Assignment

Running Head: PICOT AND LITERATURE SEARCH

Picot and literature search

The capacity of the medical practitioner to be able to assess the benefits that come with a quantitative configuration article is an important expertise for specialists and analysts of all controls including the nurses so as to enable them to judge the uprightness and value of the conclusions and proofs made in any given article. When all this is said and done, the article now becomes a very important resource material for some professionals and specialists. For graduates and junior workforce under studies who are yet to test and face most of these abilities, completing a formally composed article and carefully evaluating it to the end can be a very useful procedure to sharpen their attitudes and make their knowledge rich. A key and most important of exploring strategies is really required and trying to keep in mind and make sure that the end goal is effective. This article tends to give common sense purposes of trying to direct a formally composed qualitative exploration and going in between the lines and be able to provide the briefcase to exhibit the right standards and structures required since there are few distributed cases of evaluating most of the illustrations given out. At the point where the right setting is considered, culture and nature considered, there has to be the best patient results achieved. The reason behind this sequence of events is to be able to give nurture the attitudes and information to be able to execute EBP with extra attention and in a reliable way. In most of the instances, articles will tend to be clockwork to permit an opportunity to intertwine the available data as you work toward implementing EBP at the foundation. For you to be able to resolve questions you can use “Ask the Authors” who give the immediate line of specialists.

The important and keywords here include: quantitative, evidence, practice, based.

The fall rates of elderly patients are currently high. A recent survey revealed that all fall rates are reported per 1,000 patients daily (Bouldin et al., 2013). The survey utilized data from The National Database of Nursing Quality Indicators and collected the data from July to September in hospitals within the U.S. The findings revealed that 315,817 falls happened during the period and an injury rate of 0.93/1,000 Pd surfaced. Even though these incidents have been tried to be stopped there is evidence that incidents as such are still at large and continue to happen day by day. Further ahead, the researchers identified that the fall rates were highest in hospitals where the PRN rounding method was used. Moreover, this shows that hourly patient rounding is more effective at preventing falls than the PRN method.

PICOT Question.

The PICOT study question for this study is- How is hourly rounding more effective than PRN rounding method in elderly patients.No use abbreviation.

· Population- Elderly Patients living in a long term care facility.

· Intervention- hourly rounding.

· Comparison- Patients was rounded using PRN method

· O- Decrease the fall rate in elderly patients-this needs to be included in the PICOT

· T- 3 months-this needs to be included in the PICOT

Reference 1: Quantitative.

The first article’s title is “Falls among adult patients hospitalized in the United States: prevalence and trend.” (Bouldin et al., 2013). Its abstract reads as the purpose of this study was to ensure normative data on the fall out of patients in American hospitals (Bouldin et al., 2013). The study used data from The National Database of Nursing Quality Indicators and lasted for two years. The results showed a total of 315,817 falls and extremely high injury rates, even though these rates have decreased over the study. The study therefore concluded that hospitals where the prn method is used have statistically high fall out and injury rates.

Reference 2: Qualitative.

The second article’s title is “Preventing falls and fall-related injuries in health care facilities” (Joint Commission, 2015). It’s abstract recognizes that injuries to patients resulting from falls are a serious problem. Here, patients were believed to fall because of physiological and changes in medical conditions and not only because of the age. The study revealed that an increase in the rates of falls could be brought down through the improvement of hospital management. For instance, patients fall due to poor communication, inadequate assessment, lack of leadership, and deficiency in physical environment, failure to adhere to protocols and inadequate staff orientation. Among the strategies suggested for fall prevention are sensitization, interdisciplinary prevention measures, risk factor identification via assessments and the development of fall prevention plans.

Reference 3: Quantitative.

The title of the third article reads as “Physical restraint use rate and total fall and injurious fall rates: An exploratory study in two US acute care hospitals (Tzeng & Yin, 2012). The study sought to understand the association between the rates of patients’ physical restraints and the total rates of fallouts per 1000 patient days (Tzeng & Yin, 2012). The results revealed that managers now require balancing between physical restraints and physical fallouts.

Reference 4: Qualitative.

The title for the four article reads as “Evaluation of Sensor Technology to Detect Fall Risk and Prevent Falls in Acute Car” (Potter et al., 2017). This researched focused on a technology that would enhance and better the ability of doctors to check on patients on an hourly basis. Specifically, a sensor that could be installed with the ability to detect and warning of a falling patient. The sensors were fixed close to patient’s beds. In the findings, the fall rates reduced by about 54%. Therefore, the study concluded that the fall rates could greatly reduce through the utilization of this sensor technology.

Reference 5: Quantitative.

The fifth reference is titled as “Falls are leading cause of injury and death in older Americans” (CDC, 2016). The abstract of this source reads that elder patients fall every second of every day. In 2014 alone, these Americans suffered falls 29 million falls hence seven million injuries that cost about $31 billion in annual Medicare costs (CDC, 2016). Every day, America gets 10,000 older Americans this means the injuries due to falls may continue to raise. There is a need to reduce these falls as well as the resultant costs. The article proposes STEADI guidelines

Reference 6: Quantitative.

The sixths source examined the fall rates of elderly patients with arthritis and how the fall rates would be reduced through hourly checks. The title for this article is “Incidence rate of falls and its risk factors in patients with rheumatoid arthritis compared to controls: four years of the TOMORROW study” (Mamoto et al., 2017). It’s abstract indicates that the study aimed at studying the quantitative fall aspects of 208 RA patients over a period of four years (Mamoto et al., 2017). The research concluded that anti-CCP antibody level (>300.6 U/ml) was the highest predictor of fall out rates (Mamoto et al., 2017).

References

Stillwell, S. B., Fineout-Overholt, E., Melnyk, B. M., & Williamson, K. M. (2010). Evidence-based practice, step by step: asking the clinical question: a key step in evidence-based practice. AJN The American Journal of Nursing.

Bouldin, E. D., Andresen, E. M., Dunton, N. E., Simon, M., Waters, T. M., Liu, M., ... & Shorr, R. I. (2013). Falls among adult patients hospitalized in the United States: prevalence and trends. Journal of patient safety, 9(1), 13.

Joint Commission. (2015). Preventing falls and fall-related injuries in health care facilities. Sentinel event alert, (55), 1.

Tzeng, H. M., & Yin, C. Y. (2012). Physical restraint use rate and total fall and injurious fall rates: An exploratory studies in two US acute care hospitals. Open Journal of Nursing, 2(03), 170.

Potter, P., Allen, K., Costantinou, E., Klinkenberg, W. D., Malen, J., Norris, T., ... & Wolf, L. (2017). Evaluation of Sensor Technology to Detect Fall Risk and Prevent Falls in Acute Care. Joint Commission journal on quality and patient safety, 43(8), 414-421.

Centers for Disease Control and Prevention (CDC). (2016). Falls are leading cause of injury and death in older Americans. CDC Online Newsroom.

Mamoto, K., Inui, K., Okano, T., Sugioka, Y., Tada, M., Koike, T., & Nakamura, H. (2017). Incidence rate of falls and its risk factors in patients with rheumatoid arthritis compared to controls: four years of the TOMORROW study. Modern rheumatology, 27(1), 8-14.