Approach To Fall Management In Clinical Settings Discussion

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Approach To Fall Management In Clinical Settings Discussion

Problem Statement (PICOT)

As the healthcare landscape continues to evolve, nurses play an increasingly vital role in driving evidence-based interventions that promote health and wellness. The first section of this final capstone project focuses on developing a problem statement using the problem-intervention-comparison-outcome-time (PICOT) approach to nursing research. The topic for this project is “An interdisciplinary approach to fall management in clinical settings,” with a focus on adult and geriatric populations receiving chemo and stem cell transplants in a medical surgical/oncology unit. The problem statement analyzes the need for this intervention, describes the target population and setting, provides an overview of the intervention, analyzes potential interprofessional alternatives, defines an initial outcome, and proposes a time frame for implementation. Additionally, a thorough literature review is conducted, analyzing several sources to validate the identified need and assess existing health policies that could impact the intervention approach. This project is designed to encourage critical thinking about nursing research and its impact on patient outcomes, while also developing practical skills in proposal writing and research analysis Approach To Fall Management In Clinical Settings Discussion.

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Problem Statement

Need Statement 

The need for an interdisciplinary approach to fall management in clinical settings is a critical health promotion and quality improvement concern for adult and geriatric populations receiving chemo and stem cell transplants in a medical surgical/oncology unit. Falls are a major safety issue in healthcare facilities, and this population is particularly vulnerable due to their compromised physical condition and high risk for falls. Addressing this need requires an evidence-based, collaborative approach that promotes fall prevention and management through effective communication, comprehensive assessments, and tailored interventions that support the individual needs of each patient.

Population and Setting

The target population for the identified need of is adult and geriatric patients receiving chemo and stem cell transplants in a medical surgical/oncology unit. This unit specializes in the care of patients undergoing complex medical procedures and treatments, which can lead to an increased risk of falls due to various factors, such as the use of mobility aids, the presence of medical devices, and compromised physical conditions. As a result, the need for a comprehensive fall prevention and management program is critical in this setting Approach To Fall Management In Clinical Settings Discussion.

Intervention Overview 

To address the identified need of an interdisciplinary approach to fall management, several interventions can be implemented in the target population and setting. One of the interventions is to implement a comprehensive fall prevention program that includes strategies such as patient education, regular assessment of fall risk, and the use of assistive devices. This program can be developed through collaboration among healthcare providers, and can include fall prevention protocols, patient-centered care plans, and ongoing evaluation and feedback. Another intervention is to enhance the physical environment of the unit by improving lighting, reducing clutter, and implementing measures such as bed alarms and non-skid footwear to prevent falls.

 

Comparison of Approaches

In addition to the initial interventions proposed, several other interprofessional alternatives can also help address the identified need for interdisciplinary fall management in clinical settings. These alternatives could include the implementation of interdisciplinary education programs for healthcare providers to improve their knowledge and skills in fall prevention and management. Additionally, providing patients with education and tools such as personalized fall risk assessments and safety checklists can be beneficial in reducing falls.

Initial Outcome Draft

The primary outcome of the proposed interventions is to reduce the incidence of falls among adult and geriatric patients in medical surgical/oncology units. By improving the interdisciplinary approach to fall management and implementing comprehensive fall prevention programs, patients will experience better health outcomes, and the quality of care will improve. This will also help to reduce the risk of injury and promote patient safety Approach To Fall Management In Clinical Settings Discussion.

Time Estimate

The development and implementation of the interventions will require a well-planned and coordinated effort. It is estimated that it will take approximately six months to develop and implement the interdisciplinary education program for healthcare providers. The physical environment improvements can be implemented in the short term, while the comprehensive fall prevention program may require a longer timeframe, such as one year, for full implementation.

Literature Review

The need for an interdisciplinary approach to fall management in clinical settings has been extensively discussed in the nursing literature. According to LeLaurin & Shorr (2019)Approach To Fall Management In Clinical Settings Discussion, falls are the most common adverse event in hospitals and represent a significant burden on patients and healthcare providers. Furthermore, the elderly and individuals with chronic conditions are at an increased risk of falls due to their weakened physical conditions. The study conducted by Morris et al. (2022) indicates that fall prevention interventions reduce the risk of falls among hospitalized patients. The authors conclude that implementing a comprehensive approach that includes fall risk assessment, tailored interventions, and staff education and training can reduce the incidence of falls in hospitalized patients.

The importance of implementing fall prevention programs in medical surgical/oncology units has also been emphasized in the literature. An observational study conducted by Abdelbasset et al. (2021) found that falls occurred frequently in oncology patients and that patients who fell were more likely to experience adverse outcomes such as hospital readmission and increased healthcare costs. The authors suggest that interdisciplinary approaches to fall prevention, such as using patient-centered care plans and improving the physical environment, can help prevent falls in this patient population.

Several interventions have been proposed to address the need for interdisciplinary fall management in clinical settings. One intervention is the implementation of patient education programs. The study conducted by Alipour et al. (2021) found that educating patients about fall prevention strategies, such as staying physically active and using assistive devices, reduced the incidence of falls in older adults. Another proposed intervention is the implementation of interdisciplinary education programs for healthcare providers. A systematic review conducted by Heng et al. (2020) found that staff education and training programs can improve healthcare provider knowledge and skills related to fall prevention and management. Approach To Fall Management In Clinical Settings Discussion

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In addition to the proposed interventions, several health policies could impact the approach taken to address the identified need. For example, the Centers for Medicare & Medicaid Services (CMS) implemented the Hospital-Acquired Condition (HAC) Reduction Program, which penalizes hospitals with high rates of falls and other adverse events (Chalmers et al., 2021). This policy incentivizes hospitals to prioritize fall prevention and management by implementing evidence-based interventions such as comprehensive fall prevention programs. Furthermore, the Agency for Healthcare Research and Quality has established National Patient Safety Goals (NPSGs) that address falls prevention (Agency for Healthcare Research and Quality, n.d). These NPSGs require healthcare organizations to implement evidence-based practices such as fall risk assessments and patient education programs to prevent falls. Tinetti et al. (2019) examined the effect of a multicomponent fall prevention intervention on hospital readmission rates among older adults. The study found that the intervention reduced the rate of readmissions by 17%, highlighting the importance of implementing evidence-based fall prevention programs in clinical settings. The authors also emphasized the role of healthcare policies in incentivizing healthcare providers to prioritize fall prevention and management. Another study conducted by Yeung et al. (2018) evaluated the effectiveness of a nurse-led multidisciplinary fall prevention program in reducing falls among older adults in residential care homes. The study found that the intervention reduced the incidence of falls by 37%, highlighting the effectiveness of multidisciplinary fall prevention interventions. The authors also emphasized the importance of healthcare policies in supporting the implementation of evidence-based fall prevention programs in clinical settings. Carpenter et al. (2017) studied the effects of a fall prevention program on nursing home staff’s efficacy beliefs related to fall prevention. The study found that the intervention improved staff’s self-efficacy beliefs related to fall prevention, highlighting the importance of staff education and training in fall prevention. The authors also emphasized the role of healthcare policies in supporting staff education and training programs to improve healthcare provider knowledge and skills related to fall prevention and management.

In conclusion, falls are a significant safety concern for adult and geriatric patients receiving chemo and stem cell transplants in medical surgical/oncology units. A comprehensive interdisciplinary approach to fall management that includes patient education, staff education, tailored interventions, and environmental improvements is needed to reduce the incidence of falls in this population. The literature supports the effectiveness of fall prevention interventions and suggests that implementing these interventions can improve patient outcomes and reduce healthcare costs. Existing health policies such as the HAC Reduction Program and the NPSGs provide additional support for implementing evidence-based fall prevention interventions in healthcare settings.

References

Abdelbasset, W., Nambi, G., H Elsayed, S., M Osailan, A., & M Eid, M. (2021). Falls and potential therapeutic interventions among elderly and older adult patients with cancer: A systematic review. African Health Sciences, 21(4), 1776-83. https://doi.org/10.4314/ahs.v21i4.34

Agency for Healthcare Research and Quality. (n.d.). National Patient Safety Goals. PSNet. https://psnet.ahrq.gov/issue/national-patient-safety-goals

Alipour, V., Azami-Aghdash, S., Rezapour, A., Derakhshani, N., Ghiasi, A., Yusefzadeh, N., … & Amuzadeh, S. (2021). Cost-effectiveness of multifactorial interventions in preventing falls among elderly population: a systematic review. Bulletin of Emergency & Trauma, 9(4), 159. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8525694/

Carpenter, C. R., & Scheatzle, M. D. (2017). Effects of a Fall Prevention Program on Nursing Home Staff Efficacy Beliefs. Journal of the American Medical Directors Association, 18(5), 429–433. https://doi.org/10.1016/j.jamda.2016.12.024 Approach To Fall Management In Clinical Settings Discussion

Chalmers, K., Gopinath, V., Brownlee, S., Saini, V., & Elshaug, A. G. (2021). Adverse events and hospital-acquired conditions associated with potential low-value care in Medicare beneficiaries. JAMA Health Forum, 2(7), e211719. https://doi.org/10.1001/jamahealthforum.2021.1719

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

LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients. Clinics in Geriatric Medicine, 35(2), 273-283. https://doi.org/10.1016/j.cger.2019.01.007

Little, K. K. (2022). Developing a Standardized Process for an Effective, Evidence-Based Fall Management Program to Reduce Falls in a Nursing Home Setting.

Morris, M. E., Webster, K., Jones, C., Hill, A., Haines, T., McPhail, S., Kiegaldie, D., Slade, S., Jazayeri, D., Heng, H., Shorr, R., Carey, L., Barker, A., & Cameron, I. (2022). Interventions to reduce falls in hospitals: A systematic review and meta-analysis. Age and Ageing, 51(5). https://doi.org/10.1093/ageing/afac077 Approach To Fall Management In Clinical Settings Discussion

Tinetti, M. E., Kumar, C., & Zhang, Y. (2019). Effectiveness of a Multifactorial Intervention on Reducing Hospital Readmissions and Falls in High-Risk Older Adults: A Randomized Clinical Trial. JAMA Internal Medicine, 179(6), 774–782. https://doi.org/10.1001/jamainternmed.2018.8377

Yeung, P. Y., Kong, W. K., Chung, L. M. Y., & Chui, M. M. L. (2018). Nurse-led multidisciplinary fall prevention programme reduces falls among older adults in residential care homes. Journal of Clinical Nursing, 27(23–24), 4374–4384. https://doi.org/10.1111/jocn.14608

Guiding Questions

Problem Statement (PICOT)

This document is designed to give you questions to consider and additional guidance to help you successfully complete the Problem Statement (PICOT) assessment. You may find it useful to use this document as a pre-writing exercise, an outlining tool, or as a final check to ensure that you have sufficiently addressed all the grading criteria for this assessment. This document is a resource to help you complete the assessment. Do not turn in this document as your assessment submission.

Part 1: Problem Statement

Need Statement

Analyze a health promotion, quality improvement, prevention, education, or management need.
  • What type of need is your project trying to address?
  • Why is addressing this need important?
  • What are one or more key pieces of evidence that support the urgency of the need?

Population and Setting

Describe a target population and setting in which an identified need will be addressed.
  • What is the population you will be targeting with your project?
    • Why is it important to address your identified need within this population?
  • What is the setting you will be targeting with your project?
    • Why is it important to address your identified need and target population within this setting? Approach To Fall Management In Clinical Settings Discussion

Intervention Overview

Explain an overview of one or more interventions that would help address an identified need within a target population and setting.
  • What interventions could be applied to your identified need?
    • How well do the interventions fit your target population?
    • How well do the interventions fit your target setting?
    • How well do the interventions address your identified need?

 

Comparison of Approaches

Analyze potential interprofessional alternatives to an initial intervention overview with regard to their possibilities to meet the needs of the project, population, and setting.
  • Discuss one or more alternatives to the intervention(s) presented in your Intervention Overview.
    • How do the alternatives encourage interprofessional care approaches compared to the interventions in your overview?
    • How well do the alternatives fit your target population compared to the interventions in your overview?
    • How well do the alternatives fit your target setting compared to the interventions in your overview?
    • How well do the alternatives address your identified need compared to the interventions in your overview?

Initial Outcome Draft

Define an outcome that identifies the purpose and intended accomplishments of an intervention for a health promotion, quality improvement, prevention, education, or management need.
  • What is one outcome (or goal) that you want to achieve with your intervention and project?
    • How does this outcome illustrate the purpose of your intervention and project?
    • How does this outcome illustrate what you hope to accomplish with your intervention and project?
    • How does this outcome establish a framework that can be used to achieve an improvement in the quality, safety, or experience of care?

Time Estimate

Propose a rough time frame for the development and implementation of an intervention to address an identified need.
  • What is a rough time frame for developing your intervention?
    • Is this time frame realistic?
    • What potential challenges may impact this time frame?
  • What is a rough time frame for implementing your intervention?
    • Is this time frame realistic?
    • What potential challenges may impact this time frame? Approach To Fall Management In Clinical Settings Discussion

Part 2: Literature Review

Analyze current evidence to validate an identified need and its appropriateness within the target population and setting.
  • How does the evidence validate your identified need?
  • How does the evidence support the appropriateness of attempting to address your identified need within your target population?
  • How does the evidence support the appropriateness of attempting to address your identified need within your target setting?
Evaluate and synthesize resources from diverse sources illustrating existing health policy that could impact the approach taken to address an identified need.
  • What health policy exists that is relevant to your identified need?
    • How will this health policy impact the way to try to address your identified need?
      • In other words, are there considerations that you need to be sure you include or approaches that will be unavailable to you based on policy, as you continue to develop your project?
    • Remember: In this literature review you are expected to have addressed 10–15 unique resources.
Address Generally Throughout
Communicate problem statement and literature review in a way that helps the audience to understand the importance and validity of a proposed project.
  • Is your writing clear and professional?
  • Does your writing effectively communicate your problem statement?
  • Does your writing effectively communicate your literature review?
  • Is your writing free from errors?
  • Is your submission 5–9 pages?
  • Does your submission conform to current APA style standards?

Assessment 2 Instructions: Problem Statement (PICOT) Approach To Fall Management In Clinical Settings Discussion

Top of Form

Bottom of Form

  • Develop a 5-9 page problem statement that presents information related to the problem-intervention-comparison-outcome-time (PICOT) approach to nursing research.

You will also be required to submit your completed practicum hours using CORE ELMS. You must submit a minimum of 20 confirmed hours with each assessment deliverable to receive a grade for the entire assessment.

Introduction

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

For the first section of your final capstone project you will develop a proposal for an intervention plan to fulfill a need within a specific population. This assessment is meant to capture your initial thoughts about the need and impacting factors to help focus your in-depth analysis later on in the course.

First you will brainstorm and crystallize some of your ideas for this assessment, specifically ideas around needs, a target population, and some initial support from the literature and other sources of evidence. The problem statement is an important part of your capstone project as it will help illustrate the importance of your project, as well as help to clarify your project’s scope.

Preparations

    • Read Guiding Questions: Problem Statement (PICOT) [DOC]. This document is designed to give you questions to consider and additional guidance to help you successfully complete this assessment.
    • As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.
      • As you reflect on your work in the field, what population do you feel has the greatest need? Why? Is the need across the population, or within a specific setting?
      • What interventions already exist for the selected population? Are they effective? Why or why not?
      • How will site support from your practicum and your preceptor support your goals and objectives? Approach To Fall Management In Clinical Settings Discussion

Instructions

Note: The assessments in this course are sequenced in such a way as to help you build specific skills that you will use throughout your program. Complete the assessments in the order in which they are presented.

Your problem statement will focus on presenting information related to the problem-intervention-comparison-outcome-time (PICOT) approach to nursing research. You will also present a brief literature review that supports the need you identified in your problem statement and the appropriateness of your broad intervention approach. Provide enough detail so that the faculty member assessing your problem statement will be able to provide substantive feedback that you will be able to incorporate into the other project components in this course, as well as into the final draft of your project.

At minimum, be sure to address the bullet points below, as they correspond to the grading criteria. You may also want to read the scoring guide and the Guiding Questions: Problem Statement (PICOT) document (linked above) to better understand how each criterion will be assessed.

Reminder: these instructions are an outline. Your heading for this this section should be titled Problem Statement and not Part 1: Problem Statement.

Your Problem Statement (PICOT) should be structured as follows: Approach To Fall Management In Clinical Settings Discussion

PART 1: PROBLEM STATEMENT (2–3 PAGES)

Need Statement (1 paragraph).

    • Analyze a health promotion, quality improvement, prevention, education or management need.

Population and Setting (1–2 paragraphs).

    • Describe a target population and setting in which an identified need will be addressed.

Intervention Overview (1–2 paragraphs).

    • Explain an overview of one or more interventions that would help address an identified need within a target population and setting.

Comparison of Approaches (1–2 paragraphs).

    • Analyze potential interprofessional alternatives to an initial intervention with regard to their possibilities to meet the needs of the project, population, and setting.

Initial Outcome Draft (1 paragraph).

    • Define an outcome that identifies the purpose and intended accomplishments of an intervention for a health promotion, quality improvement, prevention, education, or management need.

Time Estimate (1 paragraph).

    • Propose a rough time frame for the development and implementation of an intervention to address and identified need.

PART 2: LITERATURE REVIEW (10–15 RESOURCES, 3–6 PAGES)

    • Analyze current evidence to validate an identified need and its appropriateness within the target population and setting.
    • Evaluate and synthesize resource from diverse sources illustrating existing health policy that could impact the approach taken to address an identified need. Approach To Fall Management In Clinical Settings Discussion

ADDRESS GENERALLY THROUGHOUT

    • Communicate problem statement and literature review in way that helps the audience understand the importance and validity of a proposed project.

Practicum Hours Submission

You have been tracking your completed practicum hours each week using the CORE ELMS. By placing the hours into CORE ELMS, you will ensure you are accumulating all hours that are needed to meet the requirements for your specialization and degree.

Submit your CORE ELMS practicum hours tracking log showing a minimum of 20 confirmed hours per assessment. Reminder: Only confirmed hours will be considered for grading.

You will not receive a grade for this assessment without a practicum hours log showing a minimum of 20 confirmed hours for the time period of this assessment. Your faculty will review your hours to date and will contact you if he or she has any questions or concerns.

Additional Requirements

    • Length of submission: 5–9 double-spaced pages.
    • Number of resources: 10–15 resources. (Your final project summation will require 12–18 unique sources across all sections.)
    • Written communication: Written communication is free of errors that detract from the overall message.
    • APA formatting: Resources and citations are formatted according to current APA style. Header formatting follows current APA levels.
    • Font and font size: Times New Roman, 12 point. Approach To Fall Management In Clinical Settings Discussion

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Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

    • Competency 1: Lead organizational change to improve the experience of care, population health, and professional work life while decreasing cost of care.
      • Explain an overview of one or more interventions that would help drive quality improvement related to an identified need within a target population and setting.
    • Competency 2: Evaluate the best available evidence for use in clinical and organizational decision making.
      • Analyze a health promotion, quality improvement, prevention, education, or management need.
      • Analyze current evidence to validate an identified need and its appropriateness within the target population and setting.
    • Competency 3: Apply quality improvement methods to impact patient, population, and systems outcomes.
      • Describe a quality improvement method that could impact a patient, population, or systems outcome.
    • Competency 4: Design patient- and population-centered care to improve health outcomes.
      • Propose a rough time frame for the development and implementation of an intervention to address an identified need.
    • Competency 5: Integrate interprofessional care to improve safety and quality and to decrease cost of care.
      • Analyze potential interprofessional alternatives to an initial intervention with regard to their possibilities to meet the needs of the project, population, and setting.
    • Competency 6: Evaluate the ability of existing and emerging information, communication, and health care technologies to improve safety and quality and to decrease cost.
      • Evaluate and synthesize resources from diverse sources illustrating existing health policy, health care technologies, or other communications that could impact the approach taken to address an identified need.
    • Competency 7: Defend health policy that improves the experience of care, population health, and professional work life while decreasing cost of care.
      • Define an outcome that identifies the purpose and intended accomplishments of an intervention for a health promotion, quality improvement, prevention, education, or management need.

Note: You will also be assessed on two additional criteria unaligned to a course competency:

    • Communicate problem statement and literature review in a way that helps the audience to understand the importance and validity of a proposed project.
    • Demonstrate completion of hours toward the practicum experience.

See the scoring guide for specific grading criteria related to these additional requirements Approach To Fall Management In Clinical Settings Discussion