NUR 550 Evidence-Based Practice Project Evaluation of Literature
Sample Answer for NUR 550 Evidence-Based Practice Project Evaluation of Literature Included After Question
Description:
The purpose of this assignment is to provide research evidence in support of the PICOT you developed for your selected topic.
Conduct a search for 10 peer-reviewed, translational research articles published within the last 5 years that demonstrate support for your PICOT. You may include previous research articles from assignments completed in this course. Use the “Literature Evaluation Table” provided to evaluate the articles and explain how the research supports your PICOT.
Once your instructor returns this assignment, review the feedback and make any revisions necessary. If you are directed by your instructor to select different articles in order to meet the assignment criteria or to better support your PICOT, make these changes accordingly. You will use the literature evaluated in this assignment for all subsequent assignments you develop as part of your evidence-based practice project proposal in this course and in NUR-590, during which you will synthesize all of the sections into a final written paper detailing your evidence-based practice project proposal.
Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.
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While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
Topic 5 DQ 1
Description:
Identify either a safety or quality improvement initiative related to improving population health. Explain how translational research can influence the development of the initiative. Include a specific example to support your response.
Topic 5 DQ 2
Description:
Identify a quality initiative from your workplace. What were some barriers to implementation? What are common barriers for translating research into practice?
Topic 5: Translating Evidence into Practice to Improve Safety and Quality and Eliminate Barriers
Description
Objectives:
- Explain how translational research can be used for safety and quality improvement initiatives related to improving population health.
2. Discuss common barriers for translating research into practice.
Study Materials
Read Chapter 8 in Population Health: Creating a Culture of Wellness.
Evidence-Based Practice in Nursing and Healthcare
Description:
Read Chapters 4 and 9 in Evidence-Based Practice in Nursing and Healthcare.
Translating Evidence into Practice: How Advanced Practice RNs Can Guide Nurses in Challenging Established Practice to Arrive at Best Practice
Description:
Read “Translating Evidence into Practice: How Advanced Practice RNs Can Guide Nurses in Challenging Established Practice to Arrive at Best Practice,” by Fenci and Matthews, from AORN Journal(2017).
Eliminating Cardiovascular Health Disparities: There has Been Progress, but There is More to
Do!
Description:
Read “Eliminating Cardiovascular Health Disparities: There has Been Progress, but There is More to Do!” by Coke, from The Journal of Cardiovascular Nursing (2018).
Quality Improvement in Athletic Health Care
Description:
Read “Quality Improvement in Athletic Health Care,” by Sauers, Sauers, and Valier, from Journal of Athletic Training
(2017).
Lost in Translation: The Promise and Problems of the Globalization of Research
Description:
Read “Lost in Translation: The Promise and Problems of the Globalization of Research,” by Baumann, from Nursing Science Quarterly (2019).
Decreasing Barriers to Research Utilization Among Labor and Delivery Nurses
Description:
Read “Decreasing Barriers to Research Utilization Among Labor and Delivery Nurses,” by Heelan-Fancher, Edmonds, and Jones, from Nursing Research (2019).
Differentiating Between Research and Quality Improvement
Description:
Read “Differentiating Between Research and Quality Improvement,” by Gregory, from Journal of Perinatal and Neonatal Nursing (2015).
Tasks
Topic 5 Participation
Description:
NA
Topic 6: Quality Improvement Initiatives and Clinical Prevention Intervention
Description
Objectives:
1. Integrate appropriate information and communication technologies for a clinical preventative intervention.
2. Evaluate clinical prevention interventions that promote health and wellness for populations.
Study Materials
Population Health: Creating a Culture of Wellness
Description:
Read Chapter 9 and review Chapter 1 in Population Health: Creating a Culture of Wellness.
Evidence-Based Practice in Nursing and Healthcare
Description:
Read Chapter 19 in Evidence-Based Practice in Nursing and Healthcare.
The Role of the Nurse in Quality Improvement and Patient Safety
Description:
Read “The Role of the Nurse in Quality Improvement and Patient Safety,” by Hickey and Giardina, from Journal of Neurological and Neurosurgical Nursing(2019).
Reviewing the Literature: Essential First Step in Research, Quality Improvement, and Implementation of Evidence-Based Practice
Description:
Read “Reviewing the Literature: Essential First Step in Research, Quality Improvement, and Implementation of Evidence-Based Practice,” by Bernhofer, from Journal for Nurses in Professional Development (2015).
Clinical Preventive Services
Description:
Read “Clinical Preventive Services,” by Guerrero Ayres and Bradley, from Encyclopedia of Nursing Research (2017).
Reviewing the Literature
Description:
Read “Reviewing the Literature,” by Bryne, from Sage Research Methods’ Project Planner (2017).
How to Conduct a Literature Review
Description:
Read “How to Conduct a Literature Review,” by Watts, from Podiatry Review (2020).
Preventative Care Benefits for Adults
Description:
Explore “Preventative Care Benefits for Adults,” located on the Healthcare.gov website.
My Healthfinder
Description:
Explore “My Healthfinder,” located on the U.S. Department of Health and Human Services website.
Healthy People 2030
Description:
Explore “Healthy People 2030,” located on the Healthy People 2030 website.
Health Communication and Health Information Technology
Description:
Read “Health Communication and Health Information Technology,” located on the HealthyPeople.gov website.
Using E-Health and Information Technology to Improve Health
Description:
Read, “Using E-Health and Information Technology to Improve Health,” located on the World Health Organization website.
Technology and the Future of Mental Health Treatment
Description:
Read “Technology and the Future of Mental Health Treatment,” located on the Mental Health Information page of the National Institute of Mental Health website.
Impacts of Information and Communication Technologies on Nursing Care: An Overview of Systematic Reviews (Protocol)
Description:
Read “Impacts of Information and Communication Technologies on Nursing Care: An Overview of Systematic Reviews (Protocol),” by Rouleau, Gagnon and Cote, from Systematic Reviews (2015).
Tasks
Course Code Class Code Assignment Title Total Points
NUR-550 NUR-550-O503 Evidence-Based Practice Project: Evaluation of Literature Table 150.0
Criteria Percentage Unsatisfactory (0.00%) Less Than Satisfactory (80.00%) Satisfactory (88.00%) Good (92.00%) Excellent (100.00%)
Content 100.0%
PICOT 5.0% The PICOT is omitted. NA NA NA The PICOT is clearly and accurately presented.
Articles 10.0% Required number of sources are not included. Article citations and permalinks are omitted. Number of required sources is only partially met. Article citations and permalinks are presented. One or more links do not lead to the intended article. Number of required sources is met, but some sources are outdated or inappropriate. Article citations and permalinks are presented. Article citations are presented, but there are errors. Sources are current and generally appropriate for the assignment criteria and nursing content. Article citations and permalinks are presented. Article citations are presented, but there are minor errors. Sources are current and highly appropriate for the assignment criteria and nursing content. Article citations and permalinks are presented. Article citations are accurate. NUR 550 Evidence-Based Practice Project Evaluation of Literature Table
Research Question, Hypothesis, Purpose or Aim of Study 10.0% Research question, hypothesis, purpose or aim of study for one or more articles is omitted. Research question, hypothesis, purpose or aim of study for each article is presented, but key information is consistently omitted. There are inaccuracies throughout. Research question, hypothesis, purpose or aim of study for each article is presented. Key aspects are missing for one or two articles. There are minor inaccuracies. Research question, hypothesis, purpose or aim of study for each article is adequately presented. Minor detail is needed for accuracy or clarity. A discussion on the research question, hypothesis, purpose or aim of study is thoroughly and accurately presented for each article.
Study Design 10.0% The study design for one or more article is omitted. The study design for each article is presented, but key information is consistently omitted. There are inaccuracies throughout. The study design is indicated for each article. Key aspects are missing for one or two articles. There are minor inaccuracies. The study design is adequately presented for each article. Minor detail is needed for accuracy or clarity. A thorough and accurate discussion on the study design for each article is presented.
Setting and Sample 10.0% The setting and sample are omitted for one or more of the articles. The setting and sample are indicated for each article, but key information is consistently omitted. There are inaccuracies throughout. The setting and sample are indicated for each article. Key aspects are missing for one or two articles. There are minor inaccuracies. The setting and sample are adequately presented for each article. Minor detail is needed for accuracy or clarity. The setting and sample in which the researcher conducted the study are detailed and accurate for each article. NUR 550 Evidence-Based Practice Project Evaluation of Literature Table
Methods 10.0% Method of study for one or more articles is omitted. Overall, the methods of study are incomplete. The method of study is presented for each article, but key information is consistently omitted. There are inaccuracies throughout. The method of study for each article is presented. Key aspects are missing for one or two articles. There are minor inaccuracies An adequate discussion on the method of study for each article is presented. Minor detail is needed for accuracy or clarity. A thorough and accurate discussion on the method of study for each article is presented.
Analysis and Data Collection 10.0% Analysis and data collection for one or more articles is omitted. Overall, the analysis and data collection are incomplete. Analysis and data collection are presented for each article, but key information is consistently omitted. There are inaccuracies throughout. Analysis and data collection for each article are presented. Key aspects are missing for one or two articles. There are minor inaccuracies. An adequate discussion on the method of study for each article is presented. Minor detail is needed for accuracy or clarity. A thorough and accurate discussion on the analysis and data collection for each article is presented.
Outcomes and Key Findings 10.0% Outcomes and key findings for one or more articles are omitted. Overall, the outcomes and key findings are incomplete. Outcomes and key findings are presented for each article, but key information is consistently omitted. There are inaccuracies throughout. Outcomes and key findings for each article are presented. Key aspects are missing for one or two articles. There are minor inaccuracies. An adequate discussion on outcomes and key findings for each article are presented. Minor detail is needed for accuracy or clarity. A thorough and accurate discussion on the outcomes and key findings collection for each article are presented.
Recommendations 10.0% Researcher recommendations are omitted for one or more of the articles. The recommendations described for three or more articles are inaccurate or incomplete. Researcher recommendations are indicated for each article. The researcher recommendations described for two of the articles are inaccurate or incomplete. Researcher recommendations for each article are presented. Researcher recommendations described for one article are inaccurate or incomplete. Researcher recommendations for each article are accurately presented. Minor detail is needed for accuracy or clarity. Researcher recommendations are accurately and thoroughly described for each article. NUR 550 Evidence-Based Practice Project Evaluation of Literature Table
NUR 550 Evidence-Based Practice Project Evaluation of Literature Table Explanation of How Articles Support Proposed Evidence-Based Practice Project Proposal 10.0% An explanation of how the article supports the proposed evidence-based practice project proposal is omitted for one or more of the articles. The explanation for three or more articles is inaccurate or incomplete. An explanation for how each article supports the proposed evidence-based practice project proposal is presented. The explanation for two of the articles is inaccurate or incomplete. A general explanation for how each article supports the proposed evidence-based practice project proposal is presented. The explanation for one article is inaccurate or incomplete. Support for the evidence-based project proposal is generally evident. An explanation for how each article supports the proposed evidence-based practice project proposal is presented. Minor detail is needed for accuracy or clarity. Adequate support for the evidence-based project proposal is demonstrated. A detailed explanation for how each article supports the proposed evidence-based practice project proposal is presented. Support for the evidence-based project proposal is clearly evident.
Mechanics of Writing (includes spelling, punctuation, grammar, and language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is employed. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. The writer is clearly in command of standard, written, academic English.
A Sample Answer For the Assignment: NUR 550 Evidence-Based Practice Project Evaluation of Literature
Title: NUR 550 Evidence-Based Practice Project Evaluation of Literature
Information and communication technologies can be integrated into the delivery of health education diabetes self-management to diabetic patients in the organization. Accordingly, technologies such as telehealth and mhealth can be used to enhance the delivery of diabetes care to the patients. Telehealth technology can be used to provide coordinated care to these patients. Nurses and the physicians can utilize it to deliver care virtually to the patients. This includes patient assessment of their adherence to the recommended interventions, monitoring response to treatment, and evaluating care outcomes (Evans et al., 2021; Whitehouse et al., 2020). The virtual interaction between healthcare providers and patients also provides the opportunity to educate the patients and stress the importance of interventions such as lifestyle and behavioral change for optimum outcomes.
Mobile health (mhealth) interventions can also be incorporated into delivery of patient education on diabetes self-management. Interventions such as short messaging services can be used to remind patients about the need for healthy lifestyles and behavioral change. They also remind them about medication refills and upcoming scheduled visits for physician review (Young et al., 2020). The use of these technologies may enhance the realization of optimum outcomes in the management of diabetes.
Researchers have investigated the effectiveness of the above technologies in diabetes self-management. The results in different studies have consistently shown that the incorporation of telehealth for delivering patient education on diabetes self-management leads to reduction in A1C values, hospitalization rate, emergency department visits, healthcare costs, and high level of patient satisfaction with the care given (Evans et al., 2021; Whitehouse et al., 2020). In addition, mhealth increases patients’ engagement in physical activity, self-efficacy, and health literacy for effective diabetes management (Young et al., 2020).
References
Evans, E., Zengul, A., Hall, A., Qu, H., Willig, A., Cherrington, A., & Thirumalai, M. (2021). Disability-Inclusive Diabetes Self-management Telehealth Program: Protocol for a Pilot and Feasibility Study. JMIR Research Protocols, 10(9), e31689. https://doi.org/10.2196/31689
Whitehouse, C. R., Long, J. A., Maloney, L. M., Daniels, K., Horowitz, D. A., & Bowles, K. H. (2020). Feasibility of Diabetes Self-Management Telehealth Education for Older Adults During Transitions in Care. Research in Gerontological Nursing, 13(3), 138–145. https://doi.org/10.3928/19404921-20191210-03
Young, H. M., Miyamoto, S., Dharmar, M., & Tang-Feldman, Y. (2020). Nurse Coaching and Mobile Health Compared With Usual Care to Improve Diabetes Self-Efficacy for Persons With Type 2 Diabetes: Randomized Controlled Trial. JMIR MHealth and UHealth, 8(3), e16665. https://doi.org/10.2196/16665
A Sample Answer 2 For the Assignment: NUR 550 Evidence-Based Practice Project Evaluation of Literature
Title: NUR 550 Evidence-Based Practice Project Evaluation of Literature
The need for patient safety and improved quality of care implores organizations and providers to leverage evidence-based practice (EBP) interventions to address any issues that can lead to occurrence of adverse events in healthcare settings and impact patient outcomes. Falls and incidences of falling among adult patients in medical-surgical settings remain a healthcare safety challenge that requires effective interventions. Falls are considered sentinel and never events by the Centers for Medicare and Medicaid Services (CMS) because they are preventable through institution of different measures aimed at addressing their adverse effects (Cerilo et al.,2022). Falls lead to increased cost of care and stay, poor patient outcomes and in some cases, serious head injuries and fractures that can cause death (Khasnabish et al., 2020). The purpose of this literature evaluation table is to present different research articles on falls and assess their application in medical-surgical settings. The use of TIPS toolkit is considered as one of the ways to reduce and prevent the occurrence of falls in different healthcare settings.
PICOT:
| Among hospitalized adult patients in medical-surgical units (P) does the use of TIPS toolkit as a bundled care approach (I) compared to normal falls prevention approach (C) reduce the prevalence of falls (O) within 6 months (T)? |
Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article | Article Title and Year Published | Research Questions/ Hypothesis, and Purpose/Aim of Study | Design (Quantitative, Qualitative, or other) | Setting/Sample | Methods: Intervention/ Instruments | Analysis/Data Collection | Outcomes/Key Findings | Recommendations | Explanation of How the Article Supports Your Proposed EBP Practice Project Proposal |
| Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., Ergai, A., Lindros, M. E., Lipsitz, S. R., Scanlan, M., Shaykevich, S., & Bates, D.JAMA Network Open, 3(11), e2025889. https://doi.org/10.1001/jamanetworkopen.2020.25889 | Evaluation of a Patient-Centered Fall-Prevention Tool Kit to Reduce Falls and Injuries.2020 | The purpose of this study was to evaluate if a fall-prevention toolkit which engages patients and families in fall-prevention process during hospitalization leads to a reduction in falls and injurious falls. | The researchers used a nonrandomized controlled trials based in the stepped wedge design. | The setting comprised of 14 medical units in academic centers in Boston and New York. The participants were all hospitalized patents in the participating settings; the patients were 37 231. | The instrument was a nurse-based fall-prevention tool kit that links evidence-based measures to patient-focused risk factors. The method incorporated continuous patient and family engagement preventing occurrence of falls. | The study collected data based on the rate of patient falls and injurious falls in every 1000 patient-days on the units. The study analyzed the data using Poisson regression to estimate the frequency of falls in the facility. | The outcome of the study shows a positive correlation between the intervention and a reduction in falls. The article also found that the nurse-driven intervention reduced injurious falls by enabling the families to have sufficient information on different ways to prevent and reduce falls. | The study recommends the use of a nurse-led and patient-centered fall-prevention tool kit to reduce the rates of falls and injurious falls. The authors assert that providers can have different modalities to implement and integrate the intervention to reduce falls in medical-surgical units. | The article supports the EBP as it shows that the proposed intervention is based on evidence and is effective in reducing the rate of falls and injurious falls among hospitalized patients. The article will offer more information about the effectiveness and efficacy of fall prevention interventions tailored to the needs of a patient. |
| Tzeng, H.-M., Jansen, L. S., Okpalauwaekwe, U., Khasnabish, S., Andreas, B., & Dykes, P. C.Journal of Nursing Care Quality, https://doi.org/10.1097/ncq.0000000000000547 | Adopting the Fall Tailoring Interventions for Patient Safety (TIPS) Program to Engage Older Adults in Fall Prevention in a Nursing Home2021 | The focus of the study was to evaluate the impact of fall (TIPS) program on prevention of falls and fall-associated injuries among older adults in nursing home. | The study used mixed method comprising of qualitative and quantitative approaches at various levels of the research gathered findings. | The study occurred in a 15-bed subacute nursing care unit. | The instrument entailed using fall TIPS initiative customized to setting The approach comprised of providing clinical decision support to prevent falls. | The article collected both qualitative and quantitative data based on the respective tools used. These included recording of monthly fall rates among patients within certain period for effective analysis. | The findings after the implementation of the Fall TIPS show that the rate of falls and injurious falls reduced with clinical significance. The researchers attribute the reduction in falls to awareness among patients, information offered to patients on the TIPS poster and other interventions like self-transfer. | The article recommends the implementation of Fall TIPS initiative in healthcare settings to lower falls and injurious fall incidents among older adult residents in nursing homes and other areas of care delivery. The article also recommends the need for larger studies in different healthcare settings to assess the overall effectiveness of such interventions. | The article supports the proposed EBP practice project proposal by demonstrating that the intervention is sound and based on evidence. The proposed EBP project focuses on reducing falls in medical-surgical unit and this study is categorical that such revelations are important to illustrate the efficacy of the Fall TIPS framework. |
| Morris, M. E., Webster, K., Jones, C., Hill, A. M., Haines, T., McPhail, S., … & Cameron, I.Age and Ageing, 51(5), afac077. https://doi.org/10.1093/ageing/afac077 | Interventions to reduce falls in hospitals: a systematic review and meta-analysis.2022 | The aim of the study was to enquire the effects of falls prevention interventions on fall rates and the risk of falling in healthcare facilities | The study is mixed as it uses a systematic review and meta-analysis. | The participants in the study were hospitalized adults | The intervention entailed staff and patient education, modification of the environment, use of assistive devices, development of policies and systems, medication management and rehabilitation as well as management of cognitive impairment | The researchers collected data from 43 studies that satisfied the inclusion criteria and 23 were included in the meta-analyses. | The findings show that the use of tailored interventions leads to a reduction in rates of falls and injurious falls. The outcomes also suggest that the use of multi-factorial interventions led to a positive impact on patient care. | The study recommends the use of patient and staff education as approaches that can have positive effects on hospital falls. The use of chair alarms, bed alarms, and wearable sensors and scored risk assessment tools did not reduce falls. | The study will be used in the EBP project proposal to demonstrate the need to use TIPS toolkit for both patients and staff with the aim of reducing and preventing the occurrence of falls and injurious falls in medical-surgical settings. |
| Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A. M., & Morris, M. E.BMC geriatrics, 20, 1-12. DOI: https://doi.org/10.1186/s12877-020-01515-w | Hospital falls prevention with patient education: a scoping review.2020 | The aim of the scoping review was to examine the content, design, and outcomes concerning patient education approaches to prevent hospital falls. The paper evaluates the significance of patient education to prevent falls and suggests for hospitals to implement in their clinical settings. | The study uses a methodological model developed by Arksey and O’Mallet and refined by Joanna Briggs Institute. | The researchers evaluated 43 articles in their analysis based on different interventions on patient education like face-to-face and educational tools. | The interventions included direct face-to-face education, educational tools, patient-focused consumer materials and hospital systems, policies and procedures | The researchers collected and analyzed data from existing studies. These included studies on falls or education associated outcomes before and after patient fall prevention education. | The findings from the article illustrate the effectiveness of the interventions that use patient education to reduce falls related to injuries like bruises, lacerations and fractures. | The study recommends the implementation of patient-centered prevention education as part of the TIPS approach to reducing falls in healthcare settings. The study observes that well-designed education initiatives can enhance knowledge and self-perception of risk and empower patients to lower their risk of falling while in hospitals. | The study is essential to the EBP project proposal since it illustrates the significance of having a patient-centered toolkit or intervention to reduce and prevent the occurrence of falls among hospitalized patients. The article will offer more information on the efficacy of the TIPS model to reduce and prevent falls. |
| LeLaurin, J. H., & Shorr, R. I.Clinics in geriatric medicine, 35(2), 273-283. DOI: 10.1016/j.cger.2019.01.007 | Preventing falls in hospitalized patients: state of the science.2019 | The aim of this study was to familiarize the audience with the strengths and the cons of different types of research used in testing fall prevention approaches or interventions. | The article uses a review of existing literature or systematic review to highlight different studies on fall prevention in healthcare settings. | The researchers evaluate different articles based on their approaches to reducing falls in healthcare settings. These include quality improvement studies, randomized studies, and non-randomized studies a well as single fall prevention interventions and multifactorial one among others. | The interventions include focusing on single approaches as well as use multifactorial interventions. | The researchers collected and analyzed data from the different types of studies that they evaluated. The researchers focused on both single and multifactorial interventions to reduce and prevent patient falls. | The findings show that different interventions are effective based on a host of factors. Again, the study notes that single interventions are more practical compared to multifactorial interventions in prevention of falls. | The study recommends the implementation of all interventions, especially those emanating from research and are effective based on the healthcare setting. The study notes that the implementation of any of the interventions is the most essential for any patient safety initiative. | The article is essential to the EBP project proposal as it offers sufficient research evidence on the efficacy of the different interventions to prevent and reduce falls in healthcare settings. |
| Dykes, P. C., Adelman, J. S., Alfieri, L., Bogaisky, M., Carroll, D., Carter, E., … & Spivack, L. B. Nurse Leader, 17(4), 365-370. https://doi.org/10.1016/j.mnl.2018.11.006 | The fall TIPS (tailoring interventions for patient safety) program: A collaboration to end the persistent problem of patient Falls2019 | The aim of the article was to offer information to nurse leaders concerning evidence about the efficacy and effectiveness of the Fall TIPS program and how they can create collaborative teams as well as access resources to support implementation at their facilities. | The article uses a qualitative approach to the issue and proposes the integration of different teams to enhance the implementation of the intervention. | The researchers assess and appraise different articles since the development of the Fall TIPS in Boston and how organizations are leveraging it to offer care. | The main intervention is the implementation of the Fall TIPS initiatives in different settings to reduce and prevent the occurrence of falls. | The researchers evaluate data from the existing studies for analysis. They do not collect any data since they only review existing studies’ findings. | The findings show that implementing a fall TIPS program can reduce and prevent the occurrence of falls in different care settings. The researchers are categorical that since its implementation, it has led to a significant reduction and prevention of falls. | The researchers recommend the use of TIPS in healthcare settings to reduce the occurrence of falls, especially in critical care settings with hospitalized adult patients | The resource is essential as it highlights the use of TIPS as an effective intervention in mitigating risks that may lead to falls. The resource will be used in the EBP project to demonstrate the need for TIPS as a way to reduce and prevent the occurrence of patient falls. |
| Cuttler, S. J., Barr-Walker, J., & Cuttler, L.BMJ open quality, 6(2), e000119. DOI: 10.1136/bmjoq-2017-000119 | Reducing medical-surgical inpatient falls and injuries with videos, icons and alarms2018 | The focus of this article was to determine the effectiveness of patient education videos and visual signs with bed exit alarms to reduce falls among hospitalized medical-surgical inpatients. | The study used a performance improvement model based on historic control | The participants were adults in medical-surgical units. | The main intervention was a four-minute video for patients’ viewing by trained volunteers. The second intervention was having icons of risk factors and interventions on the patients’ bedsides. The third intervention was having a bed alarm for those confused patients at risk of falling. | The researchers collected and analyzed data based on the incidences in every 1000 patient days for patient falls, and falls with an injury and those with serious injuries | The findings show that these interventions reduced all different types of falls in every 1000 patient days. However, icons were not fully implemented. | The study recommends more studies, especially multicenter randomized controlled trials to confirm the effectiveness of icons and video interventions o reduce falls. | The article is critical to the EBP proposed project as it demonstrates that the use of TIPS toolkit is effective but requires increased involvement and integration of all stakeholders. |
| Bargmann, A. L., & Brundrett, S. M.Military medicine, 185(Supplement_2), 28-34. | Implementation of a multicomponent fall prevention program: Contracting with patients for fall safety2020 | The study aimed at the implementation of a multicomponent fall prevention program to enhance patient safety from falls and associated risks | The researchers developed a multicomponent approach to fall prevention that comprised of literature and use of a patient fall safety agreement in the facility. | The setting for the research was a 26-bed medical-surgical telemetry unit in a 352-bed level 1 trauma center. The center caters to both civilian and military beneficiaries. | The interventions include a patient fall safety agreement among the providers and EBP fall prevention bundle. | The researchers collected and analyzed data after four months to assess the rate of falls in the unit. They also collected data from an incentive program aimed at increasing adherence to patient safety approaches. | The findings from the study show that the agreements facilitated dialogue among nurses and other providers as well as patients. The findings show that these interventions lead to a reduction in patient falls within the facility | The study recommends the implementation of this intervention since it creates a collaborative environment for nurses and other professionals to carry out safe and quality patient care. | The article is essential to the EBP project because it shows the use of these interventions leads to a decrease in the number of falls in the unit. It also demonstrates the efficacy of using multiple components to reduce and prevent falls in acute care settings. |
| Duckworth, M., Adelman, J., Belategui, K., Feliciano, Z., Jackson, E., Khasnabish, S., … & Dykes, P. C.Journal of medical internet research, 21(1), e10008. DOI: 10.2196/10008 | Assessing the Effectiveness of Engaging Patients and Their Families in the Three-Step Fall Prevention Process Across Modalities of an Evidence-Based Fall Prevention Toolkit: An Implementation Science Study2019 | The focus of the research was to determine the efficacy of fall TIPS tool in engaging patients through three-step fall prevention interventions | The researchers used random audits through a questionnaire. They also used the audits to measure adherence. They also used a case-control approach to understand the prevalence of patients using Fall TIPS to experience falls | The researchers utilized a randomized control trial with a sample size of over 10,000 subjects. | The intervention entailed conducting fall risk assessments, developing a tailored fall prevention plan, and implementing the plan consistently along other well accepted standards and precautions | The researchers collected data from the feedback offered by the participants in the site of the study. They analyzed the data using different fall modalities to assess the effectiveness of the intervention. | The findings show that each Fall TIPS modality led to the engagement of patients in the fall prevention process. The researchers assert that Fall TIPS modalities can enhance effective control of falls ad ensure that patients do not suffer from them. | The researchers recommend the use of the three modalities by healthcare organizations in different settings based on their abilities and one that aligns with the organizational culture. | The article is important to the EBP proposed project as it illustrates that importance of using the TIPS model as an intervention to reduce and prevent the occurrence of falls in medical-surgical units. The intervention is important since it demonstrates the need for better patient outcomes. |
| Carter, E. J., Khasnabish, S., Adelman, J., Bogaisky, M., Lindros, M. E., Alfieri, L., … & Dykes, P.OBM Geriatrics, 4(2), 1-21. DOI:10.21926/obm.geriatr.2002119. | Adoption of a Patient-Tailored Fall Prevention Program in Academic Health Systems: A Qualitative Study of Barriers and Facilitators.2020 | The aim of this study was to evaluate the facilitators and barriers to the adoption of Fall TIPS in healthcare settings. | The researchers used a multisite qualitative design. | The setting comprised of 11 hospitals that represented three academic health systems that had implemented Fall TIPS. The researchers identified 50 patients and 71 staff for the focus groups. | The interventions included interviews and focus groups where 71 nurses were analyzed. | The researchers collected data from these two cohorts and analyzed them using a conventional content analysis approach. | The findings show that the use of Fall TIPS led to increased levels of partnerships between nurses and patients. The fall prevention interventions were tailored to meet patient needs leading to better clinical decisions. The facilitators include motivation, use of residual fall prevention approaches and willfulness. | The researchers recommend the implementation of Fall TIPS to improve patient safety and prevent the occurrence of falls. | The article is essential as it shows the need for providers to integrate Fall TIPS where it works and leads to better patient safety measures. |
Conclusion
The evaluation table is categorical that healthcare facilities and providers can mitigate falls through a raft of evidence-based practice (EBP) interventions like the Fall TIPS model. Existing literature is emphatic that these interventions are important in reducing falls and preventing their occurrence. The articles evaluated agree that while organizational challenges can arise in the implementation process, it is critical to evaluate all the aspects of the interventions to enhance adherence to the toolkit. The articles are important as they suggest implementation of the Fall TIPS framework across all areas of patient safety.
References
Cerilo, P. C., & Siegmund, L. A. (2022). Pilot testing of nurse led multimodal intervention for falls prevention. Geriatric Nursing, 43, 242-248. DOI: 10.1016/j.gerinurse.2021.12.002
Khasnabish, S., Burns, Z., Couch, M., Mullin, M., Newmark, R., & Dykes, P. C. (2020). Best practices for data visualization: creating and evaluating a report for an evidence-based fall prevention program. Journal of the
American Medical Informatics Association, 27(2), 308-314. DOI: 10.1093/jamia/ocz190.
A Sample Answer 3 For the Assignment: NUR 550 Evidence-Based Practice Project Evaluation of Literature
Title: NUR 550 Evidence-Based Practice Project Evaluation of Literature
The need for patient safety and improved quality of care implores organizations and providers to leverage evidence-based practice (EBP) interventions to address any issues that can lead to occurrence of adverse events in healthcare settings and impact patient outcomes. Falls and incidences of falling among adult patients in medical-surgical settings remain a healthcare safety challenge that requires effective interventions. Falls are considered sentinel and never events by the Centers for Medicare and Medicaid Services (CMS) because they are preventable through institution of different measures aimed at addressing their adverse effects (Cerilo et al.,2022). Falls lead to increased cost of care and stay, poor patient outcomes and in some cases, serious head injuries and fractures that can cause death (Khasnabish et al., 2020). The purpose of this literature evaluation table is to present different research articles on falls and assess their application in medical-surgical settings. The use of TIPS toolkit is considered as one of the ways to reduce and prevent the occurrence of falls in different healthcare settings.
PICOT:
| Among hospitalized adult patients in medical-surgical units (P) does the use of TIPS toolkit as a bundled care approach (I) compared to normal falls prevention approach (C) reduce the prevalence of falls (O) within 6 months (T)? |
Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article | Article Title and Year Published | Research Questions/ Hypothesis, and Purpose/Aim of Study | Design (Quantitative, Qualitative, or other) | Setting/Sample | Methods: Intervention/ Instruments | Analysis/Data Collection | Outcomes/Key Findings | Recommendations | Explanation of How the Article Supports Your Proposed EBP Practice Project Proposal |
| Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., Ergai, A., Lindros, M. E., Lipsitz, S. R., Scanlan, M., Shaykevich, S., & Bates, D.JAMA Network Open, 3(11), e2025889. https://doi.org/10.1001/jamanetworkopen.2020.25889 | Evaluation of a Patient-Centered Fall-Prevention Tool Kit to Reduce Falls and Injuries.2020 | The purpose of this study was to evaluate if a fall-prevention toolkit which engages patients and families in fall-prevention process during hospitalization leads to a reduction in falls and injurious falls. | The researchers used a nonrandomized controlled trials based in the stepped wedge design. | The setting comprised of 14 medical units in academic centers in Boston and New York. The participants were all hospitalized patents in the participating settings; the patients were 37 231. | The instrument was a nurse-based fall-prevention tool kit that links evidence-based measures to patient-focused risk factors. The method incorporated continuous patient and family engagement preventing occurrence of falls. | The study collected data based on the rate of patient falls and injurious falls in every 1000 patient-days on the units. The study analyzed the data using Poisson regression to estimate the frequency of falls in the facility. | The outcome of the study shows a positive correlation between the intervention and a reduction in falls. The article also found that the nurse-driven intervention reduced injurious falls by enabling the families to have sufficient information on different ways to prevent and reduce falls. | The study recommends the use of a nurse-led and patient-centered fall-prevention tool kit to reduce the rates of falls and injurious falls. The authors assert that providers can have different modalities to implement and integrate the intervention to reduce falls in medical-surgical units. | The article supports the EBP as it shows that the proposed intervention is based on evidence and is effective in reducing the rate of falls and injurious falls among hospitalized patients. The article will offer more information about the effectiveness and efficacy of fall prevention interventions tailored to the needs of a patient. |
| Tzeng, H.-M., Jansen, L. S., Okpalauwaekwe, U., Khasnabish, S., Andreas, B., & Dykes, P. C.Journal of Nursing Care Quality, https://doi.org/10.1097/ncq.0000000000000547 | Adopting the Fall Tailoring Interventions for Patient Safety (TIPS) Program to Engage Older Adults in Fall Prevention in a Nursing Home2021 | The focus of the study was to evaluate the impact of fall (TIPS) program on prevention of falls and fall-associated injuries among older adults in nursing home. | The study used mixed method comprising of qualitative and quantitative approaches at various levels of the research gathered findings. | The study occurred in a 15-bed subacute nursing care unit. | The instrument entailed using fall TIPS initiative customized to setting The approach comprised of providing clinical decision support to prevent falls. | The article collected both qualitative and quantitative data based on the respective tools used. These included recording of monthly fall rates among patients within certain period for effective analysis. | The findings after the implementation of the Fall TIPS show that the rate of falls and injurious falls reduced with clinical significance. The researchers attribute the reduction in falls to awareness among patients, information offered to patients on the TIPS poster and other interventions like self-transfer. | The article recommends the implementation of Fall TIPS initiative in healthcare settings to lower falls and injurious fall incidents among older adult residents in nursing homes and other areas of care delivery. The article also recommends the need for larger studies in different healthcare settings to assess the overall effectiveness of such interventions. | The article supports the proposed EBP practice project proposal by demonstrating that the intervention is sound and based on evidence. The proposed EBP project focuses on reducing falls in medical-surgical unit and this study is categorical that such revelations are important to illustrate the efficacy of the Fall TIPS framework. |
| Morris, M. E., Webster, K., Jones, C., Hill, A. M., Haines, T., McPhail, S., … & Cameron, I.Age and Ageing, 51(5), afac077. https://doi.org/10.1093/ageing/afac077 | Interventions to reduce falls in hospitals: a systematic review and meta-analysis.2022 | The aim of the study was to enquire the effects of falls prevention interventions on fall rates and the risk of falling in healthcare facilities | The study is mixed as it uses a systematic review and meta-analysis. | The participants in the study were hospitalized adults | The intervention entailed staff and patient education, modification of the environment, use of assistive devices, development of policies and systems, medication management and rehabilitation as well as management of cognitive impairment | The researchers collected data from 43 studies that satisfied the inclusion criteria and 23 were included in the meta-analyses. | The findings show that the use of tailored interventions leads to a reduction in rates of falls and injurious falls. The outcomes also suggest that the use of multi-factorial interventions led to a positive impact on patient care. | The study recommends the use of patient and staff education as approaches that can have positive effects on hospital falls. The use of chair alarms, bed alarms, and wearable sensors and scored risk assessment tools did not reduce falls. | The study will be used in the EBP project proposal to demonstrate the need to use TIPS toolkit for both patients and staff with the aim of reducing and preventing the occurrence of falls and injurious falls in medical-surgical settings. |
| Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A. M., & Morris, M. E.BMC geriatrics, 20, 1-12. DOI: https://doi.org/10.1186/s12877-020-01515-w | Hospital falls prevention with patient education: a scoping review.2020 | The aim of the scoping review was to examine the content, design, and outcomes concerning patient education approaches to prevent hospital falls. The paper evaluates the significance of patient education to prevent falls and suggests for hospitals to implement in their clinical settings. | The study uses a methodological model developed by Arksey and O’Mallet and refined by Joanna Briggs Institute. | The researchers evaluated 43 articles in their analysis based on different interventions on patient education like face-to-face and educational tools. | The interventions included direct face-to-face education, educational tools, patient-focused consumer materials and hospital systems, policies and procedures | The researchers collected and analyzed data from existing studies. These included studies on falls or education associated outcomes before and after patient fall prevention education. | The findings from the article illustrate the effectiveness of the interventions that use patient education to reduce falls related to injuries like bruises, lacerations and fractures. | The study recommends the implementation of patient-centered prevention education as part of the TIPS approach to reducing falls in healthcare settings. The study observes that well-designed education initiatives can enhance knowledge and self-perception of risk and empower patients to lower their risk of falling while in hospitals. | The study is essential to the EBP project proposal since it illustrates the significance of having a patient-centered toolkit or intervention to reduce and prevent the occurrence of falls among hospitalized patients. The article will offer more information on the efficacy of the TIPS model to reduce and prevent falls. |
| LeLaurin, J. H., & Shorr, R. I.Clinics in geriatric medicine, 35(2), 273-283. DOI: 10.1016/j.cger.2019.01.007 | Preventing falls in hospitalized patients: state of the science.2019 | The aim of this study was to familiarize the audience with the strengths and the cons of different types of research used in testing fall prevention approaches or interventions. | The article uses a review of existing literature or systematic review to highlight different studies on fall prevention in healthcare settings. | The researchers evaluate different articles based on their approaches to reducing falls in healthcare settings. These include quality improvement studies, randomized studies, and non-randomized studies a well as single fall prevention interventions and multifactorial one among others. | The interventions include focusing on single approaches as well as use multifactorial interventions. | The researchers collected and analyzed data from the different types of studies that they evaluated. The researchers focused on both single and multifactorial interventions to reduce and prevent patient falls. | The findings show that different interventions are effective based on a host of factors. Again, the study notes that single interventions are more practical compared to multifactorial interventions in prevention of falls. | The study recommends the implementation of all interventions, especially those emanating from research and are effective based on the healthcare setting. The study notes that the implementation of any of the interventions is the most essential for any patient safety initiative. | The article is essential to the EBP project proposal as it offers sufficient research evidence on the efficacy of the different interventions to prevent and reduce falls in healthcare settings. |
| Dykes, P. C., Adelman, J. S., Alfieri, L., Bogaisky, M., Carroll, D., Carter, E., … & Spivack, L. B. Nurse Leader, 17(4), 365-370. https://doi.org/10.1016/j.mnl.2018.11.006 | The fall TIPS (tailoring interventions for patient safety) program: A collaboration to end the persistent problem of patient Falls2019 | The aim of the article was to offer information to nurse leaders concerning evidence about the efficacy and effectiveness of the Fall TIPS program and how they can create collaborative teams as well as access resources to support implementation at their facilities. | The article uses a qualitative approach to the issue and proposes the integration of different teams to enhance the implementation of the intervention. | The researchers assess and appraise different articles since the development of the Fall TIPS in Boston and how organizations are leveraging it to offer care. | The main intervention is the implementation of the Fall TIPS initiatives in different settings to reduce and prevent the occurrence of falls. | The researchers evaluate data from the existing studies for analysis. They do not collect any data since they only review existing studies’ findings. | The findings show that implementing a fall TIPS program can reduce and prevent the occurrence of falls in different care settings. The researchers are categorical that since its implementation, it has led to a significant reduction and prevention of falls. | The researchers recommend the use of TIPS in healthcare settings to reduce the occurrence of falls, especially in critical care settings with hospitalized adult patients | The resource is essential as it highlights the use of TIPS as an effective intervention in mitigating risks that may lead to falls. The resource will be used in the EBP project to demonstrate the need for TIPS as a way to reduce and prevent the occurrence of patient falls. |
| Cuttler, S. J., Barr-Walker, J., & Cuttler, L.BMJ open quality, 6(2), e000119. DOI: 10.1136/bmjoq-2017-000119 | Reducing medical-surgical inpatient falls and injuries with videos, icons and alarms2018 | The focus of this article was to determine the effectiveness of patient education videos and visual signs with bed exit alarms to reduce falls among hospitalized medical-surgical inpatients. | The study used a performance improvement model based on historic control | The participants were adults in medical-surgical units. | The main intervention was a four-minute video for patients’ viewing by trained volunteers. The second intervention was having icons of risk factors and interventions on the patients’ bedsides. The third intervention was having a bed alarm for those confused patients at risk of falling. | The researchers collected and analyzed data based on the incidences in every 1000 patient days for patient falls, and falls with an injury and those with serious injuries | The findings show that these interventions reduced all different types of falls in every 1000 patient days. However, icons were not fully implemented. | The study recommends more studies, especially multicenter randomized controlled trials to confirm the effectiveness of icons and video interventions o reduce falls. | The article is critical to the EBP proposed project as it demonstrates that the use of TIPS toolkit is effective but requires increased involvement and integration of all stakeholders. |
| Bargmann, A. L., & Brundrett, S. M.Military medicine, 185(Supplement_2), 28-34. https://doi.org/10.1093/milmed/usz411 | Implementation of a multicomponent fall prevention program: Contracting with patients for fall safety2020 | The study aimed at the implementation of a multicomponent fall prevention program to enhance patient safety from falls and associated risks | The researchers developed a multicomponent approach to fall prevention that comprised of literature and use of a patient fall safety agreement in the facility. | The setting for the research was a 26-bed medical-surgical telemetry unit in a 352-bed level 1 trauma center. The center caters to both civilian and military beneficiaries. | The interventions include a patient fall safety agreement among the providers and EBP fall prevention bundle. | The researchers collected and analyzed data after four months to assess the rate of falls in the unit. They also collected data from an incentive program aimed at increasing adherence to patient safety approaches. | The findings from the study show that the agreements facilitated dialogue among nurses and other providers as well as patients. The findings show that these interventions lead to a reduction in patient falls within the facility | The study recommends the implementation of this intervention since it creates a collaborative environment for nurses and other professionals to carry out safe and quality patient care. | The article is essential to the EBP project because it shows the use of these interventions leads to a decrease in the number of falls in the unit. It also demonstrates the efficacy of using multiple components to reduce and prevent falls in acute care settings. |
| Duckworth, M., Adelman, J., Belategui, K., Feliciano, Z., Jackson, E., Khasnabish, S., … & Dykes, P. C.Journal of medical internet research, 21(1), e10008. DOI: 10.2196/10008 | Assessing the Effectiveness of Engaging Patients and Their Families in the Three-Step Fall Prevention Process Across Modalities of an Evidence-Based Fall Prevention Toolkit: An Implementation Science Study2019 | The focus of the research was to determine the efficacy of fall TIPS tool in engaging patients through three-step fall prevention interventions | The researchers used random audits through a questionnaire. They also used the audits to measure adherence. They also used a case-control approach to understand the prevalence of patients using Fall TIPS to experience falls | The researchers utilized a randomized control trial with a sample size of over 10,000 subjects. | The intervention entailed conducting fall risk assessments, developing a tailored fall prevention plan, and implementing the plan consistently along other well accepted standards and precautions | The researchers collected data from the feedback offered by the participants in the site of the study. They analyzed the data using different fall modalities to assess the effectiveness of the intervention. | The findings show that each Fall TIPS modality led to the engagement of patients in the fall prevention process. The researchers assert that Fall TIPS modalities can enhance effective control of falls ad ensure that patients do not suffer from them. | The researchers recommend the use of the three modalities by healthcare organizations in different settings based on their abilities and one that aligns with the organizational culture. | The article is important to the EBP proposed project as it illustrates that importance of using the TIPS model as an intervention to reduce and prevent the occurrence of falls in medical-surgical units. The intervention is important since it demonstrates the need for better patient outcomes. |
| Carter, E. J., Khasnabish, S., Adelman, J., Bogaisky, M., Lindros, M. E., Alfieri, L., … & Dykes, P.OBM Geriatrics, 4(2), 1-21. DOI:10.21926/obm.geriatr.2002119. | Adoption of a Patient-Tailored Fall Prevention Program in Academic Health Systems: A Qualitative Study of Barriers and Facilitators.2020 | The aim of this study was to evaluate the facilitators and barriers to the adoption of Fall TIPS in healthcare settings. | The researchers used a multisite qualitative design. | The setting comprised of 11 hospitals that represented three academic health systems that had implemented Fall TIPS. The researchers identified 50 patients and 71 staff for the focus groups. | The interventions included interviews and focus groups where 71 nurses were analyzed. | The researchers collected data from these two cohorts and analyzed them using a conventional content analysis approach. | The findings show that the use of Fall TIPS led to increased levels of partnerships between nurses and patients. The fall prevention interventions were tailored to meet patient needs leading to better clinical decisions. The facilitators include motivation, use of residual fall prevention approaches and willfulness. | The researchers recommend the implementation of Fall TIPS to improve patient safety and prevent the occurrence of falls. | The article is essential as it shows the need for providers to integrate Fall TIPS where it works and leads to better patient safety measures. |
Conclusion
The evaluation table is categorical that healthcare facilities and providers can mitigate falls through a raft of evidence-based practice (EBP) interventions like the Fall TIPS model. Existing literature is emphatic that these interventions are important in reducing falls and preventing their occurrence. The articles evaluated agree that while organizational challenges can arise in the implementation process, it is critical to evaluate all the aspects of the interventions to enhance adherence to the toolkit. The articles are important as they suggest implementation of the Fall TIPS framework across all areas of patient safety.
References
Cerilo, P. C., & Siegmund, L. A. (2022). Pilot testing of nurse led multimodal intervention for falls prevention. Geriatric Nursing, 43, 242-248. DOI: 10.1016/j.gerinurse.2021.12.002
Khasnabish, S., Burns, Z., Couch, M., Mullin, M., Newmark, R., & Dykes, P. C. (2020). Best practices for data visualization: creating and evaluating a report for an evidence-based fall prevention program. Journal of the
American Medical Informatics Association, 27(2), 308-314. DOI: 10.1093/jamia/ocz190.
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