Benchmark - Capstone ProjectChange. DUE BY 1/17 Proposal

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Missing headings required for APA writing

Literature Comparison Comment by Vicki Swaney: Do not format bold for title page

Grand Canyon University

12/20/20

Literature Comparison Comment by Vicki Swaney: Format first heading not bold for APA

Falls are a major concern for patients, nurses and health care providers all over the world, and more so for the elderly population. Patient falls are also the most common adverse safety event patients face while in the hospital. The United States alone records rates of falls ranging from about 3.3 to 11.5 patient falls per 1000 patient days. Every year, approximately 700,000 to 1 million patient falls occur in United States hospitals (Lelaurin & Shor, 2019). Geriatric patients form one of the patient populations most at risk of falls. This is due to the numerous risk factors that predispose them, such as advanced age, multiple comorbidities, gait disorders, history of falls, female gender, cognitive decline as well as various environmental factors. Here, we take a look at the problem through a comparison of current literature that document the extent of the problem.

Comparison of Research Questions

Out of the eight articles that were analyzed, two were qualitative while six were quantitative. This therefore meant we heard two studies with research questions, with the other six having hypotheses. The first qualitative study, done by Spicer, Delmo & Agdipa (2017), had questions that focused on fall prevention practices, assessment of fall risk factors, and management of patients after a fall. On the other hand, the second qualitative study by Shumba & Abraham (2017) had questions that focused on frontline staffs’ perceptions of intrinsic and extrinsic factors that contributed to patients experiencing falls in acute care settings, as well as what factors they actually believe contribute to patient falls in the acute care setting. The first study focuses on risk factors, prevention and management of falls while the latter focuses on health care staff’s perceptions as well as the actual causes and contributing factors for falls.

The hypotheses focus on a number of issues including effectiveness of bedside rails in prevention of patient falls as compared to no use of bed rails, prevalence of falls when nurses are trained as compared to when they are not, processing of patient fall incidence information, whether increasing the percentage of nurses with bachelor degrees (BSNs) and/or certified nurse’s lead to reduction of falls (Moe et al., 2015), whether patient education videos and fall prevention visual signaling icons when added to bed exit alarms were effective in minimizing patient falls and lastly, whether patient safety can be improved by reducing falls alone in hospitals, among the elderly. Comment by Vicki Swaney: Provide examples for each section of the review as required for the assignment

Sample Population Comparison

All the eight studies selected a wide variety of diverse sample populations. The first study was conducted on patients in a medical-surgical unit, in a safety-net hospital. The study was however not specific on geriatric populations; though elderly patients were also part of the sample population. The second study was more specific, with the selected sample comprising hospitalized adults (female and male) aged 65 years and over. The third study was also widely vague, with the sample population being ‘patients in a third level hospital’. The fourth study had a sample population that comprised registered nurses (RNs), patient-care providers (PCPs), physical therapists (PTs), and occupational therapists (OTs).

The fifth study was also vague with no particular sample population. The study had a sample from a regional university hospital. The sixth study was a retrospective study and as such, rather than sample the geriatric patients, it was the BSN nurses and certified nurses who formed the sample population (Coto et al., 2020). The final two studies were also vague, with one assessing literature about 65-year olds and older while the other picked random patients in an adult medical-surgical inpatient unit. The diverse populations were however helpful in providing a clear picture of all there is concerning patient falls.

Comparison of Study Limitations

The major limitation shared among the articles was the failure to narrow down to the geriatric population. Despite falls being indiscriminate, the elderly patients are the most at risk population as well as the most affected by the scourge of falls. As such, it would have been essential to narrow down to the specific population for the study results to be more effective. The other limitation that cut across majority of the studies is improper representation of the target population. Seeing that six of the studies were quantitative studies, results of one population cannot be generalized or replicated in another population of similar characteristics. The other limitation that cut across a number of studies was the use of a single unit in the hospital: the medical-surgical unit. This skewed the study results as patient falls in this unit may have been influenced by its characteristics as well as not being specific to the geriatric population. Comment by Vicki Swaney: Provide examples for each section of the review as required for the assignment

Conclusion and Recommendations

The studies came to a number of conclusions and recommendations for further studies. Some were however not relevant to the geriatric population and as such, not effectual for reducing falls among the study population. Some of the effectual conclusions included one that the safety of patients who are confused, have unsteady gait, have fallen before, or on multiple medications need to be supervised using a team approach, with staff who are trained in caring for fall risk patients. In embracing technology to prevent patient falls, it was also recommended that multi-centre randomized controlled trials are needed to confirm the effectiveness of icons and video interventions and exit alarms (Cuttler et al., 2017). Improvements to patient outcomes may also be optimized with increased percentages of nurses with bachelor’s degrees and/or certifications. Comment by Vicki Swaney: Provide examples for each section of the review as required for the assignment

References

Coto, J. A., Wilder, C. R., Wynn, L., Ballard, M. C., Webel, D., & Petkunas, H. (2020). Exploring the Relationship Between Patient Falls and Levels of Nursing Education and Certification. JONA: The Journal of Nursing Administration, 50(1), 45-51.

Cuttler, S. J., Barr-Walker, J., & Cuttler, L. (2017). Reducing medical-surgical inpatient falls and injuries with videos, icons and alarms. BMJ Open Quality, 6(2).

Gygax Spicer, J. (2017). The Got-A-Minute Campaign to Reduce Patient Falls with Injury in an Acute Care Setting. MedSurg Nursing, 26(5). Comment by Vicki Swaney: See above examples. Missing hyperlink to article?

Horová, J., Brabcová, I., & Müllerová, N. (2018). Retrospective analysis of patient falls as a basis for evidence-based practice.

LeLaurin, J. H., & Shorr, R. I. (2019). Preventing Falls in Hospitalized Patients: State of the Science. Clinics in Geriatric Medicine. May; 35(2): 273-283

Moe, K., Brockopp, D., McCowan, D., Merritt, S., & Hall, B. (2015). Major predictors of inpatient falls: a multisite study. JONA: The Journal of Nursing Administration, 45(10), 498-502

Shumba, C., & Abraham, S. (2017). Patient falls in the acute care hospital setting as perceived by the frontline staff. Prensa Med Argent, 103(3), 2.