Assignment: HCA 699 Problem Description

Assignment: HCA 699 Problem Description

Assignment: HCA 699 Problem Description

HCA 699 Topic 2 Section A Problem Description

Background of the Problem

            In clinical settings, falls amongst admitted patients has become a major concern for stakeholders such as the Center for Medicare and Medicaid Services (CMS), Joint Commission, patients, caregivers and healthcare facilities. The occurrence of falls among the inpatient population can lead to negative consequences such as premature hospital re-admission, increased mortalities and hospital stays, extended pain and potential disabilities. According to statistics, the average fall rates amongst inpatients in the clinical settings is 17.1 per 1000 bed days (King, Pecanac, Krupp, Liebzeit, & Mahoney, 2018). Further, it is approximated that of patients admitted to the inpatient units, five of them will experience falls at least once during their stay at the hospital. As such, the prevalence of falls at hospitals ranges from 1.9%-3% even after several interventions have been adopted. As a result of the falls, 9-33% of the patients may suffer from injuries ranging from mild to fatal (de Souza et al., 2019). The Institute of Healthcare Improvement in its published report concluded that falls account for the most mortalities in older patients, 65 years and above, with 10% of these deaths occurring within the clinical setting (Bhise et al., 2018). Moreover, the falls have also been shown to predispose patients to other issues such as anxiety, distress and depression, which can affect their mental functioning along with physical abilities.

Leon and Adams (2016) demonstrated that the occurrence of falls has the capacity to increase patient costs by approximately $13,000 dollars. Other parameters such as healthcare spending per fallen patient can increase up to 60% in comparison to other patients. As such, Pearson and Coburn (2012) estimated that the costs associated with injuries and treatment will rise to approximately $54.9 billion this year. Therefore, hospital falls amongst inpatients in clinical settings is a significant matter that should be addressed.

Stakeholders/ Change Agents

            The Center for Medicare and Medicaid Services and Joint Commission always seek to examine issues that will improve the safety and quality of care offered to patients. As such, they will be important stakeholders in a project that seeks to address hospital patient falls. In addition, nurses, providers, nursing students and other healthcare workers will also play a crucial role as they will be the frontline change agents for the project (Anderson, Postler, & Dam, 2016). Other interested parties in the project will entail families and patients themselves as they are the ones who suffer the consequences of falls.

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The PICOT Question

            In order to address the issue of patient falls at the facility, the present project proposes the adoption of hourly rounds. Thus, the following PICOT question will form the basis of the project: For adult inpatients in medical surgical units (P) does the use of hourly nursing rounds (I) reduce the future risk of falls (O) when compared with call lights (C)?

The Purpose and Project Objectives

            The purpose of the project is to reduce the prevalence of falls amongst adult inpatients in the medical surgical unit. Specifically, the project will seek to compare the effectiveness of nursing rounds and call lights regarding the reduction of the prevalence of patient falls in the medical surgical units (Anderson, Postler, & Dam, 2016). Therefore, patient fall measurements will be taken before and after the introduction of nursing hourly rounds and comparing call lights to determine which intervention is more effective.

Importance of Resolving Falls to Nursing

As mentioned, nurses are the frontline workers that are directly impacted by patient falls. The prevention of patient falls will thus improve nursing work morale and help to prevent them from suffering burnout, as the workload and stress caused by patients suffering after a fall, will be reduced. Moreover, addressing patient falls will allow nurses to practice their care maximally as the patients will not suffer from the effects of the same (King et al., 2018). Further, resolving the issue of patients falls will support the role of nurses as it relates to keeping patients safe. Therefore, addressing patient falls is fundamental to the roles and responsibilities of nurses as well as their workplace wellbeing.


Write a paper of 500-750 words (not including the title page and reference page) on your proposed problem description for your EBP project. The paper should address the following:
Describe the background of the problem. Tell the story of the issue and why it deserves attention.
Identify the stakeholders/change agents. Who or what organizations are concerned about, may benefit from, or are affected by this proposal. List the interested parties, patients, students, agencies, Joint Commission, etc.
Provide the PICOT question. (PICOT: Population-Intervention-Comparison-Outcome-Timeframe). Make sure that the question fits with your graduate degree specialization.


State the purpose and project objectives in specific, realistic, and measurable terms. The objective should address what is to be gained. This is a restatement of the question, providing focus. Measurements need to be taken before and after the evidence-based practice is introduced to identify the expected changes.
Provide supportive rationale that the problem or issue is an important one for nursing to resolve using relevant professional literature sources.
Develop an initial reference list to ensure that there is adequate literature to support your evidence-based practice project. Follow the “Steps to an Efficient Search to Answer a Clinical Question” box in chapter 3 of the textbook. Refer to the “Search Method Example” as the format in which to compile this data.

The majority of references should be research articles. However, national sources such as Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), Department of Health and Human Resources (HHS), or the Agency for Healthcare Research and Quality (AHRQ) and others may be used when you are gathering statistics to provide the rationale for the problem.
Once you get into the literature, you may find there is very little research to support your topic and you will have to start all over again. Remember, in order for this to be an evidence-based project, you must have enough evidence to introduce this as a practice change. If you find that you do not have enough supporting evidence to change a practice, then further research would need to be conducted.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required for the individual sections, but is required for the final paper.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

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