Professional Capstone and Practicum.

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Professional Capstone and Practicum.

 

In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. The ability to articulate research data and summarize relevant content supports the student\’s ability to further develop and synthesize the assignments that constitute the components of the capstone project. The assignment will be used to develop a written implementation plan.Professional Capstone and Practicum.

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For this assignment, provide a synopsis of the review of the research literature. Using the \”Literature Evaluation Table,\” determine the level and strength of the evidence for each of the eight research articles you have selected. The articles should be current (within the last 5 years) and closely relate to the PICOT question developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project.Professional Capstone and Practicum. While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation 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.Professional Capstone and Practicum.

Literature Evaluation Table

Student Name:

Change Topic (2-3 sentences):hospital falls remain a debilitating problem globally. In-patient hospital falls lead to injuries, prolonged hospital stays, and increased hospital costs. Most fall prevention strategies focus on staff education, environmental modifications, and organization systems and the role that patients play in falls prevention. Therefore, investigating the role of the patient in preventing falls is crucial. The following is the identified PICOT question.Professional Capstone and Practicum.

Among hospitalized patients (P), does patient engagement and education (I) compared to other strategies (C), prevent the occurrence of patient falls (O)?

 

 

Criteria Article 1 Article 2 Article 3 Article 4
Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

 

 Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A., & Morris, M. (2020). Hospital falls prevention with patient education: a scoping review. BMC Geriatrics, 20(1). https://doi.org/10.1186/s12877-020-01515-w

 

 Lopez-Jeng, C., & Eberth, S. (2019). Improving Hospital Safety Culture for Falls Prevention Through Interdisciplinary Health Education. Health Promotion Practice, 152483991984033. https://doi.org/10.1177/1524839919840337 Johnson, K., Scholar, H., Stinson, K., NEA-BC, Sherry Razo, M., & NEA-BC. (2020). Patient fall risk and prevention strategies among acute care hospitals. Applied Nursing Research, 51, 151188. https://doi.org/10.1016/j.apnr.2019.151188 Vonnes, C., & Wolf, D. (2017). Fall risk and prevention agreement: engaging patients and families with a partnership for patient safety. BMJ Open Quality, 6(2), e000038. https://doi.org/10.1136/bmjoq-2017-000038
Article Title and Year Published

 

 Hospital falls prevention with patient education: a scoping review.

 

 

 

 

 

Published in 2020.

 Improving Hospital Safety Culture for Falls Prevention Through Interdisciplinary Health Education.

 

 

 

 

 

Published in 2019.

 Patient fall risk and prevention strategies among acute care hospitals.

 

 

 

 

 

 

 

Published in 2020.

 Fall risk and prevention agreement: engaging patients and families with a partnership for patient safety.

 

 

Published in 2017.
Research Questions (Qualitative)/Hypothesis (Quantitative)

 

 “What are the findings of current literature regarding patient falls prevention education in hospitals?”

 

A systematic quantitative review.

 The authors do not state the research questions.

They can be inferred from the study’s objective.

 How reliable and valid are fall risk prevention strategies in hospitals? Including patientsand their families is vital in fall prevention.
Purposes/Aim of the Study To conduct a current search on interventions to prevent patient falls relating to patient education, critique the design of patient education programs in hospitals, and find and appraise measures of evaluating changes in patient falls. The study aimed to determine the impact of improving hospital safety culture and interdisciplinary health education on fall prevention. To evaluate the dependability and validity of three fall risk and prevention data collection instruments. The study aimed to explore whether initiating a Fall Prevention Agreement between the

nursing team and older adults minimized the incidence of patient falls.
Design (Type of Quantitative, or Type of Qualitative)

 

 Literature review design.

Joanna Briggs Institute and

PRISMA-ScR guidelines.

 Pre and post-intervention. Mixed methods design. The Fall Prevention Agreement was developed by the

Patient Education Team consisting of a master’s degree

prepared RNs.
Setting/Sample

 

 Forty-three articles were analyzed. Health practitioners comprised the sample. 28-bed medical-surgical (M3) unit at Scottsdale Thompson Peak Medical Center.

The sample comprised unit-level and patient-level data for inpatients on the M3 unit.

 Master’s degree-prepared nurses comprised the sample in this study.
Methods: Intervention/Instruments

 

 Searching existing literature.

 

Direct face-to-face patient education about fall risks and mitigation, education tools, patient-focused customer materials, and fall prevention policies.

 

 The authors worked together with an interdisciplinary team of health practitioners to develop a health education program tailored to assess patient falls. Three tools were used for data acquisition.

 

Direct patient-level risk and prevention inventory observation tool, Unit Leadership Instrument, and Hospital Leadership Instrument.

 The intervention was the introduction of a fall reduction and safety plan,

the Fall Risk and Prevention Agreement after hospitalization.

Morse Fall Scoring system was used to communicate patient risk for falls.
Analysis

 

 The modified quality metric tool appraised the quality of patient education programs. The AHRQ Hospital Survey analyzed the collected data. Intra-class correlations were used to determine if the data collection instruments

were reliable and valid across settings.

 Mean scores measured injury and fall rates.
Key Findings

 

 The final analysis constituted 43 articles.

These studies assessed patient falls or education-related outcomes before and after falls education program implementation.

It was reported that the education programs were of low to moderate quality. However, they were effective in preventing patient falls.

 

 The researchers revealed that the program increased participant knowledge, motivations, and attitudes for fall prevention. Twenty-eight patients were directly observed. Nurses strongly agreed that beds were locked, lights were within reach, and ambulatory services were accessible from the bed. Patients were also provided with a fall reduction education program.

Nurses agreed that fall prevention strategies were consistently used for high-risk patients. However, post-fall huddles and floor mats were not frequently used.

Nurses also revealed that hospital leadership supported fall prevention strategies.

 The rates of falls and injuries were compared two-quarters before implementing the fall agreement and eight quarters. In the oncology unit, both injuries and falls had reduced by 37 and 58.6 percent, respectively.
Recommendations

 

 The researchers propose that well-designed educational programs should be implemented to empower patients to participate in fall prevention. The researchers suggest that individual-level change is effective in promoting patient safety at the organizational level. A greater understanding of factors limiting the implementation of fall prevention strategies is required. The authors recommend that additional studies, including multivariate analyses, are required to evaluate whether supporting evidence associates fall reduction with patient and family agreement.
Explanation of How the Article Supports EBP/Capstone Project

 

 This study supports the EBP project by underscoring patient education to be efficient in preventing patient falls. This study supports the Capstone by highlighting patient education and engagement as effective in fall prevention. The study supports the change project by proving that patient-centered strategies are effective for fall prevention. The article supports the capstone project by highlighting that patient and family agreement effectively minimizes patient falls.
Criteria Article 5 Article 6 Article 7 Article 8
Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

 

  

Duckworth, M., Adelman, J., Belategui, K., Feliciano, Z., Jackson, E., & Khasnabish, S. et al. (2019). 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 Study. Journal Of Medical Internet Research, 21(1), e10008. https://doi.org/10.2196/10008

 Hill, A., McPhail, S., Francis-Coad, J., Waldron, N., Etherton-Beer, C., & Flicker, L. et al. (2015). Educators’ perspectives about how older hospital patients can engage in a falls prevention education programme: a qualitative process evaluation. BMJ Open, 5(12), e009780. https://doi.org/10.1136/bmjopen-2015-009780 Barker, A., Cameron, P., Flicker, L., Arendts, G., Brand, C., & Etherton-Beer, C. et al. (2019). Evaluation of RESPOND, a patient-centered program to prevent falls in older people presenting to the emergency department with a fall: A randomized controlled trial. PLOS Medicine, 16(5), e1002807. https://doi.org/10.1371/journal.pmed.1002807 Hill, A., McPhail, S., Haines, T., Morris, M., Etherton-Beer, C., & Shorr, R. et al. (2019). Falls After Hospital Discharge: A Randomized Clinical Trial of Individualized Multimodal Falls Prevention Education. The Journals Of Gerontology: Series A, 74(9), 1511-1517. https://doi.org/10.1093/gerona/glz026
Article Title and Year Published

 

 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 Study.

 

 

Published in 2017.

 Educators’ perspectives about how older hospital patients can engage in a falls prevention education programme: a qualitative process evaluation.

 

 

 

 

 

 

 

 

 

 

 

Published in 2015.

 Evaluation of RESPOND, a patient-centered program to prevent falls in older people presenting to the emergency department with a fall: A randomized controlled trial.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Published in 2019.

 Falls After Hospital Discharge: A Randomized Clinical Trial of Individualized Multimodal Falls Prevention Education

 

 

 

 

 

 

 

 

 

 

 

 

 

Published in 2019.
Research Questions (Qualitative)/Hypothesis (Quantitative)

 

 Fall TIPS modality impacts patient engagement and consequent fall reduction. Research questions not explicitly stated. Research questions not stated. They can, however, be implied from the study’s purpose. Research questions are not stated.
Purposes/Aim of the Study To explore whether the Fall TIPS modality influences patient engagement in the 3-step fall prevention process and thus Fall TIPS efficacy. To explore the educators’ perspectives concerning the delivery of after Recovery patient education program on rehabilitation units and to hypothesize their views on the effectiveness of the program in fall reduction. The study aimed to evaluate whether a 6-month telephone-based patient-centered program—RESPOND—had an impact on falls and fall injuries in older people visiting the ED after a fall. This research aim was to assess the impact of individualized patient fall education in addition to usual care for falls in older patients post-discharge.
Design (Type of Quantitative, or Type of Qualitative)

 

 Random audits with the question

‘Does the patient/family member know their fall prevention plan?

 Qualitative exploratory design. Randomized controlled trials. A randomized controlled trial.
Setting/Sample

 

 Brigham and Women’s Hospital (Boston, MA, USA), Montefiore Medical Center (MMC; Bronx, NY, USA), and NewYork-Presbyterian Hospital (Manhattan, NY, USA). Physiotherapists trained as educators comprised of the sample.

The settings of the study were n eight aged care rehabilitation hospital

units in Western Australia.

 Two Emergency departments in Australia.

The sample comprised of patients presenting to the emergency department after a fall.

 The setting as three hospitals in Australia.

 

The sample comprised patients above 60 years admitted for rehabilitation.
Methods: Intervention/Instruments

 

 The three modalities used werelaminated Fall TIPS poster, electronic Fall TIPS poster, and the paperless patient safety bedside display. Data were obtained from three sources; interviews of focus groups, educators’ notes, and reflective researcher field notes. Participants were randomized to receive either

RESPOND (intervention) or usual care (control).

The RESPOND clinician delivered the intervention.

Patients were provided patient-centered training on patient falls.

 

 Patients were randomized to intervention and control groups.

The primary intervention was providing tailored education comprising of video and workbook as well as structured discussions.
Analysis

 

 Tools used for data analysis are not highlighted. Two independent researchers analyzed the obtained data.

Thematic analyses were used for qualitative data.

 A priori sample size calculation was performed.

Intention-to-treat- analyses were used.

 All analyses were performed using Stata 15 (Stata Statistical

Software, College Station, TX: StataCorp LLC) and following

Intention-to-treat principles.

X2 tests conducted group comparisons.

 
Key Findings

 

 1209 units were submitted to measure patient engagement and 1401 to Fall TIPS posters at the bedside.

Overall, all units achieved 80 percent compliance.

Some patients showed high levels of patient engagement while others improved over time.

 Education on fall prevention contributed to a common understanding between patients and staff.

This allowed patients to partake in fall prevention strategies.

The educators believed that they promoted staff-patient interaction. U ultimately, this contributed behavior change on the wards.

 430 patients were included in the final analysis. The mean age of participants was 73 years; 55% were female.

 

Falls per person-year were 1.15 in theRESPOND group and 1.83 in the control group.

 

 

 

 

 

 

There was no notable difference in fall injuries with the control group.

 

 

 

 The study had a total of 382 participants.

378 falls were reported by participants, six months after discharge.

 

 

 

 

 

 

 

 

No significant differences were noted in the fall rates for intervention and control groups.
Recommendations

 

 The 3 Fall TIPS modalities are effective in fall reduction. Individualized fall prevention education is effective when supported by both patients and staff. The authors recommend that incorporating patient-centered strategies in routine clinical practices for falls prevention reduces falls for patients attending the emergency department. The authors suggest that additional research is necessary to determine strategies for reducing falls during the high-risk transition period.
Explanation of How the Article Supports EBP/Capstone

 

 The article supports the Capstone by identifying patient engagement as a crucial tool for falls reduction. The article aligns with the identified Picot question. It proves that patient engagement is a crucial aspect of fall prevention education. This study concludes that patient engagement and education are effective in fall prevention. The study supports the PICOT question by highlighting that patient education is crucial in falls prevention.