response- INTRODUCING STATISTICS FOR THE DNP
Jun 2 11:24pm
Reply from Krystal F Saum
One of the first steps of EBP is identifying the nursing problem, then finding available data on that problem, and finally applying that knowledge to practice. In the following discussion nursing problems are identified for each study, how the problems define the gaps in practice and knowledge are highlighted, variables and measurements are mentioned, and a DNP project is critiqued on how well it used the question development tool.
Nursing Problems
The nursing problem identified in the research study is a high number of falls in the medical-surgical orthopedic unit (Khoja & Moosa, 2023). Similarly, the nursing problem that Bangura recognized was an increase in falls at a long-term care facility for veterans. The QI study has a connecting theme of falls, however the nursing problem identified was the increased cost and increased length of stays that resulted from the falls.
Define the Gap in Knowledge or Practice
For Khoja and Moosa’s research study, the nursing problem reveals a gap in knowledge of which intervention tool will have the best outcome to reduce falls. The QI study’s nursing problem of high cost and longer hospital stays reveals a gap in practice as to which intervention or fall prevention tool should be used. The study looked at multiple hospitals and talked to several nurses about which tools or interventions they used to prevent falls. It was apparent that every nurse had their own preference to which intervention or screening tool worked best for their patients and was easy enough to implement into their care of the patient. While nurses have their preferred methods, it could be inferred that this is causing a problem related to patient falls, due to nurses using inconsistent methods for screening and preventing falls. The DNP study practice problem of an increase of falls touches on a gap in practice of patient and staff education deficit on fall prevention specifically in the veteran long term care population.
Compare and Contrast
The research study presented the problem as a gap in knowledge as to which intervention would be best for preventing falls, similarly Bangura recognized a gap in practice and which prevention would work best for the identified population. In contrast the QI study presented the gap in practice as a qualitative study to find which strategies were being used and worked at different hospitals. All of the studies can be used to make a positive change in nursing practice; due to all of them evaluating interventions for fall prevention, nurses can use the results of the studies to implement tools like TIP to prevent falls in patients and reduce associated injuries and fatalities.
Key Measurement/Variable Used
Some of the variables in the QI study were the criteria used for nurses involved in the study including ages over 21 and must have worked on their unit for one year or longer, excluding any travel nurses (Tzeng & Yin, 2017). The measurement used in the QI study was the surveys that were given to the participating nurses. One of the measurements used in the DNP project was comparing results of unstructured rounding to intentional rounding and using a goal of 5 or less falls per month (Bangura, 2024). A variable I noted in the DNP project was staff perceptions of fall prevention strategies. For the research study the variable I identified was the TIPS screening tool implemented in the MSOU. A measurement I identified in the research study was the comparison of the percentage of falls pre and post implementation of TIPS.
Critique the Question Development Tool
The question development tool was applied to Hick’s DNP project. It identified a local problem of CLABSI in the SICU. Hick’s then went on to explain why it is a problem noting the costly effect of the infections and the associated mortality rate. The DNP paper also stated what would happen if the practice problem was not addressed, including deaths of patients. Measurements used during this DNP project included gathering data by pulling audits every month of the central line auditing tool and using the Chi-square test to measure statistical significance (Hicks, 2024).
References
Bangura, F. (2024). Development and evaluation of a nurse practitioner–directed intentional rounding strategy, and its impact on decreasing falls in a veterans long-term care facility. (Doctoral dissertation -Wilmington University). ProQuest Dissertations and These Global. https://www.proquest.com/dissertations-theses/development-evaluation-nurse-practitioner/docview/2932310765/se-2Links to an external site.Links to an external site.
Hicks, T. (2024). Quality evaluation of a central line associated bloodstream infection. Walden University CAO Repository.
Khoja, A., & Moosa, L. (2023). Impact of tailored interventions for patient safety (TIPS) to reduce fall rates. Medsurg Nursing, 32(2), 89-93. https://doi.org/10.62116/msj.2023.32.2.89Links to an external site.Links to an external site.
Tzeng, H. M., & Yin, C. Y. (2017). A multihospital survey on effective interventions to prevent hospital falls in adults. Nursing Economics, 35(6), 304-314.
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Jun 2 10:59pm
Reply from Ezinne Laura Abumere
Week 2 Discussion
Patient falls remain a major patient safety concern in healthcare settings because they contribute to injuries, prolonged hospitalization, increased healthcare costs, and reduced quality of life. Nursing research and quality improvement (QI) initiatives continue to explore evidence-based strategies that reduce falls and improve patient safety outcomes. The studies by Tzeng and Yin (2017), Khoja and Moosa (2023), and Bangura (2024) each address fall prevention from different perspectives, including research, QI, and Doctor of Nursing Practice (DNP) practice change approaches. Although all three projects focus on reducing falls, they differ in how they define the nursing problem, identify gaps, and implement change.
The nursing problem identified in Tzeng and Yin’s (2017) study concerned uncertainty about which fall-prevention interventions nurses perceived as most effective in acute care settings. This problem represented a knowledge gap because there was limited evidence regarding nurses’ perspectives on practical, effective interventions used across multiple hospitals. The researchers sought to expand understanding of evidence-based strategies that could improve patient safety and reduce adult inpatient falls. One key variable measured in this study was nurses’ perceptions of the effectiveness of fall-prevention interventions.
In contrast, Khoja and Moosa (2023) focused on a practice gap rather than a knowledge deficit. Their QI project addressed persistently elevated patient fall rates despite existing prevention efforts. The authors implemented Tailored Interventions for Patient Safety (TIPS) to improve staff engagement and patient-centered fall prevention practices. The nursing problem emphasized the inconsistent implementation of evidence-based interventions in clinical practice. A key measurement used in this project was the hospital fall rate before and after implementation of the TIPS intervention.
Similarly, Bangura’s (2024) DNP project addressed a practice gap within a veterans’ long-term care facility where patient falls remained problematic despite standard prevention protocols. The project introduced a nurse practitioner–directed intentional rounding strategy to improve patient monitoring and safety. Unlike traditional research studies that seek new knowledge, this DNP project focused on translating existing evidence into practice improvement. One important variable measured was the frequency of patient falls following intentional rounding implementation.
The three projects demonstrate both similarities and differences in how nursing problems are presented and how they may influence positive nursing practice change. Tzeng and Yin (2017) focused on generating knowledge to guide future interventions, whereas Khoja and Moosa (2023) and Bangura (2024) focused on applying evidence-based interventions to improve clinical outcomes. Research studies primarily seek to answer questions about what is effective, while QI and DNP projects aim to improve existing systems and patient outcomes. Despite these differences, all three projects support nursing practice change by emphasizing evidence-based fall-prevention strategies, interdisciplinary collaboration, and patient safety enhancement.
Hicks (2024) presented an effective framework for developing questions by emphasizing alignment among the identified problem, the evidence-based practice (EBP) question, and measurable outcomes. The framework is valuable because it ensures that nursing problems are clearly identified and linked to measurable clinical improvements. In the reviewed projects, the nursing problems were specific, clinically relevant, and measurable through fall rates or staff perceptions. However, one limitation of the framework is that it may oversimplify complex healthcare environments where multiple contributing factors influence outcomes. Additionally, some practice settings may require broader organizational considerations beyond measurable clinical variables alone. Nevertheless, Hicks’s (2024) approach strengthens evidence-based inquiry by promoting structured problem identification and outcome evaluation.
In conclusion, the three fall-prevention projects demonstrate how research, QI, and DNP initiatives address nursing problems differently while contributing to improved patient safety outcomes. Research studies focus on closing knowledge gaps, whereas QI and DNP projects emphasize closing practice gaps through evidence implementation. Together, these approaches strengthen nursing practice by promoting safer care environments and supporting evidence-based fall-prevention strategies.
References
Bangura, F. (2024). Development and evaluation of a nurse practitioner–directed intentional rounding strategy, and its impact on decreasing falls in a veterans’ long-term care facility (Publication No. 30991997) [Doctoral dissertation, Wilmington University]. ProQuest Dissertations and Theses Global. https://www.proquest.com/dissertations-theses/development-evaluation-nurse-practitioner/docview/2932310765/se-2Links to an external site.
Hicks, T. (2024). Quality evaluation of a central line associated bloodstream infection . Walden University CAO Repository.
Khoja, A., & Moosa, L. (2023). Impact of Tailored Interventions for Patient Safety (TIPS) to Reduce Fall Rates. MEDSURG Nursing, 32(2), 89–93. https://doi.org/10.62116/msj.2023.32.2.89Links to an external site.
Tzeng, H.-M., & Yin, C.-Y. (2017). A multihospital survey on effective interventions to prevent hospital falls in adults. Nursing Economics, 35(6), 304–313. https://researchexperts.utmb.edu/en/publications/a-multihospital-survey-on-effective-interventions-to-prevent-hospLinks to an external site.