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Non-Pharmacologic nursing intervention used to reduce the fall risk for hospitalized population of the United Stated.

STUDENT NAME

Nursing Science and the Research Process

NURS 502-O

Ana G Mendez University

Dr Gisela Llamas

06/13/2021

Non-Pharmacologic nursing intervention used to reduce the fall risk for hospitalized population of the United Stated 1

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Non-Pharmacologic nursing intervention used to reduce the fall risk for hospitalized

population of the United Stated.

According to Mohamed Khalifa, Renada Rochonll and Lynn Salazar, falls are the most common adverse event among hospitalized population. Falls among the previously mention population is the leading cause to chronic pain and hospitalized incidence repot. The increase of patient’s care had also been attributed to the incidence of patient’s fall among hospitalized population. Among the complication resulting from this even can be found, head injury, fracture and several complications that can include distress and patient’s death.

Patient’s fall is defined as an unplanned descent to the floor with or without injury to the patient (Mohamed Khalifa,2019). Patient fall, their consequence and non-pharmacologic nursing intervention to prevent or decrease the hospitalized patient’s fall have been the target of many researchers. The high prevalence of this incidents had made not only the national but international health authorities to make of this a target of interest. The main focus of the several research completed about this topic had been increase the quality of patient care at the time that safety is increased.

This literature review has the purpose of identify the non-Pharmacologic nursing intervention to reduce risk of fall in hospitalized population. Describe main challenged faced by hospital personnel to reduce the fall risk for hospitalized patient. Recognized the risk factor for fall in hospitalized population.

Significance of the Practice Problem

The center of Medicaid and Medicare reported that 11,000 patients fall result in death every year in the United States. Hospitalized patient’s fall is a phenomenon that is world wild. Despite the effect on patient’s health an all the complications previously mentioned falling incident had an economic impact in the cost of patient’s care. The statistic reports that the cost of care increase to more than 40 billion by 2020 related to hospitalized patient’s falls. It is estimated that the care of each patient with a fall incident is average 13,500 dollar more expensive that the average patient without the fall. Falling patient tent to remain 6.5 days more in the hospital compared with patients with the same condition that did not suffered a falling incident. The increase in the length of the hospitalization not only increase the cost of this but also increase the risk of a hospitalization acquire infection.

Patient: s fall also involve an emotional angle. Falling patients remain longer in the hospital this contribute to the increase of a separation anxiety. The prolong change on the patient environment may contribute to change on the mental status of the elderly patients with a shift toward confusion and anxiety. It is important to mention that elderly population is the highest risk identified population. It is reported that hospitalized elderly population falls three times more frequent than the rest of the hospitalized patient grouped minorities. In additional to the physical harm and cost, falls may also contribute to emotional injuries (Mohamed Khalifah,2019)

Research Question

This literature review is developed with the intention of illustrate: What are the Non-Pharmacologic nursing intervention used to reduce risk for fall in hospitalized population of the United State? The aim of this study is as follows :1 Identify the Non-Pharmacologic nursing intervention to reduce risk of fall in hospitalized population 2. Describe main challenged faced by hospital personnel to reduce the fall risk for hospitalized patient. 3. Recognized the risk factor for fall in hospitalized population

Theoretical Framework

The Human Care nursing theory develop by Jean Watson is time framework selected to be applied in this literature review. This nursing theory was developed by jean Watson between 1975-1979. This theory was developed while Watson was teaching at the university of Colorado. This nursing theory fir the purpose of this literature review as it has the patient or client as the main core center. The caring theory of Jean Watson stablish Safety as a main priority in the patient care process. The Jean Watson human caring theory also stablish a holistic approach to the patient and his/her environment taking into consideration the family. This nursing theory stablish each member of the multidisciplinary team as a potential caregiver. Self-care is another of the eligibility criteria used to select this theory. Patient’s falls self-perception or the inability of the patient for self-care is one of the risk factors that contribute or facilitate patient’s falls.

Synthesis of the Literature

While the articles review currently purpose different solution and illustrate a wide range of statistic data. They all agreed that falls among hospitalized patients are the most to second most common cause of injuries suffered by the hospitalized population of the united stated and the world. Both articles clearly indicate the negative effects of a fall int the rehabilitation and healing process of the patient. The increase in the cost of care, the quality of care as well as pharmacological and nonpharmacological solutions are illustrated on both articles. It is very important to mention that article number on was published by a specialized source in Austri and article number two was publishing in the United stated proving that this is a matter that concern not any America by the health authorities and professional of all nations.

Improving Patient safety by reducing falls in Hospitals among the elderly: A review of successful strategies (Mohamed Khalifah,2019) is a literature review that propose a combination of strategies, pharmacological and non-pharmacological. This review encompasses and summarized information review and illustrated 34 articles prescreened and selected from 381 samples originally selected by the researched (Mohamed Khalifa,2019). Among the non-pharmacological proposed solution and special attention to nurses and patient education was place. The assessment for the patient’s environment and the durable medical equipment involve in the patient care were also assessed by several of the original researchers.

Partnering with the patient to reduce the fall in a medical-surgical unit (Renada Rochon, DNP, RN, ACNS-BC, Lynn Salazar MSN, RN) describe the assessment and the results of a program develop by a hospital in south Texas with the intention of decrease the incidence of fall in a surgical united. This article has a combination of qualitative and quantitative information. Once again, the education to patient and staff is essential for the authors of this program. This program encompassed education to different levels and disciplines as well as the patient. The relationship patient clinical personal is an essential key on this program. The program objective was the reduction of fall in the surgical units. The result contains the discussion portion of the program report evidence that the adequate implementation of the program step by step resulted on non-patients fall for two consecutive months.

The real-world journey in implementing fall prevention best practice in three acute cares: This article was written by Sandra Ireland RN, Helen Kirkpatrick, ZRN, Sheryl Boblin RN PHD, Kim Robertson. The methodology for this article was a case study. The research style is qualitative. This qualitative review used the Promoting Action Research in Health System (PARIHS) as the framework. This framework is widely applied in the evaluation of the implementation of evidence on the evidence practice act on the health care practice (Helrich et al 2010).

The data collection was completed utilizing, nurses’ interview, literature review of published articles. The data collection was conducted on a very organized manner starting with data collection, Assertion of the event and how they involve personnel described the event. This article came to conclusion and had recommendation for other facilities to avoid falls. Interventions such as assessment of the employee’s expertise and their experiences and the importance of keeping any measure implement easy to fallow and the need to recognize the importance of continues the study of this matter (hospitalized patient’s falls).

Perception related to falls and falls prevention among hospitalized adults. An article written by Renee Samples Twibell, RN PhD, Debra Siela RN, PHD, Terri Sproat RN , BSN and Gena Coers RN BSN. This article provided bring a different angle to this literature review. The authors of this paper proposed that prevention f patient’s falls during hospitalization depend not only on hospital personnel but also on the patient’s behaviors and patient perception of themselves.

It is well recognized and mentioned by the author that nurses and hospital personal screen the patient for fall risk and implement measures to educate patient regarding this matter and the prevention. The variable that the patient may be condition to not following the instructions provided by personal linked to their perceived likelihood of falling. Meaning that despite the hospital screening and instructions to patient. Patient do not see themselves at risk of the above-mentioned incident an chooses not to follow the programs or the instruction.

As a non-pharmacological solution, the researched stated the important of implement four screening steps. The step shall be completed in conjunction by the nurse and the patient with the aim of increase the patient awareness of the falling risk instead of increasing the fear of the event. The research also proposed that fear to fall among hospitalized patient led to patient to poor posture control, decrease gait that in conjunction with the use of sedative during the hospitalization increment the incident of patient fall. By the contrary patient’s selected to participate in this program and complete the screening steps in conjunction with the nurse report no fall incident during the hospitalization.

Jill Cox PhD RN, Charlotte Thomas-Hawkins, PhD RN, Edmund Pajarillo PhD RN, Susan DeGennaro MSN RN Edna Cadmus PhD, Rn, Miguel Martines MA joined efforts to publish an article named: Factor associated with fall in hospitalized adults patient. The authors on this research agreed that even when the falls in the hospital setting will not be complete avoided there are several measures that may be implemented to reduce the incidence of this event. This group of authors were able to identify main factors that influence or predispose a hospitalized patient to fall. Among the more common included on this category are, age, health status, medication history comorbidity condition, functional ability, as well as environmental issues (Jill Cox Phd RN, Charlotte Thomas-Hawkins, PhD RN, Edmund Pajarillo PhD RN, Susan DeGennaro MSN RN Edna Cadmus Phd , Rn, Miguel Martines MA , 2014). This research plays the biggest important in to factors assessment and prevention. Assessment is the base of the identification of main risk factors involve on a case-to-case individual evaluation of the patient. Assessment will lead to the implementation of the appropriated fall control measure. Meanwhile all the members of a multidisciplinary team caring for the patient had a roll in the prevention it is crucial to mention the importance of the Registered Nurse (RN). The RN is generally in charge of the patient assessment and the early implementation of a prevention patient fall protocol.

Either when it is not the intention of this article to distinguish hospitalized patients by their diagnosis the research would like to take into consideration and article that prove to have a valuable insight regarding hospitalized patient’s fall.

Falls and Hospitalized patients with Cancer. A literature review by Rebecca Allan-Gibbs CNS-BC, RN, AOCNS. This article reviews the many factors that contribute to the functional decline or conditioning deterioration that is evidence on patients diagnosed with cancer. The articles listed to detail the different approach to treat cancer and how this will predispose the patient to fall. This article proposed as the main intervention the nurses who must be very familiarized with their patient’s risk fall factors. This review also indicates that even when cancer and hospitalizations fall are linked for all the predisposing factors previously mention further research will be necessary.

Preventing fall in hospitalized patient. Engage patients and families in a three steps prevention process the reduce the risk of falls. This article published on 2018 had the intention to identified risk factors for fall in hospitalized patients, describe how to screen and assess patient for fall risk, discuss a three-steps process to fall prevention (Preventing fall in hospitalized patient. Engage patients and families in a three steps prevention process the reduce the risk of falls,2018). This article identified three main type of fall, accidental falls, anticipated physiological fall and unanticipated physiological falls. On the other hand, the article mentions the risk factors for patient falls with a big enfaces on previous fall history, gait instability and alteration of the mental status. The article places a direct relationship between the risk factors and the patient’s fall resulting on physical injuries.

The third objective for this article is satisfied by the implementation of a three-step program. The step one is in alignment with the Nursing program is assessment and screening. every patient shall be screened for fall risk upon admission to the facility. This screening will tent to predict which patient is at risk of a fall with a physiological component. The second step is fall prevention care planning. This step place high importance on the importance of develop a care plan with intervention fit to address the risk factors identified during assessment rader that a standard care plan. The third step is the implementation face where the care plan is carried out. The patient and the family must be included on this step. Both parties must be aware of the fall risk factors as well as the non-pharmacological measure to be implemented for patient fall prevention. This paper also highlights the nurse’s role to prevent patient role. This paper as all the other included in this literature review underlines the important of the nurses regarding fall prevention.

Sitter as a patient safety strategy to reduce hospital falls as systematic review. this article was completed by Adela M. Greeley, MD*; Elizabeth P. Tanner, MD; Selene Mak, PhD, MPH; Meron M. Begashaw, MPH; Isomi M. Miake-Lye, PhD and Paul G. Shekelle, MD, PhD and published 2020. This article is a large review commissioned by the Department if Veterans affairs. This article illustrates the statistic result and the impact of the hospitalized patient’s falls. This article reports the patient fall rate among the hospitalize population in United states as 1.3 to 8.9 per 100 patients hospitalized this will translate to 700 southands to 1 million of hospitalized patient who fall every year (Adela M. Greeley, MD*; Elizabeth P. Tanner, MD*; Selene Mak, PhD, MPH; Meron M. Begashaw, MPH; Isomi M. Miake-Lye, PhD; mand Paul G. Shekelle, MD, PhD,2020)

This article illustrates that the use of nurse and other team members as a one-to-one monitor system for patient with risk factor will increase the cost of care towards the health system. A solution newly introduce is the use of sitters.

This article arrives to conclusion that are controversial whether the use of sitter did not decrease neither increase the rate and incidence of fall. Also, along with the use of sitter there are other alternative measure that may be applied. The authors of this research found only 1 study related to this matter on PubMed by 2019.This study faced a limitation in term of quality and quantity base studies to review or follow.

Along with this research there was a study conducted by Lex D de Jong PhD, Tammy Wesselmann M (social worker), Su Kitchen RN, BSC as a clinical coordinator and Anne Marie Hill PHD, Professor. Exploring Hospital patient sitters’ fall prevention task readiness: across a sectional survey. Was accepted and published on January,24,2019. This qualitative analysis had a sample of 90 sitters working in 5 hospitals of the United States. The cross-sectional survey was conforming by closed and open-ended items with the intention of collecting qualitative data that was posteriorly analyzed by the original researchers. This article had very interesting outcomes. The research identifies the most common reason for fall as reported by the sitter patient mental status such as confusion and agitation. The most frequent strategies were focused on environment. The sitters report as their biggest barrier at the time of performed their assigned duties patient behaviors such as aggression and non-compliance with the provided instructions. The inadequate handovers is the number one safety factor identify pretending to personnel.

Mean while there is an evident disparity identify in this articles by not only by the sitters but also by this investigators were the main cause of fall pretending to the patient (AMS ) is not addressed or did not go in alignment with the strategy used mainly targeting the environment instead of making the patient behavior the center of the interventions .Also as a recommendation contain in the research and reported by the original researchers the need of continue education was illustrated by the majority of the sitters interviewed .

Education intervention for health professional on falls prevention in health care setting: 10 years scoping review: This article was publishing in November 09,2020. L Shawn, D Kigali, and M K Fairlie. This article encompasses the work of the three researchers mentioned above whom review 39 publications with a time frame from 2008-2019. These articles were mainly forcus on different method of clinical personnel education. Didactic literature, video presentation, interactive learning activities among others are the main interventions proposed by this research. Even when the researcher identifies and support the fact that health care personal education is crucial to increase hospitalized patient’s safety by decreasing the incidence hospitalized patients falls. They were not capable of identify and uniformed educational plan that encompasses all the necessary elements.

It is already stablishing and prove that patient’s fall is the leading cause of patient trauma amount hospitalized population. The majority of the research on this topic focus on the importance of patient and hospital personnel assessment. Nevertheless, it is important to review how patients see and experience this event. There is fore that an article name Patient’s Perspective on Hospital Falls Prevention Education. This article as many other reviewed places high importance on the patient education on several aspects such as fall prevention strategies, using of a call bell, select and wear appropriate shoes adequate use of assistant devices such as walker a cane as adequate.

Despite this education this study also encompassed a multifocal assessment that include an interview. The focus of this interview is to ascertain the patient perception of themselves. It is crucial to ascertain if the patient identify him/herself of a person at risk of fall, or if the patient feels it is more at risk during the hospitalization that been home. The interview will also stablish the patient degree of knowledge and the effectiveness of the teaching provide to the patient. If the patient use an assistive devised the clinical personal must ensure that patient has use this devised before, and must evaluate the patient competency with the management of such devised. Once again, a trend has been identified on this paper. The two main non-pharmacological interventions to avoid fall among hospitalized patients are based on assessment and education.

The falls of the patient in the hospital setting it is in many cases the consequences of several factors. Even when this paper has the intention of analyzed or list nonpharmacological interventions to reduce the fall risk in the hospital. The establishment of main factors that predisposed the patient or place the patient at fall risk it is of vital. The article Falls Among Hospitalized Patient published in the Journal of Frailty, sarcopenia, and Falls (JFSF) on August16,2017adressed this instituting as the main factors: This article groups this factors on three main categories. Intrinsic fall factors that take into consideration and assessed the shape and physical condition of the patient at the moment of the admission. evaluating and collecting data on aspects such as patients age, gender, balance, history pf previous fall and any chronic or acute medical conditions. The extrinsic that involve the environmental factors. This category will comprise elements such as adequate lighting, floors, specialty slippery floors or materials used to maintain floors that may result unsafe for the patient. Patients’ clothes and footwear it is also included in this category. The walking aids, such as cane, walker, wheelchair are another box on this categories. This section aims to analyze how the Durable medical equipment may be better utilized to ensure patient’s safety. Hospital beds with their bedside rail are also content on this category and along with them the personnel competent aspect of always keeping the bed in a safety position with the adequate high. The third and last categories is Exposure to risk. These categories place a relationship between the level of activity and the risk of fall. As per this relationship the most active people and the less active people are the most prone or at higher risk of falling.

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This articles vs many other stated that hospitalized patients fall are preventable with the integration of a multifactor plan that among other evaluate the proper utilization of the hospitals environmental and Durable medical equipment as wee as constant evaluation of the standard practice effectiveness. This article also places the formula of reducing the extrinsic factors that are in base modified as well as the reduction of the risk factors.

The united stated has the prevention of hospitalized patient’s fall as one of the main clinical indication. Several health organizations such as joint commission is taking special interest on this matter. Falls Prevention Implementation strategies in use at 60 United States Hospitals: A descriptive study take this as the aim of their review. This research had the purpose of identifies and describe the hospitals falls preventions. This article enlisted non pharmacologist measure to prevent fall of hospitalized patient and even when the intervention and the plan on this paper are not direct patient care interventions the overall result of this interventions are as well targeting the increase of hospitalized patient safety by decreasing falls. This research took in 2017 a sample of 80 hospitals participating in the National Database of Nursing Quality Indication whom. This hospital participation was voluntarily. This research was the first conducted to the day of completion with this line of work. This research analyzed the hospitals intervention and the result. The highlight of this result identified that majority of the hospitals maintain an interdisciplinary falls community that usually meets every 30-60 days. This committee will review any incidence, the falls risk associated to the incidence future strategies to implement with the aim of reduce the risk of further occurrence. Hospitals used a leadership to set the strategies and the expectations of the fall prevention. This leadership personal is mainly conformed by nurses with a lower representation of physician. As the result of this the originally research proposed that hospitals implement a multidisciplinary approach due to the complexity and several risk factors that are immerse in a patient fall incidence.

When fall is a real concern must of the hospitals fall prevention are only partially effective. This lead Catherine M Walsh RN MSN Li-Jung Liang PhD, Tristan Grogan MS, Courtney Coles MPH, Norman McNair RN PhD, Teryl K Nuckols MD, MS to develop a review of the hospital programs that encompassed different aspects. The aspects include actions that covers all the aspect of this safety issue. Actions such as identification and flags of the high-risk patient as well as establishment of hourly nursing round led the hospital to report at the end of the research and the plan implementation the hospital was able to report a 28% diminished fall.

Although patient falls in the hospital has been the aim of many research Preventing Falls in Hospitalized patient: State of science by Jennifer H Lelaurin, MPH, Ronald I Shorr, MD, MS, FACP present a very summarized view of the non-pharmacological intervention proposed to resolve or decrease the incidence of this problem. Risk identification either stablishing the fall risk or the or fall prediction with screening tools. This is usually stablishing by check list. Implementation of alarm systems. Alarms of different modules either pads, pulling bottoms or such is place on the bed, the patient or both with the intention of alert the hospitals personal when the patient identify as a risk fall has the intention of leave the bed or the wheelchair without assistance. This method even when it is highly popular it is not a research that prove their effectiveness reducing the patient falls risk or incidence in the different setting where it is utilized. Sitters as exposed before; it is effective yet costly fall prevention strategy. Sitters provide the care one a one-to-one base and while providing surveillance services a well trained and license sitter may perform therapeutic.

This research introduces a new concept does not encounter by this researcher in any of the previous review articles. This is an excellent strategi adopted by many hospitals. The intention of this intervention is to meet patients’ needs at bedtime at regulars’ intervals usually every 1-2 hours intervals.

Patients’ education. Patient: s education is a common intervention adopted by most of the hospital. Nevertheless, patient intervention is a single intervention that must be encompassed in a multifactor program to be highly effective.

Environmental modification. The environmental factors are a high-risk factor o take into consideration. Falls involving environmental factors lead on a great scale to death or the permanent loss of a function. The main interventions identified for this categories are : ensure adequate lighting, ensure non slippery floor taking in to account not only the material used for the cleaning and sanitation of the facility but also the flooring material as some research prove that vinyl flooring decrease the change of falls when comparing with carpet flooring . There is on the other side any scientific evidence that validate that low-low bed position decrease the risk for fall in hospitalized patients.

The review of this article also leads to comment about physical restrained. This extremely invasive method is very controversial. This method may lead to Alteration of the mental status of the patient producing delirium. This method also has a big impact on the patient dignity and autonomy. This method even when it is listed by the originally researcher is more prone to produce falls than to decrease the risk or protect the patient from falling there is not recommended by either the original researcher or this reviewer.

The implementation of non-slip socks given to the patients by the admitting facilities under the assumption that they will provide safety and decrease the risk for fall. Beside that the institution of the use of non-slip socks provide the facility with and standardized procedure. In contrast with the manufactured claims that the use of this product among hospitalized patients. Other wise some research cast doubts over this product and their efficacy of reducing the risk for fall.

The similarities among all the articles are several with a high light on assessment of the patient and the environment. The assessment will allow the identification of the patient risk factors that is one of the aspects that all the research paper reviewed took into consideration. Patient and nurse’s education as well as the inclusion of the family as a member of the care team. All the articles conclude and stated the important of continue the research regarding this international health system concern. All the articles support the project question for this literature review illustrating non-pharmacological measure used to reduce fall risk among hospitalized population.

Practice Recommendations

With the intention of identify the non-pharmacological nursing intervention to reduce the risk of fall in the hospitalized population, describe main challenged faced by the hospitals personnel to reduce the fall risk for hospitalized patient, recognized the risk for fall in hospitalized population. This work aims to build a summarized source of information to review the above mentioned topic. This research is committed to search for alternative and nonpharmacological solutions for the safety concerning problem as mentioned above in this literature review. The principal to investigator attempts to offer useful information to implement in the hospital setting with the completion of this review.

Project Description

This literature review will be completed with the purpose of identify the non-Pharmacologic nursing intervention to reduce risk of fall in hospitalized population. Describe main challenged faced by hospital personnel to reduce the fall risk for hospitalized patient. Recognized the risk factor for fall in hospitalized population. With the review of several source of information it is know that patient fall during hospitalization are a high impact occurrence with devastated negative impact. This topic it is very important to explore due to the high incidence of hospitalizations. Every year it is reported around 700,000 to 1000,000 incidents of hospitalization fall with a outrages negative impact in patient condition. I will select publication from the last 5 years that address this matter. I will review no less than 30 articles from 2015-2021. For this review I will utilize scholarship articles. The articles are obtained from internet platform such as, CINAHL, Medline, PubMED, NCBI also I will use Anag G Mendez virtual library. The following Keyword will be using in my literature review: Safety, fall, hospitalized population, non-pharmacological interventions. This literature review will be effective because of the availability and the summary that it presents about the selective research question and objective, despite the fact that there is disperse literature published about the target of my study. The search engines will be based on the keyword mentioned above. The search will allow the researcher looking for information to find a summarized and condensed amount of data and information around my research topic. This will give the advantage of have value information and measure to implement with the purpose of increase safety for hospitalized patients. The result obtain from this literature review will contribute to identify non-pharmacological measure to implement to improve the safety of hospitalized population in the United States by reducing the incidence of falls.

This literature review will be kept for a period of 5 years, locked in the principal’s home office of the principal investigator. After this year’s expire any information will be destroyed by a paper shredder and discarded by the principal investigators. The principal investigator and his mentor will have access to the information obtained.

Project Evaluation Results

After the articles are selected reviewed the summary of article will be complete. This summary will be illustrated on the final report. In the review of the article the first step is to ensure they are within the constrain time frame stablish for this literature review. The articles will be reviewed to ascertain intervention that have being implemented and their results. I will review primary research evidence as well as systematic reviews, using quantitative and qualitative statistical data.

I will include summary table with all citation. This table will conform Appendix A & B. Appendix A will include citation, question, hypothesis, theoretical foundation research design and sample size. Appendix B will also include citation, question research and strategies.

Each article will be evaluated as relevant information. the articles included in this review will provided relevant information related to my research question. The articled may or may not directly answer my research question. The articles may or may not support the different non-pharmacological intervention proposed by the different authors of institution presenting a supportive or an opposite point of view. Either or the cases, the articles included in this review will provided valuable information regarding the literature review objectives.

Discussion and Implications for Nursing and Healthcare

This project is for nurse’s health care workers and a third component: The patient. The main implication for this literature will be identification of non-Pharmacologic nursing intervention used to reduce the fall risk for hospitalized population. This literature review will be provided organized and concentrated information about the selected topic. This project will be provided information and tools to increase the safety of the selected population in the hospital setting. This review will be a guide not only for the bedside nurse but for managerial personnel as well. This review and the information summarized may be utilized in the hospital setting as part of their Quality Improvement programs.

The expected benefits of this studies include the increase of knowledge by all the members of the care team regarding the selected topic. The increase on the Skilled nurse ability to assess the hospitalized population risk of fall. This will allow the implementation of an individualized plan of care that address the different angles of this matter. The benefits of this research will not only be in one direction towards the health care providers. The hospitalized population will benefit also with teaching and education that will apply not only in the hospital setting by increasing their safety.

Plans for Dissemination.

At the end of this project, it will be disseminated by presenting and oral demonstration. A power point presentation will be completed and present to professor and student for this course. I will do a poster boar with a brief a summarized information of my research and result to be exposed at Ana G Mendez South Campus gallery. A handout flyer will be delivered to the students on this course as well with the same information as stated above. A hard copy of the whole project will be available at Ana G Mendez South Campus library. This copy will have open access and may be used by other students interested in this project topics and its results.

Summary and Conclusion

This paper will be developed to identify What are the non-Pharmacologic nursing intervention used to reduce risk for fall in hospitalized population of the United State? The literature review will allow a better comprehension of the impact of this matter in the hospitalized population. The incidence of falls amounts hospitalized population in the United States is alarming. That is why this matter has been the topic of several research and plan to decrease the incidence through the implementation of non-pharmacological nurses’ intervention.

The main intervention identify in this research are intended to: Impress the importance of patient assessment to identify the risk for fall, the awareness of the patient’s perspective of themselves and the new environment. Develop a plan of care that address all the physical and emotional aspect involved in the care of the patient to increase patient awareness cooperation and increase the safety. The patient must be involved in the creation of such plan. This will increase patient’s compliance and decrease limitation such as patient not been able to fully understand the plan and the different aspect and faces of the plan implementation. Patient and caregiver education implementing face to face session. Alternative method of patient education may include posters, pamphlets, brochures.

Based on the result of this review done to this point, the importance of the target topic, the principal investigator proposes the completion of the literature review. The completion of the review will allow the expansion of the collected information to enhance more detail and result with the intention of answer the research question proposed.

References

1. Allan-Gibbs R. (2010). Falls and Hospitalized Patients With Cancer. Clinical Journal of Oncology Nursing, 14(6), 784–792. https://doi-org.librarylogin-cupey.uagm.edu/10.1188/10.CJON.784-792

2. Cox, J., Thomas-Hawkins, C., Pajarillo, E., DeGennaro, S., Cadmus, E., & Martinez, M. (2015). Factors associated with falls in hospitalized adult patients. Applied Nursing Research, 28(2), 78–82. https://doi-org.librarylogin-cupey.uagm.edu/10.1016/j.apnr.2014.12.003

3. Dykes, P. C., Adelman, J., Adkison, L., Bogaisky, M., Carroll, D. L., Carter, E., Duckworth, M., Herlihy, L., Hurley, A. C., Khasnabish, S., Kurian, S., Lindros, M. E., Marsh, K. F., McNinney, T., Ryan, V., Scanlan, M., Spivack, L., Shelley, A., & Yu, S. P. (2018). Preventing falls in hospitalized patients: Engage patients and families in a three-step prevention process to reduce the risk of falls. American Nurse Today, 13(9), 8–13.

4. Greeley, A. M., Tanner, E. P., Mak, S., Begashaw, M. M., Miake-Lye, I. M., & Shekelle, P. G. (2020). Sitters as a Patient Safety Strategy to Reduce Hospital Falls: A Systematic Review. Annals of Internal Medicine, 172(5), 317–324. https://doi-org.librarylogin-cupey.uagm.edu/10.7326/M19-2628

5. Heng, H., Slade, S. C., Jazayeri, D., Jones, C., Hill, A. M., Kiegaldie, D., Shorr, R. I., & Morris, M. E. (2021). Patient Perspectives on Hospital Falls Prevention Education. Frontiers in public health, 9, 592440.

https://doi.org/10.3389/fpubh.2021.592440

6. Ireland, S., Kirkpatrick, H., Boblin, S., & Robertson, K. (2013). The Real-World Journey of Implementing Fall Prevention Best Practices in Three Acute Care Hospitals: A Case Study. Worldviews on Evidence-Based Nursing, 10(2), 95–103. https://doi-org.librarylogin-cupey.uagm.edu/10.1111/j.1741-6787.2012.00258.x

7. Jong, L. D., Weselman, T., Kitchen, S., & Hill, A. (2020). Exploring hospital patient sitters’ fall prevention task readiness: A cross‐sectional survey. Journal of Evaluation in Clinical Practice, 26(1), 42–49. https://doi-org.librarylogin-cupey.uagm.edu/10.1111/jep.13114

8. Kafantogia, K., Katsafourou, P., Tassiou, A., & Vassou, N. (2017). Falls among hospitalized patients. Journal of frailty, sarcopenia and falls, 2(3), 53–57.

9. KHALIFA, M. (2019). Improving Patient Safety by Reducing Falls in Hospitals Among the Elderly: A Review of Successful Strategies. Studies in Health Technology & Informatics, 262, 340–343. https://doi-org.librarylogin-cupey.uagm.edu/10.3233/SHTI190088

10. LeLaurin, J. H., & Shorr, R. I. (2019). Preventing Falls in Hospitalized Patients: State of the Science. Clinics in geriatric medicine, 35(2), 273–283. https://doi.org/10.1016/j.cger.2019.01.007.

11. ROCHON, R., & SALAZAR, L. (2019). Partnering with the Patient to Reduce Falls in a Medical-Surgical Unit. International Journal of Safe Patient Handling & Mobility (SPHM), 9(4), 135–142.

12. Samples Twibell, R., Siela, D., Sproat, T., & Coers, G. (2015). Perceptions Related to Falls and Fall Prevention among Hospitalized Adults. American Journal of Critical Care, 24(5), e78-85. https://doi-org.librarylogin-cupey.uagm.edu/10.4037/ajcc2015375

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Non-Pharmacologic nursing intervention used to reduce the fall risk for hospitalized population of the United Stated.

Appendix A

NOTE: Order these appendices in the order in which they were referred to in the paper.

Summary of Primary Research Evidence (this table may be single space)

Citation	Question or Hypothesis	Theoretical Foundation	Research Design (include tools) and Sample Size	Key Findings	Recommendations/ Implications	Level of Evidence

Legend:

Level I: systematic reviews or meta-analysis Level II:  well-designed Randomized Controlled Trial (RCT)  Level III:  well-designed controlled trials without randomization, quasi-experimental  Level IV:  well-designed case-control and cohort studies  Level V: systematic reviews of descriptive and qualitative studies  Level VI:  single descriptive or qualitative study  Level VII: opinion of authorities and/or reports of expert committees

Appendix B

Summary of Systematic Reviews (SR) (this table may be single space)

Citation	Question	Search Strategy	Inclusion/ Exclusion Criteria	Data Extraction and Analysis	Key Findings	Recommendation/ Implications	Level of Evidence

Legend:

Level I: systematic reviews or meta-analysis Level II:  well-designed Randomized Controlled Trial (RCT)  Level III:  well-designed controlled trials without randomization, quasi-experimental  Level IV:  well-designed case-control and cohort studies  Level V: systematic reviews of descriptive and qualitative studies  Level VI:  single descriptive or qualitative study  Level VII: opinion of authorities and/or reports of expert committees