Research Critiques and PICOT Statement Final Draft
Running Head: LITERATURE EVALUATION 2
LITERATURE EVALUATION 3
Typing Template for APA Papers: Qualitative Research Critique and Ethical Considerations Kieran M Njobe
Grand Canyon University: < NRS-433V >
<10/11/2020>
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1
Qualitative Research Critique and Ethical Considerations
Introduction
Fall in the hospital has become a significant safety issue in the healthcare system. Each year, about 900,000 people fall in the hospitals raising substantial safety concerns. While numerous strategies have developed to mitigate this problem, they have not been successful. More concerted efforts are required to reduce falls in hospitals. This paper reviews various articles that focus on fall prevention in hospitals.
Background
Emerging data indicate that about 35 falls result in fractures, and about 50% lead to serious injuries. Also, harm to healthcare professionals and patients may manifest through dissatisfaction, guilt, litigation, complaints, fear for further falls, and psychological distress. Most of the falls are not a result of aging. They result from individual and environmental factors that come to interplay due to an individual’s risky behavior. By identifying these factors, it is possible to come up with effective fall prevention strategies.
Summary of the Clinical Issue
Hospitals are some of the places that are unfamiliar to most of the inpatients. As a result of this, it can be a huge challenge when one is unwell and gets injured simultaneously. A fall to take place in the hospital setting means that the patient might have been feeling dizzy, weaker, or less steady than they had expected when they got out of their bed to walk to the washroom or pick something. Most of the injuries that take place in the hospital are as a result. If a patient falls while this might or the other lengthen their stay at the hospital. All individuals are usually vulnerable to falls regardless of age, but when one gets older, there is a higher risk of them falling. There can be a significant impact on the patient because more resources in terms of money are used to treat the fall. Falls can be very harmful and even cause the death of the patient. Practical prevention approaches are of great significance in ensuring that any effect associated with the falls is identified, and preventive measures are taken to solve falls.
Gu, Y. Y., Balcaen, K., Ni, Y., Ampe, J., & Goffin, J. (2016). Review on prevention of falls in hospital settings. Chinese nursing research, 3(1), 7-10. Retrieved from https://www.sciencedirect.com/science/article/pii/S2095771816300202
This article will first cover the different causes of falls in the hospital settings, identify various preventive measures that can be used by the hospitals for the sake of ensuring that falls are prevented. Falls are the leading causes of death and an extension of patient stay at the hospital. Moreover, the article provides an overview of some of the best practices that can be used to prevent falls. . There is a benefit of coming up with a comprehensive program used in hospitals for the prevention or a reduction in the number of falls incurred in hospitals. The program will be made up of the patients' evaluation, the different environmental modifications, and relevant training offered to staff to lead to a reduction in the overall falls that take place in hospitals. The implementation of such programs can help reduce and improve the care offered to patients.
This is an example of a qualitative study because there is the collection and analysis of the non-numerical data.
The study aims to ensure there is the prevention of falls among patients in the hospital setting.
The Research Question: How effective are the different intervention programs or systems in ensuring falls are reduced among hospitals?
Objective: Ensure there is a reduction of falls that take place within the healthcare institution or hospital
The Picot Question seeks to Identify the Problem of falls in Hospital settings. In the study, the root cause of falls is classified into three categories; accidental falls, anticipated physiological, and unanticipated physiological. With timely intervention and implementation of measures such as falls risk assessment, falls have been reduced to about 61% in settings that have this tool in place. The Morse Falls risk assessment scale is one of the most popular used in health care settings. The PICOT question seeks to identify best practices that can be implemented to reduce falls in hospital settings, and these methods have been highly effective in preventing falls
Method
The Setting of the Study: In hospitals and different healthcare facilities.
The assessment is used to identify the patient who is at a higher risk of falling. Some of the significant and less expensive scales used include the STRATIFY scale or the Morse fall.
After identifying the patients, standard procedures can be used to ensure there is a minimization of the risks of falls. Physical therapy should flow up with a plan for the patient identified as a high fall risk. Care plans should be individualized, depending on the specific needs of the patient. The use of assistive devices should be implemented as well, as well as improved communication between healthcare workers.
Limitations - Despite the benefits of these fall assessment methods, it has its limitations: it does not assess the effect of the environmental factors that contribute to falls. It only considers the assessment of patients relative to one another.
Recommendations: The researchers recommend that the healthcare institutions or hospital staff make sure there is a reduction in the time the patient walks from one place to the other. When the patient walks from one point to the other, there is a need to provide the assisting devices. The development of a safety culture is of great significance in ensuring continuous improvement that can be driven toward ensuring improvement and patients' needs are met.
The implication for Nurses –
Nurses are at the forefront of frequent contact with the patient, and in other to reduced falls, nurses should be given the tools needed to implement the plan. Inservice and other training programs should be mandatory. Standard practice should be implemented even though it may differ from one facility to another; the result must be consistent with fall reduction and identifying fall risk behavior.
Morris, R., & O’Riordan, S. (2017). Prevention of falls in the hospital. Clinical Medicine, 17(4), 360. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6297656/
Falls that take place among the inpatients have frequently reported safety incidences in the NHS hospitals. Around half of the physical injuries and fractures that take place in hospitals are usually as a result of falls. This article gives a detailed analysis of the different causes of falls in hospital settings. Moreover, there is the provision of the other intervention measures that can be used to ensure there is a reduction or complete elimination of the falls. Organizations need to adopt some of the best practices to ensure that patients are well cared for, and minimal injuries are experienced.
It is an example of a qualitative study because it does not make use of statistical methods. Explanations are provided to give the reader more information about what most of the patients go through while staying at the hospital.
The Purpose Statement: To determine how having strong leadership in a healthcare facility and organization oversight can help to have a better combination in cultural evolution. This is while having relevant evidence and measurement of the performance of different healthcare institutions' performance to improve the safety of patients.
The Research Question: In what ways can strong leadership and organizational oversight successfully prevent falls in hospitals? Are adopted written policies implemented at the clinical settings. Or rather, do health care providers comply with the standard guidelines in place. Morris, R., & O'Riordan, S. (2017). “ It was also apparent through correlation with organizational level data, that there were significant disparities between written policy and the practical implementation thereof at the clinical front line.” With the implementation of fall wrist bracelets, call light in place, clutter-free environment, and other standard practices, inpatient falls have increased. However, the implementation of fall risk assessment and strong leadership reduced the number of falls in an inpatient setting. The intervention aims to reduce falls by empowering leadership roles that constitute the interdisciplinary team of professionals whose objective is to promote fall behavior attitudes. Informed decisions are made by this body and applied accordingly. For example, falls must be reported to the physician even if the patient was assisted to the floor. Launching an investigation helps to identify the root cause of the problem, and as a result, education and training are provided based on this data.
The Setting of the Study: The study is taking place in different healthcare institutions and hospitals in Wales and England. These Healthcare settings were required to respond to organization questions about what was in place to prevent falls, and 5000 patients were audited.
Method used: The national audit of inpatient falls.
The number of patients involved in the study is 5,000 in total. In the selection, a selected healthcare system within Wales and England, where asked questioned related to their Health system in place From the result obtain; there was inconsistency amongst this various healthcare system, When using a fall assessment tools, they were a wide variation in terms of the results obtained. For example, call bell-like within sight, Toileting, mobility aide within reach, and vision assessment had a range of 45% to 80 percent more chances of causing falls than delirium, Blood pressure, and medication only 40% to 50%.
Limitations
Data for this study was obtained from a wide and diversifying population, consistent with Wales and England. As a result, the implementation of an informed decision will be very challenging.
Benefits
A multi-professional Team will enforce the policy changes, and as a result, compliance will be assured. For example, a medical team of experts will review the patient on the ground for a more positive therapeutic outcome.
Results
From the organization data obtain, using fall risk assessment factors but intrinsic as well extrinsic, call bell within site, toileting, and vision impairment were the highest risk factor during delirium, Blood pressure, and medication as at the lower end.
The Key Findings: The careful risk assessment of falls effectively ensures that patients, especially the elderly and weaker ones, do not fall in hospitals while trying to move from one location to the other. Assessing risks that might expose the patient to fall helps develop strategies and programs that prevent patients from falling, thus providing better healthcare services.
Recommendation of the Researcher: The authors of the study recommend that all the patients hospitalized in different healthcare facilities should be subjected to risk assessment of falls in one way or the other.
Ethical Considerations: There are various ethical considerations in research. Two of these considerations are informed consent and confidentiality. In both the studies reviewed in this paper, the researchers obtained full consent from the participants before the study. The researchers also ensured the data obtained from the participants is kept securely and used only for the study's purposes.
Conclusion
In conclusion, both the studies reviewed in this paper evaluate various strategies for reducing falls in hospitals. Various approaches have been recommended that can be used in the healthcare system to ensure patients' safety. The studies were also conducted based on the ethical principles of confidentiality and informed consent.
References
Gu, Y. Y., Balcaen, K., Ni, Y., Ampe, J., & Goffin, J. (2016). Review on prevention of falls in hospital settings. Chinese nursing research, 3(1), 7-10. Retrieved from https://www.sciencedirect.com/science/article/pii/S2095771816300202
Morris, R., & O’Riordan, S. (2017). Prevention of falls in hospital. Clinical Medicine, 17(4), 360. Retrieved fro https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6297656/