NRS 493 Patient Falls in Healthcare Facilities

For this assignment, provide a synopsis of the review of the research literature. Using the “Literature Evaluation Table,” determine the level and strength of the evidence for each of the eight research articles you have selected. The articles should be current (within the last 5 years) and closely relate to the PICOT question developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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1 Fall Prevention Program for At Risk Patients Elaine Navarro Grand Canyon University Dr. Rebecca Luetke June 20th, 2021 2 Fall Prevention Program for At-Risk Patients Introduction Nowadays, health care providers widely use evidence-based practice (EBP) to provide patient-centered care in clinical practice and research. EBP in medicine often consists of recognizing uncertainties and articulating them to solutions by searching for EBP literature and evaluating and applying patient care findings. PICOT framework provides a wellconstructed approach to develop a researchable question and finding relevant results. It offers conceptual and specific clarity to clinical problems. The PICOT comprises of mnemonics derived from clinical research question elements, including P (population/patient), I (intervention), C (comparison), O (outcome), and sometimes T (time), where the PICOT process starts with a case scenario, followed by the question elicit to derive an answer. These papers provide a PICOT question and describe the nursing intervention, clinical problem, patient outcome, and elaborate how the PICOT problem relates to EBP. PICOT Question The PICOT question being addressed: “How often do falls occur for at-risk elderly patients when multiple fall prevention approaches are used, such as fall risk assessment, verbal or visual “fall risk” communication, chair or bed alarms, structured nursing rounds, and video monitoring compared to falls when using only one intervention. Clinical Problem Patient falls continue to be a worrying global concern for most health care systems.NRS 493 Patient Falls in Healthcare Facilities

It is estimated that about 3-10% of patient falls often result in intracranial hemorrhage or bone fractures. In addition, hospital falls pose numerous adverse consequences for patients and their kin, including depression, reduced mobility, fear of fall, injuries, functional ability, increased morbidity and mortality, and decreased quality of life and independent living (Zhao et al., 2019). Therefore, there is a need to establish why patient fall continues to create a 3 problem for patients after implementing fall prevention interventions and finding EBP to reduce falls and their related injuries. In order to determine an answerable question, the PICOT framework is a critical process to successfully identify the best EBP approach for a fall intervention program. Likewise, the process helps determine the practice issue associated with falls and establish EBP interventions to reduce falls among elderly patients at the University of Miami Medical Building. Nursing Intervention In at-risk elderly patients above 65 years (Patient population), how effective is multiple fall prevention approaches, such as fall risk assessment, verbal or visual “fall risk” communication, chair or bed alarms, structured nursing rounds, and video monitoring (Intervention of interest) compared to falls, while using only one intervention (Comparison intervention). The outcome measures the effectiveness of utilizing multiple intervention approaches on falls and resulting injuries related to falls (Outcome) during clinical checkups (Time). Using various interventions increases the chances of reducing potential falls among at-risk patients within the hospital building. In addition, the fall prevention approach using multiple interventions fosters collaborative efforts among health care providers, particularly involving all the health care providers on duty. The nurse intervention applies all intervention tools, such as fall risk assessment, verbal or visual “fall risk” communication, chair or bed alarms, structured nursing rounds, and video monitoring. Relevance In a dynamic clinical setting, falls remain a challenge, particularly when determining the best fall prevention that provides a safe and injury-free environment. Several studies conducted using randomized controlled trials (RCT) provide better EBP to prevent patient falls and related injuries. For example, Barker et al. (2016) established that “positive changes in falls prevention practice occurred following the introduction of the 6-PACK programme.” 4 Their study t used a 6-pack multiple fall prevention intervention methods to minimize fall rates and related injuries compared to traditional fall prevention methods. The 6-PACK programme used by Barker et al. (2016) is a multiple fall prevention intervention designed using EBP prevention guidelines. Conclusion Patient fall is still a complex phenomenon, which makes prevention a challenge to most health care facilities. NRS 493 Patient Falls in Healthcare Facilities

Hospitalized patient fall have the highest reported incidents by health care providers, which is estimated at 3 to 5 falls in every 1000 patient days (Zhao et al., 2016). Widely conducted clinical research has a significant impact on improving health care practices, particularly on medical decision-making. Nurses are strategically positioned to lead a multifactorial fall prevention intervention designed specifically for clinical areas in buildings. Multiple intervention approaches aim to increase awareness by using alert signs, alarms, video monitoring, and bed or chair alarm of at-risk patients of falling. Therefore, multifactorial intervention incorporates environmental and system-level interventions to offer improved effectiveness and potency. 5 References Barker, A. L., Morello, R. T., Wolfe, R., Brand, C. A., Haines, T. P., Hill, K. D., … & Kamar, J. (2016). 6-PACK programme to decrease fall injuries in acute hospitals: cluster randomised controlled trial. bmj, 352. From https://doi.org/10.1136/bmj.h6781 Zhao, Y. L., Bott, M., He, J., Kim, H., Park, S. H., & Dunton, N. (2019). Evidence on fall and injurious fall prevention interventions in acute care hospitals. JONA: The Journal of Nursing Administration, 49(2), 86-92. From https://doi.org/10.1097/NNA.0000000000000715 Course Code NRS-493 Class Code NRS-493-O503 Criteria Content Percentage 100.0% Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article 5.0% Article Title and Year Published 5.0% Research Questions (Qualitative) or Hypothesis (Quantitative), and Purposes or Aim of Study 10.0% Design (Type of Quantitative, or Type of Qualitative) 5.0% Setting or Sample 5.0% Methods: Intervention or Instruments 5.0% Analysis 10.0% Key Findings 10.0% Recommendations 10.0% Explanation of How the Article Supports EBP or Capstone 10.0% Presentation 10.0% Mechanics of Writing (includes spelling, punctuation, grammar, and language use) 10.0% Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style 5.0% Total Weightage 100% Assignment Title Literature Evaluation Table 1: Unsatisfactory (0.00%) Author, journal (peer-reviewed), and permalink or working link to access article section is not included. Article title and year published section is not included. Research questions (qualitative) or hypothesis (quantitative), and purposes or aim of study section is not included. Design (type of quantitative, or type of qualitative) section is not included. Setting or sample section is not included. Methods: Intervention or Instruments section is not included. Analysis section is not included. NRS 493 Patient Falls in Healthcare Facilities

Key findings section is not included. Recommendations section is not included. Explanation of how the article supports EBP or capstone section is not included. The piece is not neat or organized, and it does not include all required elements. Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is employed. Sources are not documented. Total Points 50.0 2: Less Than Satisfactory (75.00%) Author, journal (peer-reviewed), and permalink or working link to access article section is present, but it lacks detail or is incomplete. Article title and year published section is present, but it lacks detail or is incomplete. Research questions (qualitative) or hypothesis (quantitative), and purposes or aim of study section is present, but it lacks detail or is incomplete. Design (type of quantitative, or type of qualitative) section is present, but it lacks detail or is incomplete. Setting or sample section is present, but it lacks detail or is incomplete. Methods: Intervention or Instruments section is present, but it lacks detail or is incomplete. Analysis section is present, but it lacks detail or is incomplete. Key findings section is present, but it lacks detail or is incomplete. Recommendations section is present, but it lacks detail or is incomplete. Explanation of how the article supports EBP or capstone section is present, but it lacks detail or is incomplete. The work is not neat and includes minor flaws or omissions of required elements. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. 3: Satisfactory (79.00%) Author, journal (peer-reviewed), and permalink or working link to access article section is present. Article title and year published section is present. Research questions (qualitative) or hypothesis (quantitative), and purposes or aim of study section is present. Design (type of quantitative, or type of qualitative) section is present. NRS 493 Patient Falls in Healthcare Facilities