NRS 433 PICOT Question and Literature Search Essay
NRS 433 PICOT Question and Literature Search Essay
NRS 433 PICOT Question and Literature Search Essay
NRS 433 PICOT Question and Literature Search Sample
Literature Evaluation Table
Student Name:
Nursing Practice Problem (200-250 words):
Patient falls occurring in healthcare facilities, especially in inpatient settings, are a major patient safety concern because of their adverse effects on patient care and quality outcomes. Patient falls lead to increased cost of care, longer stays in hospitals and affect the overall quality outcomes. As a core part of healthcare providers’ team, nurses should develop and use evidence-based practice (EBP) interventions to reduce their occurrence through empowering patients, especially by raising awareness of their susceptibility to falls. The Centers for Disease Control and Prevention (CDC) asserts that falls constitute a serious patient safety risk and lowers the ability of the affected patients, especially older patients in inpatient settings, to attain autonomy and conduct self-care as proposed by Orem’s self-care deficit theory. For instance, statistics by CDC asserts that an estimated 36,000 deaths occur each year associated with falls among elderly patients. Yet another 3 million visit emergency departments due to experiencing falls. Because they are preventable, the Centers for Medicare and Medicaid Services, based on its value-based purchase model, does not consider falls as events that require reimbursement since they are not only preventable but also manageable using evidence-based practice (EBP) strategies like patient-centered education and awareness (Vincenzo et al., 2022). As part of tailoring interventions for patient safety (TIPS) patient education helps providers and patients to reduce the prevalence and susceptibility of falls and falling (Dykes et al., 2023). The purpose of this paper is to evaluate existing literature that supports the proposed EBP project on reducing falls in inpatient settings through patient education and awareness. The paper reviews qualitative and quantitative articles and demonstrates their significance to the PICOT question or framework.
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PICOT Question
Among patients in inpatient settings (P), does patient education and empowerment (I) compared to normal safety measures (C), reduce and eliminate falls by 50% and related impacts (O) within three months (T)?
| Criteria | Article 1 | Article 2 | Article 3 |
| APA-formatted article citation with permalink | Dabkowski, E., Cooper, S. J., Duncan, J. R., & Missen, K. (2022). Exploring Hospital Inpatients’ Awareness of Their Falls Risk: A Qualitative Exploratory Study. International journal of environmental research and public health, 20(1), 454.
https:// doi.org/10.3390/ijerph20010454 |
Heng, H., Slade, S. C., Jazayeri, D., Jones, C., Hill, A. M., Kiegaldie, D., … & Morris, M. E. (2021). Patient perspectives on hospital falls prevention education. Frontiers in Public Health, 9, 592440. DOI: 10.3389/fpubh.2021.592440 | Heng, H., Kiegaldie, D., Slade, S. C., Jazayeri, D., Shaw, L., Knight, M., … & Morris, M. E. (2022). Healthcare professional perspectives on barriers and enablers to falls prevention education: A qualitative study. Plos one, 17(4), e0266797.
https://doi.org/10.1371/journal.pone.0266797 |
| How does the article relate to the PICOT question? | The article relates to the PICOT as it focuses on enhancing patient’s understanding of their risks to falls and thus the need for education and awareness to empower them to take control and reduce their vulnerability to falls. | The article relates to the PICOT question by demonstrating that the proposed intervention, patient education and empowerment, can help reduce the risk of falls in any setting, especially primary setting. | The article relates to the PICOT as it emphasizes the critical role of providers in understanding barriers and facilitators of patient education to prevent falls. The article emphasizes the need for education and ensuring that all providers help patients to get sufficient knowledge and awareness. |
| Is the article qualitative, quantitative, or mixed methods?
Justify your selection. |
Qualitative
The article is an exploratory qualitative study. Exploratory studies are by design qualitative because they seek experiences and perceptions of the participants to the phenomenon under investigation |
Qualitative
The article is qualitative based on the method that it employs, focus groups and its aim as it explores patient perspectives and preferences concerning falls prevention education |
Qualitative
The study used semi-structured focus groups comprising nurses and allied health professionals. |
| Purpose statement | The aim of the study was to explore perceptions and experiences among patients about their understanding of inherent risks to falls. | The purpose of the study was to comprehend the perspectives and preferences of inpatients about falls prevention education. | The purpose of the study was to get enhanced understanding of health professional views and experiences of falls education |
| Research question(s) | What are the impact of perceptions and experiences of patients on understanding of their risks for falls in public rural and regional hospitals in Australia? | While the study does not demonstrate research questions or question, a possible one would be;
What are patients’ perspectives and preferences on falls prevention education? |
The research question was:
What are the views and experiences of health professionals on nursing education? |
| Outcome(s) | Falls education is essential and should be consistent to empower patients to adjust to clinical changes and conditions; either temporarily or permanently. | The outcomes demonstrate that most patients were not aware of their risks of falling while in the inpatient facility or setting. Their experiences were not consistent and poor patient knowledge was a key barrier to having information on their risks of falling | The outcomes entails barriers and facilitators in providing patient falls education in hospitals, especially among inpatients. These barriers and facilitators formed the core part of findings and subsequent recommendations. |
| Setting
(Where did the study take place?) |
Public regional and rural hospitals in Victoria Australia. | The study occurred in inpatient facility of two hospitals belonging to the one private health network. | Three large hospitals in Australia that included one acute setting and two rehabilitation facilities |
| Sample | 18 participants aged 40 years and above | The sample consisted of 11 participants from a potential list of 33 individuals | The sample comprised 23 participants who were placed in focus groups. |
| Method | Qualitative exploratory design or method | Focus groups | The study used focus groups |
| Key findings of the study and implications for nursing practice | The key findings in this article is that giving patient education empowers them to understand their inherent risk to falls. Secondly, it ensures that they have sufficient strategies to prevent any risks and possible adverse events associated with falls.
The implications of the study for nursing practice entail having sufficient patient education and empowerment strategies to reduce and prevent the occurrence of falls |
The findings were categorized under themes based on the analysis of data. The researchers found that a majority of patients had limited knowledge and different experiences related to falls. Falls prevention education offered in inpatient settings increased their capability and knowledge for self-care.
The study has significant implications for nursing practice that include developing of patient-centered approaches to fall prevention among providers and healthcare facilities |
The authors found barriers and facilitators to patient falls prevention education. The barriers were ineffective communication among providers, perceived patient-associated barriers to falls education, and sub-optimal systems to offer enhanced education. The facilitators included implanting strategies to enhance patient engagement and empowerment, access to effective modes of patient education, and having inter-professional collaboration. |
| Recommendations of the researcher | The researcher recommends the need for continuous and consistent fall prevention education and awareness to help patients and their families manage them effectively. | The researchers recommend the provision of patient education as a critical component of reducing and preventing patient falls, especially a patient-centered multi-factorial model appeared as the most effective and appropriate. | The authors recommended that fostering collective responsibility among the professionals and overcoming related barriers to falls education is critical to improving perception and experiences of healthcare professionals to reduce falls. |
| Criteria | Article 4 | Article 5 | Article 6 |
| APA-formatted article citation with permalink | Duckworth, M., Adelman, J., Belategui, K., Feliciano, Z., Jackson, E., Khasnabish, S., … & Dykes, P. C. (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. DOI: 10.2196/10008 | Severo, I. M., Kuchenbecker, R. D. S., Vieira, D. F. V. B., Lucena, A. D. F., & Almeida, M. D. A. (2018). Risk factors for fall occurrence in hospitalized adult patients: a case-control study. Revista latino-americana de enfermagem, 26, e3016. DOI: 10.1590/1518-8345.2460.3016 | Montejano-Lozoya, R., Miguel-Montoya, I., Gea-Caballero, V., Mármol-López, M. I., Ruíz-Hontangas, A., & Ortí-Lucas, R. (2020). Impact of nurses’ intervention in the prevention of falls in hospitalized patients. International Journal of Environmental Research and Public Health, 17(17), 6048. DOI: 10.3390/ijerph17176048. |
| How does the article relate to the PICOT question? | The article relates to the PICOT by demonstrating the effectiveness of patient education and empowerment through the engagement | The article relates to the PICOT as it shows that offering interventions like patient education reduces possible risk factors for occurrence of falls among hospitalized patients | The article relates to the PICOT question as it shows that education intervention should also target healthcare providers, especially nurses to prevent the occurrence of patient falls. |
| Is the article qualitative, quantitative, or mixed methods?
Justify your selection. |
Quantitative
The article used quantitative approaches in collecting and analyzing data from the study. |
Quantitative
The article is quantitative as it deploys case-control design |
Quantitative
The article is a quasi-experimental trial and this makes it a quantitative approach. |
| Purpose statement | The primary purpose of this article was to evaluate the effectiveness of engaging patients as part of a three-step fall prevention strategy. | The purpose of the study was to identify risk factors for falls among adult inpatients in Brazilian hospitals. | The purpose of the study was to evaluate the effects of an educational intervention focused on hospital nurses in reducing the prevalence of falls. |
| Research question(s) | Does the use of Fall TIPS impact patient engagement based on a 3-steo fall prevention process? | What are the risk factors for falls among hospitalized patients? | What is the effects of an education intervention for nurses in reducing patient falls? |
| Outcome(s) | . The outcomes from the study demonstrate that engaging patients is critical to implementing effective tailored interventions for patient safety (TIPS) in reducing falls among inpatients. | The outcomes show that fall prevention risks are varied and patients require sufficient knowledge and awareness on their occurrence through effective education. The study asserts that understanding the risk factors helps providers to make better clinical decisions and influence patient safety. | The educational intervention reduced the overall incidence of falls based on the intervention group. The control group has increased probability of patient falls. |
| Setting
(Where did the study take place?) |
The setting for the study comprised health facilities in Boston and New York. | The setting consisted 12 clinical and surgical units in an 843-bed capacity health care facility. | The setting was a level three hospital in Spain. |
| Sample | Nurses were the sample at the selected sites for the study. | The sample comprised 358 clinical and surgical patients | The sample comprised 581 patients with average age of 68.3 years. |
| Method | Three modalities including laminated Fall TIPS poster, electronic fall TIPS poster and paperless patient safety sheets at the bed side. | The method used was observational case-control design | The researchers used a quasi-experimental method. |
| Key findings of the study and implications for nursing practice | The findings are categorical that Fall TIPS, including the engagement of patients through their education are essential to reduce the susceptibility of patients.
The article’s implications to nursing practice include increased engagement of patients to improve their perceptions and acceptance of fall prevention approaches |
The article identified a host of risk factors that include confusion and disorientation, frequent urination, walking difficulties and limitations, not having a caregiver, and the number of medications administered within three days before the occurrence of falls.
The implications of the article for nursing practice include tailoring education and awareness intervention to patient needs and status, ensuring effective understanding of possible personal limitations, and engaging patients to take significant role in fall prevention. |
The intervention, an education program, reduced the fall incidences. The findings also demonstrate that patients aged over 65 years were more susceptible to falls. Nurses should have sufficient knowledge about such facts so that they develop tailored interventions to reduce susceptibility to falls.
The article has significant implications for nursing practice and healthcare system in general. Firstly, it shows that nurses need knowledge to effectively empower and education patients about their risk for falls. Secondly, education is a core part of having sufficient information on patient falls, especially based on one’s setting. |
| Recommendations of the researcher | The researchers recommend more studies to evaluate the effectiveness of patient engagement and safety attributes to reduce falls in inpatient settings | The researchers recommend the need for nurses to have sufficient evidence to identify the risk of falling among patients and implement best preventive interventions, including patient education and empowerment so that they understand their inherent susceptibility to falls. | The researchers recommend preparing nurses to understand and carry out systematic risk evaluations based on their knowledge and expertise to empower patients and prevent their susceptibility to falls in all settings. |
Conclusion
Patient falls remain a critical patient safety issue that should be addressed by all stakeholders, especially nurses and physicians. The use of education and empowerment of patients will help patients manage their situations and reduce their susceptibility to falls as it will help in identifying inherent risks to falls. The intervention also requires effective participation of nurses through their own education sessions before they can develop relevant interventions for nurses to reduce and prevent falls.
References
Centers for Disease Control and Prevention (CDC) (2023). Older Adult Fall Prevention. https://www.cdc.gov/falls/index.html
Dykes, P. C., Curtin-Bowen, M., Lipsitz, S., Franz, C., Adelman, J., Adkison, L., … & Bates, D. W. (2023, January). Cost of inpatient
falls and cost-benefit analysis of implementation of an evidence-based fall prevention program. JAMA health forum, 4(1): e225125-e225125). DOI:10.1001/jamahealthforum.2022.5125
Vincenzo, J. L., Patton, S. K., Lefler, L. L., McElfish, P. A., Wei, J., & Curran, G. M. (2022). A qualitative study of older adults’
facilitators, barriers, and cues to action to engage in falls prevention using health belief model constructs. Archives of gerontology and geriatrics, 99, 104610. https://doi.org/10.1016/j.archger.2021.104610
References
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PICOT Question and Literature Search
The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.
For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.
Use the “Literature Evaluation Table” to complete this assignment.
Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
The PICOT question will provide a framework for your capstone project.
Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.
Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.
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.
