Discussion: Scholarly article review guideline

Running Head: PICOT STATEMENT 1

PICOT Statement for the Capstone Project

Name

Institutional Affiliation

13/2/2020

This study source was downloaded by 100000758613853 from CourseHero.com on 11-17-2022 15:01:44 GMT -06:00

https://www.coursehero.com/file/65054226/PICOT-Statement-for-the-Capstone-Project-revieweddocx/

PICOT STATEMENT 2

PICOT Statement for the Capstone Project

Patient fall has been a major concern in the clinical practice setting. Based on statistical

data, cases of clinical patients` falls have increased. Patient fall is not only prevalent in my

organization but also experienced in many other different healthcare settings. Statistics indicate

that the number of patient falls experienced in the United States hospitals range from 700,000 to

1,000,000 every year (Lee, 2019). Patient falls undermine the quality of care offered to the

patients and impend the realization of evidence-based practice goals. Black, Balneaves,

Garossino, Puyat & Qian (2015) identify that the promotion of patient safety is one of the goals

of evidence-based practice. Hence, compromised patient safety translates to negative patient

outcomes.

As a nurse providing care to patients in the medical-surgical ortho/neuro unit, the safety

of the patients ought to be a priority. This is because most of the patients in this unit are

dependent and bed-linden due to the health conditions that make them physically impaired.

Equally, the unit houses cancer patients who are also in intense pain. Due to the increased acuity

of the patients, their safety is generally at stake. Other factors that increase the patients` fall risks

include their medications, having a previous history of falls, old age, and environmental hazards.

Collectively, these factors contribute to the increased fall cases experienced by patients in the

clinical care setting. The organization is continually facing significant financial loss owing to the

lack of reimbursement due to the never events. Fehlberg et al. (2017) argue that the Center for

Medicare & Medicaid Services (CMS) does not reimburse health facilities for the cost incurred

from the care of the patients after fall. Therefore, the capstone project will determine whether the

implementation of multi-dimensional evidence-based interventions would result in effective falls

prevention compared to the utilization of standard patient fall prevention interventions.

This study source was downloaded by 100000758613853 from CourseHero.com on 11-17-2022 15:01:44 GMT -06:00

https://www.coursehero.com/file/65054226/PICOT-Statement-for-the-Capstone-Project-revieweddocx/

PICOT STATEMENT 3

PICOT statement

The PICOT statement that will guide this project is “among hospitalized patients (P),

does the implementation of multi-dimensional evidence-based interventions (I) compared with

standard fall prevention interventions (C) result in reduced patient falls (O) within three

months(T)?

Evidence-based Solution

There is a need to implement multi-faceted evidence-based interventions. Multi-faceted

fall mitigation interventions in fall management are patient-centered and established based on the

individualized risk factors for each patient (Breimaier, Halfens & Lohrmann, 2015). These

interventions include a comprehensive screening of each patient, multidisciplinary engagement

in patient care, nurturing of a patient safety culture, and effective training of the nurses and other

care providers on fall prevention.

Nursing Intervention

Hopewell et al. (2019) advocate for comprehensive screening of the patients. Nurses will be

required to undertake comprehensive assessments of all institutionalized patients to identify

potential fall risk factors. On the other hand, nurses must assume a leading role in promoting

multidisciplinary engagement to promote collective responsibility in managing patient falls. This

would facilitate the cultivation of a safety culture that targets the elimination of safety hazards.

Finally, staff training would equip the care providers with skills and competence to mitigate fall.

Singh & Okeke (2016) emphasize on the need to train nurses on effective patient risks`

assessment to prevent falls.

This study source was downloaded by 100000758613853 from CourseHero.com on 11-17-2022 15:01:44 GMT -06:00

https://www.coursehero.com/file/65054226/PICOT-Statement-for-the-Capstone-Project-revieweddocx/

PICOT STATEMENT 4

Patient Care

The findings from the comprehensive assessment of the patients will be utilized in the

establishment of individualized fall prevention interventions that are tailored to the identified fall

risk factors. Equally, in order to nurture a patient safety culture, reporting of patients` falls should

be encouraged to ensure effective documentation of the fall cases. Correct documentation of fall

cases would provide a wide data base that would be utilized in supporting fall prevention

interventions. In addition, there is a need to institute purposeful hourly rounding as one of the

evidence-based interventions advocated for by the Agency of Healthcare Research and Quality.

Through purposeful hourly rounding, patient needs such as pain management, position, and the

need to ambulate would be recognized hence interventions done accordingly. Evidence-based

interventions should be integrated with other standard measures such as maintaining low bed

positions, the use of bed alarms, and eliminating environmental hazards.

Health Care Agency

The Agency of Healthcare Research and Quality recommends the utilization of the

STEADI (Stopping Elderly Accidents, Deaths & Injuries) ToolKit in the management of falls

among hospitalized patients (Agency for Healthcare Research and Quality, 2013). Through the

use of the STEADI`s tools, it will be possible to single out patients with low, moderate as well as

high fall risk; recognize risk factors that are modifiable and implement effective interventions

(Centers for Disease Control and Prevention, 2019).

Nursing Practice

The current problem of patient falls greatly affect the practice of nursing. Therefore,

nurses must be on the frontline in implementing to implement evidence-based interventions and

must mobilize other stakeholders. Upon implementation, nurses must also evaluate the

This study source was downloaded by 100000758613853 from CourseHero.com on 11-17-2022 15:01:44 GMT -06:00

https://www.coursehero.com/file/65054226/PICOT-Statement-for-the-Capstone-Project-revieweddocx/

PICOT STATEMENT 5

effectiveness of the implemented changes. It is expected that, through effective implementation

and monitoring of the proposed change, the quality of nursing care will be enhanced and result in

improved overall patient outcomes. Patient acuity is likely to reduce, hospital-acquired injuries

might decrease, a decline in complications resulting from falls may be experienced, and patients

are likely to spend less in the hospital setting.

References

Agency for Healthcare Research and Quality. (2013). Preventing Falls in Hospitals Overview.

Retrieved 13 February 2020, from

https://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/fallpxtkover.html

Black, A. T., Balneaves, L. G., Garossino, C., Puyat, J. H., & Qian, H. (2015). Promoting

evidence-based practice through a research training program for point-of-care

clinicians. The Journal of nursing administration, 45(1), 14.

Breimaier, H. E., Halfens, R. J., & Lohrmann, C. (2015). Effectiveness of multifaceted and

tailored strategies to implement a fall-prevention guideline into acute care nursing

This study source was downloaded by 100000758613853 from CourseHero.com on 11-17-2022 15:01:44 GMT -06:00

https://www.coursehero.com/file/65054226/PICOT-Statement-for-the-Capstone-Project-revieweddocx/

PICOT STATEMENT 6

practice: a before-and-after, mixed-method study using a participatory action research

approach. BMC nursing, 14(1), 18.

Centers for Disease Control and Prevention. (2019). Make STEADI Part of Your Medical

Practice | STEADI - Older Adult Fall Prevention | CDC Injury Center. Retrieved 13

February 2020, from https://www.cdc.gov/steadi/index.html

Fehlberg, E. A., Lucero, R. J., Weaver, M. T., McDaniel, A. M., Chandler, M., Richey, P. A., ... &

Shorr, R. I. (2017). Impact of the CMS no-pay policy on hospital-acquired fall prevention

related practice patterns. Innovation in aging, 1(3), igx036.

Hopewell, S., Copsey, B., Nicolson, P., Adedire, B., Boniface, G., & Lamb, S. (2019).

Multifactorial interventions for preventing falls in older people living in the community:

a systematic review and meta-analysis of 41 trials and almost 20 000 participants. British

Journal Of Sports Medicine, bjsports-2019-100732. doi: 10.1136/bjsports-2019-100732.

Lee, E. (2019). Use of the nursing outcomes classification for falls and fall prevention by nurses

in South Korea. International journal of nursing knowledge, 30(1), 28-33.

This study source was downloaded by 100000758613853 from CourseHero.com on 11-17-2022 15:01:44 GMT -06:00

https://www.coursehero.com/file/65054226/PICOT-Statement-for-the-Capstone-Project-revieweddocx/ Powered by TCPDF (www.tcpdf.org)