MM week 4

Michelle Murray

NU760

In-text citation for the resource – in the References list below this table include a full citation.

You are required to upload the full-text file for each article represented in the matrix table into the assignment drop box.

What is the purpose of the resource to support the prompt for the unit?

1. Is the resource a research or non- research study (Hint: JH EBP Rating Scale notes which are research or non- research at the side of the scale)?

2. What is the study design (i.e., Systematic Review of RCTs, Prospective Cohort, etc.)?

3. If not a research study, what type of literature is represented in the resource (i.e., peer- review like narrative review, case reports, clinical guidelines in published journals or non-peer review like editorials, policy briefs, opinion pieces)?

What are the findings and the recommendations in this resource that are relevant to your proposed graduate scholarship project?

How does this resource support your proposed project?

Articles/resources #1-2 in the table need to demonstrate the observation of the problem you identified for which you are designing a project to address.

1 Kakara et al., (2021). https://doi.org/10.10

Determines the burden/patterns of ED visits associated

Research (JH Level III) Evidences quantifiable and clinically significant fall-related healthcare

Supports your problem statement by documenting real-world fall burden and

Michelle Murray

NU760

16/j.jsr.2021.08.002 (CDC)

with falls in older adults and confirms the seriousness of the outcomes of falls which fall prevention programs are designed to mitigate. (CDC).

Epidemiologic investigation of national ED visits patterns (seasonal/location change).

utilization and variation by fall location/time- evidences the necessity of organized assessment and prevention as opposed to sporadic practices.

helps justify implementing a standardized program to reduce fall events and consequences.

2 Adam et al. (2023). https://doi.org/10.13 71/journal.pone.0294 017

Evidences downstream functional impairment (ADL impairment) following falls, which supports the importance of preventing falls in frail older adults.

Research (JH Level III).

Retrospective cohort/longitudinal secondary analysis and hazard-modelling and trajectory analysis.

The reason falls during the previous 6 months were correlated with increased risk of ADL impairment; but a sub- group experienced long- term impairment. Authors come to a conclusion that older adults require a holistic approach to fall risk evaluation and access to evidence-based prevention.

Improves the urgency and relevance of your project goal (reduce falls to prevent injury/functional decline) directly and aids in the measurement of outcomes associated with quality of life.

Articles/resources #3 -6 in the table need to demonstrate support for the intervention you have selected to address the identified problem.

3 Gillespie et al. (2012).

https://doi.org/10.100 Offers evidence on high-levels of effective interventions (what

Research (JH Level I)

Cochrane systematic review of RCTs

Balance/strength exercise program and Tai Chi decrease falls; multifactorial can

Directly informs the evidence- based Directly informs the evidence-based “menu” for individualized prevention plans

Michelle Murray

NU760

2/14651858.CD00714

6.pub3 works) to provide program aspects.

(with/without meta- analysis).

decrease fall rate. Favors the integration of interventions as opposed to the use of one tactic.

in your nurse-led program (e.g., balance/strength + tailored risk-factor actions).

4 Guirguis-Blake et al. (2024). https://doi.org/10.10 01/jama.2024.4166

Provides modern synthesized data of multifactorial + exercise interventions to prevent using practice-relevant prevention techniques.

Research (JH Level I)

Updated systematic review (USPSTF evidence report; RCT-focused).

Multifactorial interventions significantly reduced fall incidence rate; exercise showed consistent benefit for falls and injurious falls across multiple outcomes.

Justifies your intervention model (screen -assess - customize plan) and justifies the incorporation of structured exercise as a fundamental part when possible, in adult day care.

5 Dykes et al. (2020). https://doi.org/10.10 01/jamanetworkope n.2020.25889

Demonstrates real- world effectiveness of a nurse-led, tailored fall-prevention toolkit linked to patient- specific risk factors (high implementation relevance).

Research (JH Level II)

Nonrandomized controlled trial (stepped- wedge / interrupted time series evaluation).

Implementation had been linked to a decrease in falls of approximately 15 percent and a decrease in injurious falls of approximately 34 percent; it focuses on customized plans, communication tools and constant monitoring, as well as unit champions.

Well advocates your model of nurse-led: risk assessment to customized plan to consistent implementation; training/monitoring, which can be directly applied to adult day care workflow.

6 Logan et al. (2021). https://doi.org/10.11 36/bmj-2021-066991

Gives stringent support to a multifactorial fall prevention program within care-home settings, which is

Research (JH Level I)

Multicenter cluster randomized controlled

Compares a structured multifactorial program (Guide to Action for Care Home) with normal care; demonstrates that structured protocols can

Endorses viability and design of standardized multifactorial prevention in supervised environments- handy in your project in the training of staff,

Michelle Murray

NU760

applicable to congregate older- adult settings.

trial with economic evaluation.

be introduced at multiple sites with fidelity concerns.

workflow design, and monitoring plans.

References

Adam, C. E., Fitzpatrick, A. L., Leary, C. S., Ilango, S. D., Phelan, E. A., & Semmens, E. O. (2024). The impact of falls on activities of daily living in older adults: A retrospective cohort analysis. PLoS one, 19(1), e0294017. https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0294017&type=printable

Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., ... & Bates, D. W. (2020). Evaluation of a patient- centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial. JAMA network open, 3(11), e2025889. https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2773051/dykes_2020_oi_200851_1605020862.72395 .pdf

Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Sherrington, C., Gates, S., Clemson, L., & Lamb, S. E. (2012). Interventions for preventing falls in older people living in the community. Cochrane database of systematic reviews, (9). https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007146.pub3/pdf/full

Guirguis-Blake, J. M., Perdue, L. A., Coppola, E. L., & Bean, S. I. (2024). Interventions to prevent falls in older adults: updated evidence report and systematic review for the US preventive services task force. Jama, 332(1), 58-69. https://jamanetwork.com/journals/jama/articlepdf/2819574/jama_guirguisblake_2024_us_240003_1718902289.4098 6.pdf

Michelle Murray

NU760

Logan, P. A., Horne, J. C., Gladman, J. R., Gordon, A. L., Sach, T., Clark, A., ... & Sims, E. (2021). Multifactorial falls prevention programme compared with usual care in UK care homes for older people: multicentre cluster randomised controlled trial with economic evaluation. bmj, 375. https://www.bmj.com/content/bmj/375/bmj-2021-066991.full.pdf

Kakara, R. S., Moreland, B. L., Haddad, Y. K., Shakya, I., & Bergen, G. (2021). Seasonal variation in fall-related emergency department visits by location of fall–United States, 2015. Journal of safety research, 79, 38-44. https://pmc.ncbi.nlm.nih.gov/articles/PMC8640371/pdf/nihms-1751162.pdf

Michelle Murray

NU760

In-text citation for the resource – in the References list below this table include a full citation.

You are required to upload the full-text file for each article represented in the matrix table into the assignment drop box.

What is the purpose of the resource to support the prompt for the unit?

1. Is the resource a research or non- research study (Hint: JH EBP Rating Scale notes which are research or non- research at the side of the scale)?

2. What is the study design (i.e., Systematic Review of RCTs, Prospective Cohort, etc.)?

3. If not a research study, what type of literature is represented in the resource (i.e., peer- review like narrative review, case reports, clinical guidelines in published journals or non-peer review like editorials, policy briefs, opinion pieces)?

What are the findings and the recommendations in this resource that are relevant to your proposed graduate scholarship project?

How does this resource support your proposed project?

Articles/resources #1-2 in the table need to demonstrate the observation of the problem you identified for which you are designing a project to address.

1 Kakara et al., (2021). https://doi.org/10.10

Determines the burden/patterns of ED visits associated

Research (JH Level III) Evidences quantifiable and clinically significant fall-related healthcare

Supports your problem statement by documenting real-world fall burden and

Michelle Murray

NU760

16/j.jsr.2021.08.002 (CDC)

with falls in older adults and confirms the seriousness of the outcomes of falls which fall prevention programs are designed to mitigate. (CDC).

Epidemiologic investigation of national ED visits patterns (seasonal/location change).

utilization and variation by fall location/time- evidences the necessity of organized assessment and prevention as opposed to sporadic practices.

helps justify implementing a standardized program to reduce fall events and consequences.

2 Adam et al. (2023). https://doi.org/10.13 71/journal.pone.0294 017

Evidences downstream functional impairment (ADL impairment) following falls, which supports the importance of preventing falls in frail older adults.

Research (JH Level III).

Retrospective cohort/longitudinal secondary analysis and hazard-modelling and trajectory analysis.

The reason falls during the previous 6 months were correlated with increased risk of ADL impairment; but a sub- group experienced long- term impairment. Authors come to a conclusion that older adults require a holistic approach to fall risk evaluation and access to evidence-based prevention.

Improves the urgency and relevance of your project goal (reduce falls to prevent injury/functional decline) directly and aids in the measurement of outcomes associated with quality of life.

Articles/resources #3 -6 in the table need to demonstrate support for the intervention you have selected to address the identified problem.

3 Gillespie et al. (2012).

https://doi.org/10.100 Offers evidence on high-levels of effective interventions (what

Research (JH Level I)

Cochrane systematic review of RCTs

Balance/strength exercise program and Tai Chi decrease falls; multifactorial can

Directly informs the evidence- based Directly informs the evidence-based “menu” for individualized prevention plans

Michelle Murray

NU760

2/14651858.CD00714

6.pub3 works) to provide program aspects.

(with/without meta- analysis).

decrease fall rate. Favors the integration of interventions as opposed to the use of one tactic.

in your nurse-led program (e.g., balance/strength + tailored risk-factor actions).

4 Guirguis-Blake et al. (2024). https://doi.org/10.10 01/jama.2024.4166

Provides modern synthesized data of multifactorial + exercise interventions to prevent using practice-relevant prevention techniques.

Research (JH Level I)

Updated systematic review (USPSTF evidence report; RCT-focused).

Multifactorial interventions significantly reduced fall incidence rate; exercise showed consistent benefit for falls and injurious falls across multiple outcomes.

Justifies your intervention model (screen -assess - customize plan) and justifies the incorporation of structured exercise as a fundamental part when possible, in adult day care.

5 Dykes et al. (2020). https://doi.org/10.10 01/jamanetworkope n.2020.25889

Demonstrates real- world effectiveness of a nurse-led, tailored fall-prevention toolkit linked to patient- specific risk factors (high implementation relevance).

Research (JH Level II)

Nonrandomized controlled trial (stepped- wedge / interrupted time series evaluation).

Implementation had been linked to a decrease in falls of approximately 15 percent and a decrease in injurious falls of approximately 34 percent; it focuses on customized plans, communication tools and constant monitoring, as well as unit champions.

Well advocates your model of nurse-led: risk assessment to customized plan to consistent implementation; training/monitoring, which can be directly applied to adult day care workflow.

6 Logan et al. (2021). https://doi.org/10.11 36/bmj-2021-066991

Gives stringent support to a multifactorial fall prevention program within care-home settings, which is

Research (JH Level I)

Multicenter cluster randomized controlled

Compares a structured multifactorial program (Guide to Action for Care Home) with normal care; demonstrates that structured protocols can

Endorses viability and design of standardized multifactorial prevention in supervised environments- handy in your project in the training of staff,

Michelle Murray

NU760

applicable to congregate older- adult settings.

trial with economic evaluation.

be introduced at multiple sites with fidelity concerns.

workflow design, and monitoring plans.

References

Adam, C. E., Fitzpatrick, A. L., Leary, C. S., Ilango, S. D., Phelan, E. A., & Semmens, E. O. (2024). The impact of falls on activities of daily living in older adults: A retrospective cohort analysis. PLoS one, 19(1), e0294017. https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0294017&type=printable

Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., ... & Bates, D. W. (2020). Evaluation of a patient- centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial. JAMA network open, 3(11), e2025889. https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2773051/dykes_2020_oi_200851_1605020862.72395 .pdf

Gillespie, L. D., Robertson, M. C., Gillespie, W. J., Sherrington, C., Gates, S., Clemson, L., & Lamb, S. E. (2012). Interventions for preventing falls in older people living in the community. Cochrane database of systematic reviews, (9). https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007146.pub3/pdf/full

Guirguis-Blake, J. M., Perdue, L. A., Coppola, E. L., & Bean, S. I. (2024). Interventions to prevent falls in older adults: updated evidence report and systematic review for the US preventive services task force. Jama, 332(1), 58-69. https://jamanetwork.com/journals/jama/articlepdf/2819574/jama_guirguisblake_2024_us_240003_1718902289.4098 6.pdf

Michelle Murray

NU760

Logan, P. A., Horne, J. C., Gladman, J. R., Gordon, A. L., Sach, T., Clark, A., ... & Sims, E. (2021). Multifactorial falls prevention programme compared with usual care in UK care homes for older people: multicentre cluster randomised controlled trial with economic evaluation. bmj, 375. https://www.bmj.com/content/bmj/375/bmj-2021-066991.full.pdf

Kakara, R. S., Moreland, B. L., Haddad, Y. K., Shakya, I., & Bergen, G. (2021). Seasonal variation in fall-related emergency department visits by location of fall–United States, 2015. Journal of safety research, 79, 38-44. https://pmc.ncbi.nlm.nih.gov/articles/PMC8640371/pdf/nihms-1751162.pdf