NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

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Capella university

NURS-FPX 8030 Evidence-Based Practice Process for the Nursing Doctoral Learner

Prof. Name

Date

Critical Appraisal of Evidence-Based Literature

Patient fall among older adults is a severe patient safety concern that poses a significant impact on patient outcomes. In-patient falls harm patients due to severe injuries and fractures and increases medical care costs due to additional care and prolonged hospitalization, resulting in economic strain (Mikos et al., 2021). Elderly patient falls in the acute setting of Henry Ford Hospital (HFH) are also a serious issue and have serious implications. Heikkilä et al. (2024), exhibited that inpatient falls contribute to prolonged hospital stays and patient injuries, impacting patient recovery and resource usage. This assessment is based on a critical review of the literature, focusing on patient fall issues.

PICO(T) Question

The PICO(T) question regarding patient safety issues of patient falls guiding this research is: In an acute care unit, would a standard patient fall prevention bundle, in comparison to current prevention practices, lower fall incidences in elderly adults within 12 weeks? This PICO(T) research question intends to examine whether executing a fall prevention bundle can mitigate patient fall incidents among elderly patients. It deals with hospitalized elderly patients in an acute setting. It compares a standard fall prevention bundle to current preventative efforts to assess its impact on minimizing elderly patients’ falls over 12 weeks. The fall prevention bundle entails approaches like risk evaluation, staff and patient education, environment adjustments, and the use of supportive devices.

Thesis Statement

The study states that deploying an established fall prevention bundle in the acute care setting will result in a significant decrease in fall rates among older patients over 12 weeks, improving patient safety and healthcare outcomes. It also positively affects organizational performance and reputation. The thesis underlines the significance of evidence-based approaches in inpatient fall avoidance and the necessity for an evaluation to impact medical policies and care practices successfully.

Critical Appraisal and Selection of Tool

The selected articles will be assessed through the Joanna Briggs Institute (JBI) critical appraisal checklist for systematic reviews and research syntheses. This tool evaluates the methodical integrity and reliability. It is ideal for a variety of intervention studies usually employed in patient fall prevention research. The objective of this appraisal is to evaluate a study’s methodical excellence and establish how well it has handled the bias in the planning, conduct, and evaluation.

The JBI tool contains criteria like the conciseness of the research topic, inclusion criteria, the study design viability, resilience of the data gathering approach, quality evaluation, the reliability and accuracy of the findings, and publication prejudices (Munn et al., 2012). This extensive approach ensures an adequate assessment of the study’s shortcomings and strengths. The JBI tool was selected because it offers an extensive framework for reviewing peer-reviewed studies, which are common in inpatient fall prevention research. This ensures that the evidence is pertinent and credible.

Annotated Bibliography

Strini, V., Schiavolin, R., & Prendin, A. (2021). Fall risk assessment scales: A systematic literature review. Nursing Reports, 11(2), 430-443. https://doi.org/10.3390/nursrep11020041

The authors undertook a systematic literature review on the fall risk evaluation scale used in medical settings. The study’s reliability is evident in its robust search method, including numerous databases like MEDLINE, The Cochrane Database, and CINHAL and presenting precise exclusion and inclusion criteria. The inclusion criteria include the last 10 years’ articles, abstracts, and Italian or English languages. The authors offer an extensive overview of their data extraction strategy to ensure integrity and reproducibility.

Scholar evidence for the study’s credibility comes from its compliance with standards for systematic reviews, as shown by predefined search terms like “fall risk assessment tool” and data collection methods. Using the JBI critical appraisal checklist, this research demonstrates credibility and quality in several aspects, like a clear definition of its research question: Analysis of fall risk assessment tools present in the literature. It offers reliable data gathering and evaluation methods and an extensive summary of the literature on fall risk assessment tools.

NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

The study concentrates on fall risk evaluation tools, and their significance to patient safety stems from their wider implications for mitigating the risk of harm from falls among hospitalized patients by adequate screening. The article contributes to the literature and supports patient safety by aiding in improved interventions to avoid elderly patient falls by exploring the fear of falling of patients and other factors. Offering extensive tools like the Johns Hopkins Fall Risk Assessment Tool (JHFRAT) to assess the fall risk among elderly patients in the acute care setting boosts care practices.

Morris, M. E., Webster, K., Jones, C., Hill, A. M., 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), 77. https://doi.org/10.1093/ageing/afac077

The study presented a meta-analysis and systematic review of interventions to avoid patient falls in a hospital setting. The study stands out for its systematic approach, as evidenced by its extensive literature search technique and detailed data collection methodology. The authors thoroughly disclose their eligibility criteria and systemic methods for analyzing intervention evidence, promising clarity and reliability. Scholarly endorsement of the study’s rigorousness includes compliance with known systematic review guidelines, such as the Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and the use of crucial keywords.

NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

Using the JBI critical appraisal checklist, the article shows its excellence in various aspects, such as explicitly stating its aim and research question, which is the impact of fall avoidance strategies on fall outcomes. It utilizes thorough gathering and analyzing of data methods, assesses bias, and provides solid findings for conclusions. This paper is critically pertinent to the problem of inpatient falls because it explores the prevalence of fall rates. It offers evidence-based interventions such as education, wearable sensors, alarms, environmental modifications, and risk evaluation tools, which are critical for efficient fall prevention. Adding to the systematic and meta-analysis literature on intervention reviews promotes the adoption of research-based interventions to minimize inpatient falls among older patients and improves patient safety and care standards.

Parsons, R., Blythe, R. D., Cramb, S. M., & McPhail, S. M. (2023). Inpatient fall prediction models: A scoping review. Gerontology, 69(1), 14-29. https://doi.org/10.1159/000525727

The study presented a scoping review based on a methodological approach that explored inpatient fall prediction models with machine learning. The study is significant for its extensive and systematic method, as demonstrated by its thorough research technique, which included databases such as PubMed, IEEE Xplore, CINAHL, and EMBASE, and thorough data collection procedures. The authors rigorously disclose their inclusion criteria and methodologies for analyzing data on inpatient fall risk models, assuring integrity and accuracy. Scholarly support for the study’s thoroughness includes following recognized principles for systematic reviews, as demonstrated by the use of methods recommended by the O’Malley and Arksey framework.

NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

Using the JBI critical appraisal checklist, the paper displays high standards in multiple areas, including a well-defined research topic, study design, robust data gathering and evaluation approaches, and strong evidence supporting its findings. This article is pertinent to the concern of inpatient falls because understanding the inpatient fall prediction model is essential for establishing efficient fall prevention methods. For instance, fall prediction models are based on patient evaluations that entail signs of physical health or cognitive skills. Providing the literature on fall avoidance reviews helps stakeholders execute proven strategies to reduce fall rates, which improves patient safety and medical outcomes.

Odasso, M. M., Kamkar, N., Pieruccini-Faria, F., Osman, A., Sarquis-Adamson, Y., Close, J., & Kobusingye, O. (2021). Evaluation of clinical practice guidelines on fall prevention and management for older adults: A systematic review. JAMA Network Open, 4(12), e2138911-e2138911. https://doi.org/10.1001/jamanetworkopen.2021.38911

The authors conducted a systematic review to assess best practices for fall avoidance and management in older patients in acute care settings. The study demonstrates superior quality through its rigorous strategy for literature choices, which includes several databases such as MEDLINE, PubMed, and PsycINFO and uses specified criteria for inclusion. The authors offer thorough information regarding data collection using the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) tool, ensuring clarity. Scholastic support for the research’s reliability comes from its conformity to standards for systematic reviews, like the PRISMA guidelines, as indicated by the robust data-gathering strategies.

NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

Implementing the JBI Critical Review Checklist, the paper displays high standards in several domains: it explicitly states its research aims, uses data gathering and analytic methods, and provides an extensive evaluation framework, such as evaluation scores, for evaluating findings. The paper focuses on clinical guidelines for avoiding falls; its significance to patient safety stems from the ability to enhance medical procedures. It entails assessing risk, gait analysis, fracture management, multimodal interventions, environment adjustment, and correcting footwear. It contributes to the literature to comprehend clinical guidelines for fall avoidance and patient safety by fostering improved medical services that lower patient fall occurrences and boost outcomes.

Giovannini, S., Brau, F., Galluzzo, V., Santagada, D. A., Loreti, C., Biscotti, L., & Bernabei, R. (2022). Falls among older adults: Screening, identification, rehabilitation, and management. Applied Sciences, 12(15), 7934. https://doi.org/10.3390/app12157934

The article presents an extensive narrative assessment of fall-related risk factors, recognizing risks, avoidance and management, and highlighting rehabilitation techniques. The study illustrates high quality due to its stated research objectives, structured approach to literature search, and extensive data analysis. For example, the authors used the Scale for Assessment of Narrative Review Articles (SANRA) standards to evaluate quality. Scholarly justification for the study can be exhibited by the narrative explanation of their methodology, which adheres to the JBI Criteria.

NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

Utilizing the JBI Critical Evaluation Checklist, this paper is clear, reproducible, and credible. It successfully compensates for bias using established inclusion criteria and a strong data source and research method. This article is pertinent to the inpatient fall issue because it emphasizes fall epidemiology, risk factors (cognitive incapacity, medication effect, gait abnormalities), and management (physical activity) in reducing fall rates. Adding to the literature promotes the execution of inpatient fall prevention techniques that can be customized to various medical facilities, lowering the incidence of patient falls and improving safety for patients.

Interventions Used to Improve or Solve the Patient Safety Problem

Various evidence-based strategies can efficiently resolve the patient safety problem of falls among elderly patients, which is caused by insufficient fall prevention measures for patients in hospitals. First, introducing comprehensive fall mitigation intervention, including environmental modifications, the use of assistive devices, and rigorous risk assessment, can significantly decrease fall events in hospital settings (Heng et al., 2020). Secondly, offering training and education to clinicians and patients about the risks of falls and management approaches to avoid fall incidents.

It improves abilities to manage patients and mitigate fall rates (Heng et al., 2020). These interventions comply with best practices suggested by organizations like the Centers for Disease Control and Prevention (CDC) through the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) program and The Joint Commission emphasizing the significance of patient risk analysis, patient and clinician education and safe environment to mitigate the risk of patient fall (CDC, 2024).

Thirdly, technological interventions like video monitoring, wearable sensors, and alarms can enhance the efficacy of fall prevention bundles by providing real-time feedback to medical staff and allowing them to respond promptly to inpatient falls. These systems use sensors to monitor patient movement and provide swift notifications to staff when a patient tries to move or get out of bed, causing fall risk (Park et al., 2020). Hospitals can improve patient safety by integrating evidence-based fall prevention interventions with innovative tools.

Summary

Resolving the patient safety issue of inpatient falls using proven strategies is critical to enhancing medical care and patient outcomes. Medical facilities, such as HFH, can implement successful methods to decline the frequency of elderly patient falls and improve patient safety by critically reviewing the literature and adopting interventions based on robust evidence. Hospitals can mitigate patient falls and create safer conditions by implementing an extensive fall avoidance bundle that includes education, environmental adaptation, risk analysis, and the adoption of cutting-edge technology. Medical facilities can improve patient safety and enhance medical services and quality by focusing on evidence-based procedures and continuously reviewing and refining fall avoidance interventions.

References

CDC. (2024).  STEADI – Older adult fall prevention. cdc.gov. https://www.cdc.gov/steadi/about/index.html

Giovannini, S., Brau, F., Galluzzo, V., Santagada, D. A., Loreti, C., Biscotti, L., & Bernabei, R. (2022). Falls among older adults: Screening, identification, rehabilitation, and management. Applied Sciences, 12(15), 7934. https://doi.org/10.3390/app12157934 

NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

Heikkilä, A., Lehtonen, L., & Junttila, K. (2024). Consequences of inpatient falls in acute care: a retrospective register study. Journal of Patient Safety, 20(5), 340-344. https://doi.org/10.1097/PTS.0000000000001230

Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A. M., & Morris, M. E. (2020). Hospital falls prevention with patient education: A scoping review. BioMed Central Geriatrics, 20, 1-12. https://doi.org/10.1186/s12877-020-01515-w

Mikos, M., Banas, T., Czerw, A., Banas, B., Strzępek, L., & Curyło, M. (2021). Hospital inpatient falls across clinical departments. International Journal of Environmental Research and Public Health/International Journal of Environmental Research and Public Health, 18(15), 8167–8167. https://doi.org/10.3390/ijerph18158167

Morris, M. E., Webster, K., Jones, C., Hill, A. M., 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), 77. https://doi.org/10.1093/ageing/afac077

Munn, Z., Barker, T. H., Moola, S., Tufanaru, C., Stern, C., McArthur, A., & Aromataris, E. (2020). Methodological quality of case series studies: An introduction to the JBI critical appraisal tool. JBI Evidence Synthesis, 18(10), 2127-2133. https://doi.org/10.11124/jbisrir-d-19-00099

Odasso, M. M., Kamkar, N., Pieruccini-Faria, F., Osman, A., Sarquis-Adamson, Y., Close, J., & Kobusingye, O. (2021). Evaluation of clinical practice guidelines on fall prevention and management for older adults: A systematic review. JAMA Network Open, 4(12), e2138911-e2138911. https://doi.org/10.1001/jamanetworkopen.2021.38911

Park, M. O., Doan, T., Dohle, C., Vermiglio-Kohn, V., & Abdou, A. (2020). Technology utilization in fall prevention. American Journal of Physical Medicine & Rehabilitation, 100(1), 92–99. https://doi.org/10.1097/phm.0000000000001554

NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

Parsons, R., Blythe, R. D., Cramb, S. M., & McPhail, S. M. (2023). Inpatient fall prediction models: A scoping review. Gerontology, 69(1), 14-29. https://doi.org/10.1159/000525727

Strini, V., Schiavolin, R., & Prendin, A. (2021). Fall risk assessment scales: A systematic literature review. Nursing Reports, 11(2), 430-443. https://doi.org/10.3390/nursrep11020041

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