integrated into practice to help determine an appropriate approach effective in preventing hospital falls.
PICOT Statement
Addressing most healthcare problems require a multidisciplinary approach and incorporation of the patients into their management to help in achieving better health outcomes. The involvement of patients in the prevention of falls while in the health facility is crucial in essential, as it will facilitate their efforts to help prevent falls. Through patient education, their participation in fall prevention is enhanced, which helps in reducing the prevalence of falls. Frequent rounding by nurses has also shown effectiveness in reducing the prevalence of falls (Alert, 2015). However, addressing this nursing practice issue has not been successful in preventing falls, emphasizing the need for various healthcare providers to develop measures that will be effective in reducing fall prevalence in facilities (Alert, 2015). Regarding this healthcare problem, the PICOT question is; ‘For hospitalized patients (P), does patient education on falls during admission and frequent rounding during hospitalization (I), compared with usual nursing care (C), reduce the risk of patient falls (O) within four months? (T)’
Quantitative Research Articles
Background
The articles used in this section of the research explains why it is essential to prevent cases of patient fall in hospital settings (Hicks, 2015). The articles provide a detailed explanation of the importance of patient rounding in preventing falls among hospitalized patients. However, this article highlights that preventing falls in health facilities has been significantly challenging, thus causing more associated complications (Morgan et al., 2017). The challenges which make addressing this issue difficult helped the researchers to emphasize a collaborative approach in addressing this condition.
The background information in these articles adequately introduce the nursing practice problem, and through it, the readers get the necessary orientations. Additionally, the background information emphasizes the efforts by the researchers to address this issue and reduce the prevalence (Hicks, 2015). The articles incorporate citations from other literature which are also relevant to the research topic. This is an essential aspect, as it enables the reader to understand views from other researchers on the prevention of falls (Morgan et al., 2017). The articles also provide the relevance of their studies in addressing this healthcare problem by providing data on patient falls, accompanied by an emphasis on why the various healthcare providers need to analyze and understand the data correctly. The articles also explain the objective of the studies, which includes the application of a collaborative approach, which in this case include patient rounding, to prevent incidences of falls among hospitalized patients (Hicks, 2015). The aims of the two studies in the articles correlate with the research question. Even though the researcher does not elaborate on this, the reader can progress to methodology and read about how this intervention has been applied to help prevent falls among hospitalized patients.
Method of Study
The article does not include a section that describes the various benefits and risks associated with the research. The readers, however, can understand the benefit of these researches is the reduction of patient falls among hospitalized patients, especially from the background information provided in the articles. There is no adequate information about informed consent in both articles; thus, one could question the ethical and credibility issues. Worth noting is the patient-centred approach used as the guiding framework, which emphasizes addressing various patient needs (Hicks, 2015). The variables used in the research are explained in detail, together with a questionnaire used to assess the outcomes of the intervention after its implementation (Morgan et al., 2017). These explanations enable the reader to understand the fact that the researchers employed reliable methods in their research. Being quantitative research, the researchers used SPSS to help in data analysis (Hicks, 2015). The methodology used was appropriate, and from here, the reader can proceed to the result section, where they can now interpret the results to enable them to understand the outcomes.
Results of Study
The results obtained indicated a significant reduction in the number of patients falls after implementing this intervention. By analyzing the data provided in the result section, the reader can comprehend how a collaborative approach, specifically patient rounding is essential in reducing the prevalence of falls among hospitalized patients (Hicks, 2015). The validity of the results obtained was supported by the fact that other researchers have also proved the effectiveness of patient rounding in reducing fall prevalence in health facilities. Additionally, the study involved 14 participants in one setting, indicating that despite the results being relevant, there are significant limitations in their applications (Morgan et al., 2017).
The findings obtained from the research apply to nursing practice since collaboration and patient rounding is essential functions of nurses while caring for patients and addressing their health concerns to help them achieve better health outcomes. Besides, the effectiveness of intervention in addressing the healthcare issue, as seen in the results, emphasizes the need for nurses to conduct frequent rounding and embrace collaboration to help in minimizing the prevalence of falls. It is also crucial for other researchers to conduct similar research in other institutions with a higher number of participants and different settings to confirm the effectiveness of this intervention in addressing the healthcare problem.
Ethical Considerations
Ethical consideration is crucial for any research, especially those revolving around healthcare issues (Ketefian, 2015). The research articles do not describe if the researchers obtained informed consent from the participants before conducting the research and do not include a section describing the participants’ welfare and their readiness to participate in the research. These ethical issues may make the readers question the credibility of the results obtained.
Qualitative Research Articles
Background
Like the qualitative articles, these articles begin by explaining why falls are a significant healthcare concern and the importance of preventing falls in health facilities. These articles also describe the association between patient education and fall prevention in health facilities (McKenzie et al., 2017). Additionally, the articles used are within the past five years, indicating that the interventions discussed in them effectively address this healthcare issue since the research is up to date. Creating patient awareness regarding this healthcare issue by educating them during admission has proven to reduce the prevalence of falls in health facilities, as it enhances patient participation (Godlock et al., 2016). However, there is limited research regarding the best nursing interventions that nurses can apply to help in reducing the prevalence of falls among hospitalized patients.
Properly recognizing and understanding this gap is crucial in enabling the reader to appreciate it despite its significance in reducing the prevalence of falls (McKenzie et al., 2017). This gap helped develop the aim of the research, which focused on how patient education on falls during admission can help address the issue and reduce its prevalence (Godlock et al., 2016). Even though the background information lacks a research question, it can be drawn from the research aim, which focuses on preventing falls in health facilities. By understanding the research’s aim, the reader can then proceed to the methodology to understand how the care providers responded to the researchers concerning the intervention.
Fall Prevention in a Long Term Facility
Methods
The researchers started by clarifying that they used a qualitative to assess the attitude and knowledge about the effectiveness of various educational interventions helpful in addressing the healthcare issue (McKenzie et al., 2017). The approach used included training of the care providers regarding various ways helpful in supporting education programs. It was a fundamental approach as it raised the care providers’ awareness concerning ways of preventing incidences of falls and enhanced their attitudes towards backing up the various educational interventions. To obtain responses from the participants regarding the training programs, the researchers used focused group discussions, which were essential, as, through them, the researchers could determine the various attitudes and beliefs which the care providers have regarding the educational programs (Godlock et al., 2016).
Minimizing the prevalence of falls among hospitalized patients was the main focus of the studies as supported by a broad range of credible sources and various literature. However, the articles did not contain a methodology section regarding the perspectives from which the studies were developed. The assessment of the effectiveness of the intervention was carried after 15months, which could have some limitations as, by this time, most participants might have forgotten essential aspects of the program (Godlock et al., 2016). Lastly, the methodology was comprehensive, as the researchers provided detailed information regarding the training of the staff and population, together with reliable means used in the evaluation.
Results
After evaluating the data obtained, the researchers found out that there was a significant reduction in the prevalence of falls in health facilities following the implementation of the intervention developed (Godlock et al., 2016). Additionally, the care providers, through the training, we’re able to determine the effectiveness of patient education in minimizing the prevalence of falls (McKenzie et al., 2017). The results also indicated increased willingness by the care providers to take part in the training, which addressed the healthcare issue. The results obtained from the research emphasizes the need for various training institutions and health facilities to train their care providers to help them in promoting various educational interventions, which are crucial in achieving better patient health outcomes by minimizing the prevalence of falls.
Ethical Considerations
The researches were conducted in compliance with the various ethical requirements. The participants were willing to participate in the study, their welfares were considered, and they provided informed consent to proceed with the research (McKenzie et al., 2017). This is a crucial part because the reader can determine the credibility and reliability of this research since they adhered to the various ethical requirements.
Outcomes Comparison
The development of the PICOT question, together with the incorporation of the research, aimed to address the healthcare issue of the high prevalence of falls in health facilities. The anticipated outcome of the PICOT question was a significant reduction in the prevalence of falls in health facilities through proper implementation of the various interventions. The outcomes of the four articles align with the anticipated outcomes, as they further elaborate on the effectiveness of these interventions in preventing falls among hospitalized patients (Alert, 2015).
Proposed Evidence-Based Practice Change
The evidence presented in the articles revolves around the effectiveness of two interventions in addressing the healthcare issue. The first intervention, which includes patient rounding, has proven to reduce this prevalence, as supported by the findings from the two articles. Additionally, by first ensuring care providers understand the need and importance of enhancing patient awareness, patient education is also essential in reducing the prevalence of falls. It involves the patients in managing their healthcare problems (McKenzie et al., 2017). Each intervention, however, has some limitations. Therefore, the PICOT question incorporates both the interventions, including patient education and rounding used to prevent hospital falls. Therefore, nurses should apply the findings from the two research to help address the issue, as the various researches have shown the effectiveness of these interventions in addressing the problem (Alert, 2015).
Conclusion
In summary, various studies have been done to address the issue of falls among hospitalized patients. There is, however, no substantial impacts of the interventions from the studies in minimizing the prevalence of falls. The research studies focused on two interventions to help address the problem: patient rounding and patient education during admission and hospital stays. Despite limitations, the two interventions have shown significant success in minimizing the prevalence of fall, which emphasize the need for nurses to integrate them in their practice to help them address this healthcare problem.
References
Alert, S. E. (2015). Preventing falls and fall-related injuries in health care facilities. The Joint Commission, 55, 1-55. https://www.jcrinc.com/-/media/tjc/documents/resources/patient-safety-topics/sentinel-event/sea_55_falls_4_26_16.pdf
Godlock, G., Christiansen, M., & Feider, L. (2016). Implementation of an evidence-based patient safety team to prevent falls in inpatient medical units. MedSurg Nursing, 25(1), 17. https://search.proquest.com/openview/83f08e2a2bd66b5a980cf222334936ba/1?pq-origsite=gscholar&cbl=30764
Hicks, D. (2015). Can rounding reduce patient falls in acute care? An integrative literature review. Medsurg Nursing, 24(1), 51. https://search.proquest.com/openview/7891afc5d54f14c1e75dacf018155793/1?pq-origsite=gscholar&cbl=30764
Ketefian, S. (2015). Ethical considerations in research. Focus on vulnerable groups. Investigación y Educación en Enfermería, 33(1), 164-172. http://www.scielo.org.co/pdf/iee/v33n1/v33n1a19.pdf
McKenzie, G., Lasater, K., Delander, G. E., Neal, M. B., Morgove, M., & Eckstrom, E. (2017). Falls prevention education: Interprofessional training to enhance collaborative practice. Gerontology & geriatrics education, 38(2), 232-243. https://www.tandfonline.com/doi/abs/10.1080/02701960.2015.1127809
Morgan, L., Flynn, L., Robertson, E., New, S., Forde‐Johnston, C., & McCulloch, P. (2017). Intentional Rounding: a staff‐led quality improvement intervention in the prevention of patient falls. Journal of Clinical Nursing, 26(1-2), 115-124. https://onlinelibrary.wiley.com/doi/abs/10.1111/jocn.13401
Taylor, E., & Hignett, S. (2016). The SCOPE of hospital falls a systematic mixed studies review. HERD: Health Environments Research & Design Journal, 9(4), 86-109. https://journals.sagepub.com/doi/abs/10.1177/1937586716645918?casa_token=frRpsqqClKIAAAAA:4D-dug-sOgBoOYsRrobOeREwoQqBNCLaNWPaIJSH_sHxj1Z2NiCsQpuStCMpYMyh-jcFe8415dLuTus