Evidence Based Practice

Ebele C. Oraekwe

NR 449: Evidenced Based Practice

Injuries and fall from Immobility: Preventing falls in Hospitals

Clinical Question

Statement of the Problem

Nurses and general medical practitioners are guided by certain directives in line of duty. They are expected to give the patients the best services. The issue of falling from immobility has since been debated and it is found out that these falls can be prevented. However, there are still many cases of patients falling from immobility. What is even shocking is the fact that some hospitals record as many as 50% falling. This is a sign that there is a gap existing in this particular aspect. Current statistics portray a potential assumption that people do not fall when they are immobile.

Significance of the problem

This is action research that not only seeks to identify gaps underlying in-hospital care but also tries to come up with solutions to the problem. The recommendations from this paper can be applied in hospitals to help address the problem. This research will dig deeper into the problem and identify possible causes of the scenario hence making it possible to find possible ways that nurses can apply to ensure patients with injuries do not fall from immobility. It is also one way of encouraging professionalism and adherence to the code of conduct in nursing. The statistical report from this statement of the problem will also be useful in identifying the specific types of patients that experience falling.

PICOT question

This is my PICOT question in this paper. These questions define to me specifically what should be addressed at the end of the unit. It gives the scope of what exactly I should focus on when answering the problem and gives directions on how to conduct the research (Echevvarria & Walker, 2014). It also helps to avoid irrelevance hence saving time and other resources.

Purpose of this paper

This paper covers the search strategies that will be applied to get answers to the research questions. The paper is significant because it presents the sources of knowledge that give information on professionalism in nursing practice.

Levels of Evidence

Type of question asked

The PICOT question above is a therapy question because it seeks to achieve some outcome, in this case preventing falls from immobility in hospitals. This is the most asked type of question because all action-based research seeks to deliver some outcomes that improve the experience in a certain sector. Therapy questions seek to help sick people to have a better experience through their recovery journey and improve their lifestyle.

Type of evidence

The most appropriate type of evidence if I found is a Randomized Control Trial (RCT). However, cohort studies can also be useful when answering the question. RCT establishes the relationship that exists between a cause and an outcome, making it the best evidence in this case where the researcher seeks to identify possible causes and solutions (McAlister et al.2017). RCTs generate basic evidence that is significant in improving patients’ management. Research also depicts RCT to be very appropriate in clinical research.

Search Strategy

Search topics

There are certain phrases I used to search for evidence. The following three phrases were used: Injuries and falls from immobility; Preventing falls from immobility; Why patients fall from immobility

Keywords used are immobility, fall, and injury

Databases

I used several databases including articles and books. Based on the nature of the study and the type of picot question, the best search results were either books or articles and journals.

Search strategy decisions

I decided to use two major articles for the research. I reduced the number of sources. Limiting them to two to avoid loss of scope and focus. The limitations were done based on the content that I wanted. I specifically want to identify the causes of falling from immobility and what can be done. This has to do with improving patients’ management and general nursing practice. I, therefore, chose articles that had content that was relevant to this clinical study.

Identification of two most relevant articles

Nursing ethical considerations and their roles

Principles of nursing practice

I found these two articles to be very relevant in this clinical study. The fact that cases of falling from immobility depict a gap in the general nursing practice. These two articles provide relevant information about ethical considerations in the context of nursing practice in hospitals and give insights into cases of falling and conveys some underlying issues on the same. I, therefore, found them to be most appropriate

Conclusion

In a nutshell, the topic search strategy is as important as any other part of a clinical study. When preparing to conduct a study, it is important to come up with the topic search strategy first to have an easy time during the actual study. It helps one to remain focused by only relying on sources that were identified in the search strategy.

References

Echevarria, I. M., & Walker, S. (2014). To make your case, start with a PICOT question. Nursing2020, 44(2), 18-19.

McAlister, F. A., Van Diepen, S., Padwal, R. S., Johnson, J. A., & Majumdar, S. R. (2017). How evidence-based are the recommendations in evidence-based guidelines? PLoS medicine, 4(8).