Identification of a Practice Issue for EBP: Fall Prevention.

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Identification of a Practice Issue for EBP: Fall Prevention.

 

To prepare for Application 1: • Consider the specifics of your practicum setting, as well as practice-related challenges in your specialty area that interest you. Brainstorm practice issues in which an outcome is different from what would be expected according to the research literature. • Select one issue to focus on for this assignment.Identification of a Practice Issue for EBP: Fall Prevention. This will be your issue for the entire EBP Assignment, so be sure it is one that will enable you to fulfill the project requirements (e.g., you can develop new approaches to practice). You may wish to speak with your Practicum Mentor about your selection. • Explore the research literature on this issue. To complete: In a 1- to 2-page paper, address the following: • Provide a summary of the selected practice issue in which the outcome is different from what would be expected according to the research literature. (Note: The issue you select must be suitable for completing the entire EBP Assignment.)Identification of a Practice Issue for EBP: Fall Prevention.

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Guirguis-Blake et al., (2018) acknowledge falls as a major cause of mortalities and morbidities caused by injuries in people aged 60 years or older. They further highlight that, in the year 2014, more than 28% of adults in community settings aged 65 or older experienced falls leading to more than 28 million fall incidences and in the year 2015, the number of fall-related mortalities was 33,000.Identification of a Practice Issue for EBP: Fall Prevention. Tricco et al. (2017) highlight similar findings by admitting that falls are an issue of public health significance since they pose a huge burden to the healthcare system and patients. In the year 2012, Medicare incurred up to $31 billion to manage falls. Among elderly people, falls increase the risk of depression and reduce QoL. Linehan & Linehan (2018) emphasize that, since the aging population continues to increase globally, fall prevention among elderly persons remains fundamental for healthcare systems.Identification of a Practice Issue for EBP: Fall Prevention.

Fabry (2015) discuss hourly rounding as a new practice to prevent falls in inpatient settings. Rounding helps to address patient’s needs since it integrates both environmental and behavioral aspects to address 4P’s. However, the findings of the study by Brown (2016) reveal that the implementation of hourly rounding does not affect the rates of falls in inpatient settings. These findings are based on a retrospective study design conducted in a 241-bed capacity acute care setting. The institution had a fall rate of 30 before the implementation and 27 post-implementation (Brown, 2016). Although the researchers noted a small margin decrease in the fall rate, the outcome was not statistically significant.  This finding informs the need to develop strategies to improve the effectiveness of hourly rounding to improve the outcomes of fall prevention programs.

Research Question: In elderly inpatient adults within an urban-acute care agency in the Midwestern United States, does hourly rounding of nursing staff protocol adoption as recommended by the geriatric-specific standard of care compared to the use of bedside alarms reduce the rate of falls in three months of implementation?Identification of a Practice Issue for EBP: Fall Prevention.

Introduction

Falls are considered to be a public healthcare concern across the world. In essence, fall risks increase with age and hospitalization and they result in injuries, illnesses, long hospital stays and increased treatment cos as well as morbidity and mortality. As such, falls are devastating to both clinicians and patients and the general healthcare system. Identification of a Practice Issue for EBP: Fall Prevention.This necessitates the development of an evidence-based intervention to help reduce and prevent falling particularly in the acute care settings where severe injuries, urgent medical conditions and surgical recoveries are actively treated. A gap in practice is evident from the increased number of fall rates in acute care setting. Hourly rounding of hospital staff presents significant potential to resolving falls in the hospital since it facilitates early identification of risks and enhances prevention before the falls occur(Linehan& Linehan, 2018).Identification of a Practice Issue for EBP: Fall Prevention.

Project question

In elderly inpatient adults within an urbanacute care agency in Midwestern United States, does hourly rounding of nursing staff protocol adoption as recommended by geriatric specific standard of care compared to the use of bedside alarms reducethe rate of falls in three months of implementation?Identification of a Practice Issue for EBP: Fall Prevention.

Salient elements

Behavior change theories are essential in the success of most evidence-based practices in nursing practice. They help in understanding why people practice or fail to practice health promoting behaviors, identify the needed information in designation of effective interventions as well as offer insights into designing a successful program(Tricco et al., 2016). In this case, the social learning / social cognitive behavior change theory is identified to inform the project question.

Social cognitive theory is associated with individual experiences, environmental factors and the actions of others and the impact on individual health behaviors. This theory was developed by Albert Bandura in 1960s as the social learning theory characterized by self-evaluation, self-observation, self-reaction and self-efficacy(Guirguis-Blake et al., 2018).This theory is informative to the practice in that it explains the importance of resources and support in raising self-efficacy in individual behaviors. It also notes that environmental changes encourage behavior change by providing opportunities, assisting changes, and offering social support(Tricco et al., 2017). It also helps to recognize the environmental constraints that might discourage changes in behavior. As such, this theory will support the organizational change and help the nurses to increase their self-efficacy levels in making the intervention a success(Bassett, Siu & Honaker, 2018). They will be able to develop positive attitudes towards hourly rounding and develop an intentional behavior focused on patient welfare.Identification of a Practice Issue for EBP: Fall Prevention.

Questions and concerns

The questions or concerns I may have related to project development include:

  • Will the hourly rounding of healthcare providers improve patient satisfaction?
  • What health or safety risks are associated with the intervention?
  • Does the intervention require an increased nursing staff level?
  • Does the nursing staff require education on how to conduct the hourly rounds? How effective will be the education and how will it be carried out if necessary?
  • What strategies should be put forward to enhance the active engagement and collaboration of patients and the nurses in the intervention to make it more purposeful?
  • What strategies will be developed to identify and recognize the concerns of both the nurses and the patients during the course of implementation of the hourly rounding intervention?Identification of a Practice Issue for EBP: Fall Prevention.

Conclusion

Falls are a major healthcare concern particularly due to the increasing aging population requiring acute care treatment. Hourly rounding of hospital staff is an effective intervention in reducing falls and the project seeks to employ behavior change theory to explore and adopt the change in acute care setting.Identification of a Practice Issue for EBP: Fall Prevention.

FALL PREVENTION

Application 1: Identification of a Practice Issue for the Evidence-Based Practice (EBP) Project (6 points)

 

To students: In addition to the Learning Resources and facilitated discussions provided each week, you are expected to integrate articles from peer-reviewed journals to inform and support your positions and conclusions in the Application Assignments. Graduate-level scholarship provides the foundation for your work and requires a higher level of evidence than lay references, such as the dictionary, Wikipedia, general Internet sites, nursing newspapers, expert opinion, and the like.Identification of a Practice Issue for EBP: Fall Prevention.

In a 1- to 2-page paper, address the following:

  • Provide a summary of the selected practice issue in which the outcome is different from what would be expected according to the research literature. (Note: The issue you select must be suitable for completing the entire EBP Project.) (6 pts)

 

Note: Up to 2 points may be deducted for grammar, spelling, and/or APA errors.

 

This Application is due by Day 7 of Week 2.

·         Writing Tip of the Month: Run-On Sentences and Sentence Fragments

 Run-on sentences and sentence fragments are often misunderstood, with some writers thinking of them simply as sentences that are too long or too short, respectively. Instead, these syntax errors result when necessary sentence components are missing or connected incorrectly, regardless of sentence length. Please take the time to review the rules for constructing a complete sentence to identify and avoid these types of errors.

 

 

·        Add a cover page (no running head).  include your name and the assignment title and include a Reference Page in APA format

·        it is BEST to always have a brief introduction and conclusion/summary paragraph to round out the paper.

·        Note: Up to 1 point may be deducted for grammar, spelling, and/or APA 7 errors.

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Falls Prevention

 

Assignment: Application 1: Identification of a Practice Issue for the Evidence-Based Practice (EBP) Assignment

In many of the courses in the DNP program, you have been asked to analyze research literature when exploring issues in health care. Reflect now on an issue in your practice area that has different outcomes from what is supported by the literature. For example, the literature evidence notes that nosocomial infections are reduced when procedures such as hand washing, glove use, and isolation strategies are implemented. In your clinical area, you have implemented these strategies and you are not seeing a reduction in nosocomial infections.Identification of a Practice Issue for EBP: Fall Prevention.

For Application 1, you select an issue that will serve as the launching point for your Evidence-Based Practice (EBP) Assignment.

Before you proceed with this assignment, you may wish to review the overview of the full EBP Assignment.

To prepare for Application 1:

  • Consider the specifics of your practicum setting, as well as practice-related challenges in your specialty area that interest you. Brainstorm practice issues in which an outcome is different from what would be expected according to the research literature.
  • Select one issue to focus on for this assignment. This will be your issue for the entire EBP Assignment, so be sure it is one that will enable you to fulfill the project requirements (e.g., you can develop new approaches to practice). You may wish to speak with your Practicum Mentor about your selection.
  • Explore the research literature on this issue.

To complete:

In a 1- to 2-page paper, address the following:

  • Provide a summary of the selected practice issue in which the outcome is different from what would be expected according to the research literature. (Note:The issue you select must be suitable for completing the entire EBP Assignment.)Identification of a Practice Issue for EBP: Fall Prevention.