NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

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Capella university

NURS-FPX 8045 Doctoral Writing and Professional Practice

Prof. Name

Date

Synthesis of Evidence Substantiating a Practice Gap

Gaps in healthcare practices are defined as a difference between current operations and evidence-based best practices, highlighting areas where knowledge, skills, or system improvements are needed. Cass Regional Medical Center (CRMC) also identified a similar practice gap associated with a lack of communication regarding patient risk for falling across the care teams. A research study by Howick et al. (2024) has identified that communication represents one of the key elements to facilitate the quality of care and avoid patient safety risks in the hospital context. The literature review supports the practice gap and the interventions, majoring in interprofessional communication and collaboration to reduce fall rates in the healthcare setting. 

Identification of Scholarly Articles

Several research works have been carried out to support the identified clinical practice that there is no communication among the care teams regarding fall risk in CRMC. For example, Albertini and Peduzzi (2024) describe the need for interdisciplinary processes, underscoring the value of communication between the staff and patients or caregivers and staff-staff communication for fall risk reduction.

Baumann et al. (2022) state that interprofessional collaboration is vital to avoid fall incidents; the special focus is to develop standardized communication documents. The article supports the practice gap of poor communication protocols in the CRMC, increasing in-patient fall incidents. Garcia et al. (2021) added elements related to communication and cooperation with other professionals. Effective communication is essential as miscommunication can compromise patient safety, particularly regarding fall-risk safety.

Lakbala et al. (2024) identified that about 18% of fall events are related to staff and communication factors, which supports the practice gap of lack of team communication for fall risk assessment. According to Singh et al. (2020), communication is an effective element of policies and procedures that relate to care before and after falls occur. The article supports the argument that there should be proper communication practices in healthcare settings to avoid fall incidents, which is not seen in CRMC as the practice gaps indicate a lack of communication among team members. These literature studies emphasize the need to enhance communication between different professions to affect the fall episodes in CRMC.

Critical Review of Selected Articles

Communication failures regarding patient fall risk among healthcare teams have been identified as a critical practice gap contributing to poor adherence to fall prevention strategies in CRMC. This gap is prevalent across hospital departments, where interprofessional collaboration and effective role delineation are necessary to improve patient safety. Addressing this requires understanding the dynamics of interprofessional communication and implementing targeted interventions to strengthen cooperation. This critical review examines five recent studies to explore the need for effective communication in hospital settings to prevent patient safety, particularly regarding in-patient falls.

A major part of the problem of falls in healthcare facilities can be solved by focusing on communication. In the article, Albertini and Peduzzi (2024) have highlighted that enhancing collaborative practices is crucial to improve fall prevention in hospital inpatient units; health professionals need to develop collaborative competencies defined as the interprofessional communication and interaction between the providers and the patients/caregivers. The qualitative exploratory and descriptive research aims to identify healthcare professionals’ attitudes toward fall prevention.

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

The authors employed two focus groups with healthcare professionals and used thematic content analysis according to the framework of Canadian interprofessional competencies. The framework emphasizes the need for professionals to develop competencies for effective teamwork, including team communication, which is critical for improving fall prevention outcomes in hospital care. The study was chosen because it fits the outlined practice gap and demonstrates that better communication among healthcare teams, patients, and caregivers is crucial for fall prevention. According to the Johns Hopkins model, the evidence by Albertini and Peduzzi (2024) is level III, which means using data from research and clinical experience to make decisions in patient care.

Interprofessional collaboration is another aspect of health facilities that maintains patient safety and prevents falls. The article under discussion by Baumann et al. (2022) is devoted to different aspects of interprofessional collaboration, emphasizing communication. The authors endorse implementing formalized means of information exchange, including using plain language and standardized registration forms to share the key fall risk information with the care team members. The study employed semi-structured interviews collected from September 2016 to March 2017 through individual calls and one focus group discussion.

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Through this research design, the authors assessed the experiences and views of the healthcare providers. Based on the Johns Hopkins evidence appraisal tool, the Baumann et al. (2022) evidence is at Level III. A good qualitative study that gives useful information about healthcare providers’ views: still, selecting participants and nonprobability sampling is the study’s weakness. The research revealed that the fall rates can be prevented through interprofessional training and better communication instruments. This article could help the project by providing reminders of the need for interprofessional communication and the need for continued, adequately funded fall prevention across care teams.

Gauging nurses’ perceptions of the status of fall prevention plans within the healthcare context is crucial to gaining frontline insights. The rapid review of Garcia et al. (2021) summarizes the current literature on nurses’ attitudes to barriers and enablers of fall prevention interventions. The study aims to understand how nurses perceive recommended fall prevention measures and the challenges to their implementation.

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

A narrative review of 10 studies with no formal quality assessment shows that preventing falls is moderated by several factors, including communication and collaboration. Garcia and colleagues support the identified practice gap in CRMC, which is the absence of communication that affects fall prevention among the care team. The article is on level V according to the Johns Hopkins appraisal tool. The results indicate that to prevent falls, it is necessary to develop unique approaches to address the communication barriers and other aspects. The article could inform the project by emphasizing the importance of interprofessional communication in addressing the identified fall risk communication practice gap.

The communication factors are still highlighted in the fall incidences. Lakbala et al. (2024) discuss the causes of inpatient falls and methods of their reduction using Root-cause Analysis (RCA) in healthcare facilities. The study aims to explore the risk factors for inpatient falls and the prevention strategies. A narrative review approach, using a systematic search of articles published from January 2005 to March 2023 in various databases. The data analysis employed a five-stage framework, revealing that 18% of the studies reported staff and communication factors related to fall rates.

According to the Johns Hopkins appraisal tool, the study would be given a Level V, which means moderate quality evidence. The results suggest that patient-related, environmental, organizational, and communication solutions should be considered to prevent falls. The findings from Lakbala et al. (2024) can be used to enhance the understanding and management of falls in CRMC, especially by using systematic RCA and addressing communication-related aspects of fall risk safety to address the practice gap of communication failures among care teams. 

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Falling is a major risk among patients with spinal cord injury (SCI). Therefore, Singh et al. (2020) discuss the current fall prevention and management policies in Canadian rehabilitation hospitals and reveal disparities in the policies’ application. The study compared and contrasted the fall prevention and management policies and practices of 6 tertiary care rehabilitation hospitals in Canada. The research used document analysis to review policies and procedures from these hospitals, categorizing them into pre-fall, post-fall, and communication practices.

This article emphasizes the importance of communication as one of the pre-fall and post-fall strategies. The study affirms the need for proper communication practices in health facilities to prevent fall-related mishaps. Based on the appraisal tool by Johns Hopkins, the study was assessed as Level IV based on clinical practice guidelines. The implications are that timely communication and planned fall prevention strategies are critical in advancing patient safety and quality. The article could be used to develop specific, evidence-based protocols and communication approaches that could be used to fill the practice deficiency in the CRMC environment.

Research Synthesis Using MEAL Plan

The five articles’ synthesis substantiates the practice gap regarding communication failures regarding fall risk among healthcare teams at Cass Regional Medical Center (CRMC). This practice gap impacts the fall prevention strategies at the center, resulting in increased inpatient fall rates. Albertini and Peduzzi (2024) emphasize that enhancing interprofessional communication and collaborative practices is critical to improving fall prevention in hospital inpatient units.

Baumann et al. (2022) emphasize that effective interprofessional collaboration and formalized communication tools, such as standardized forms and plain language, can reduce fall rates in healthcare settings. Garcia et al. (2021) highlight that nurses face communication and collaboration barriers in implementing fall prevention measures, emphasizing the need for tailored interprofessional communication strategies to reduce fall risks effectively. 

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

The study by Lakbala et al. (2024) identifies inpatient falls as a multifactorial issue, emphasizing communication-related factors impeding prevention efforts. Singh et al. (2020) reviewed fall prevention and management policies, highlighting disparities and emphasizing the role of communication in pre-fall and post-fall strategies to improve safety. This research underscores the need to adapt interventions to specific patient populations to ensure the standardization of communication practices across CRMC departments.

Unanswered questions include how communication-specific interventions directly impact fall rates and which tailored communication strategies are most effective for different inpatient populations. Further research is needed to explore optimal methods for integrating interprofessional communication tools into diverse healthcare environments and the long-term sustainability of communication-driven fall prevention programs.

Writing Feedback

Integrating feedback on writing skills assists writers in enhancing the quality of assessments to encourage a proper flow and easy readability. Prior feedback noted organization, grammatical accuracy, clear and formal style, and APA compliance. The feedback focused on adequately citing current and relevant literature, highlighting a writer’s ideas. Nonetheless, the development of the writers in terms of critical synthesis to increase the cohesiveness of ideas across source materials could be done.

To improve this skill, writers may write more connected arguments by discovering relationships between the sources and the themes. Employing such structures as the MEAL plan may help them improve their synthesis skills. The resources will include academic writing workshops, a writing guide on advanced synthesis techniques, and access to a writing center. Both seeking peer reviews and self-editing exercises will also contribute to the improvement of writers’ academic writing confidence and skills.

Conclusion

The literature synthesis reveals a lack of effective communication regarding fall-risk management among Cass Regional Medical Center (CRMC) teams. The evidence as a whole underscores the value of spreading and improving interprofessional communication to address the issue of inpatient falls. The studies encourage the development of specific fall communication approaches to address the underlying collaboration issues that hinder the prevention of falls. Such results point to the fact that to improve fall prevention and increase the level of patient safety, CRMC must implement evidence-based, standardized communication interventions.

References

Albertini, A. C. da S., & Peduzzi, M. (2024). Interprofessional approach to fall prevention in hospital care. Revista Da Escola de Enfermagem Da USP, 58. https://doi.org/10.1590/1980-220X-REEUSP-2023-0239en

Baumann, I., Wieber, F., Volken, T., Rüesch, P., & Glässel, A. (2022). Interprofessional collaboration in fall prevention: Insights from a qualitative study. International Journal of Environmental Research and Public Health, 19(17), 10477. https://doi.org/10.3390/ijerph191710477 

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment

Garcia, A., Bjarnadottir, R. (Raga) I., Keenan, G. M., & Macieira, T. G. R. (2021). Nurses’ perceptions of recommended fall prevention strategies. Journal of Nursing Care Quality, Publish Ahead of Print(3). https://doi.org/10.1097/ncq.0000000000000605 

Howick, J., Bennett-Weston, A., Solomon, J., Nockels, K., Bostock, J., & Keshtkar, L. (2024). How does communication affect patient safety? Protocol for a systematic review and logic model. BMJ Open, 14(5). https://doi.org/10.1136/bmjopen-2024-085312

Lakbala, P., Bordbar, N., & Fakhri, Y. (2024). Root cause analysis and strategies for reducing falls among inpatients in healthcare facilities: A narrative review. Health Science Reports, 7(7). https://doi.org/10.1002/hsr2.2216

Singh, H., Flett, H. M., Silver, M. P., Craven, B. C., Jaglal, S. B., & Musselman, K. E. (2020). Current state of fall prevention and management policies and procedures in Canadian spinal cord injury rehabilitation. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-05168-8

Citation	Conceptual Framework	Design/ Method	Sample/ Setting	Major Variables Studied and their Definitions	Measurement	Data Analysis	Findings	Appraisal: Worth to Practice
Albertini and Peduzzi (2024)	Canadian framework of interprofessional competencies – emphasizes teamwork and collaborative practice for fall prevention.	A qualitative exploratory and descriptive case study using thematic content analysis of focus group discussions.	Sample: Health professionals Participants met three inclusion criteria: working in the hospital for at least one year, experience in inpatient units, and involvement in fall prevention care. Setting: A hospital located in São Paulo, Brazil, with over 512 inpatient beds and multiple specialized units	Independent variables: Factors influencing fall prevention practices, such as interprofessional communication, role clarification, health education about fall risks, and continuing education for staff.  Dependent variable: Perception and experience of health professionals regarding fall prevention practices	Data was collected through focus groups analyzed using thematic content analysis. Themes were identified based on convergence between participants’ responses.	The study used Bardin’s thematic content analysis. Steps: Transcription, coding, subcategory development, and cross-analysis.	Teamwork and collaboration are critical for effective fall prevention. The study focuses on effective communication practices, role clarification, and ongoing education for staff.	Strengths: Value of interprofessional collaboration and continuing education for fall prevention.  Weaknesses: Limited generalizability due to the qualitative design and small sample size.  Ranking: Level III (Johns Hopkins Appraisal Tool).
Baumann et al. (2022)	Not discussed in the study. However, The study emphasizes interprofessional collaboration and communication strategies for preventing falls.	Qualitative study using semi-structured interviews and a focus group discussion.	Healthcare providers from various healthcare settings, including nursing and rehabilitation. Data was collected from individual calls and one focus group.	Interprofessional collaboration: Defined as communication and teamwork between healthcare professionals to prevent falls.	Semi-structured interviews and focus group discussions assess healthcare providers’ views on collaboration and fall prevention.	Thematic analysis of the interview and focus group data.	Effective communication, standardized forms, and interprofessional training are key to reducing fall rates. Using plain language and formalized communication tools improves the sharing of fall-risk information.	Strengths: Valuable insights into healthcare providers’ experiences on fall prevention strategies and interprofessional collaboration.  Weaknesses: Nonprobability sampling and selection bias, limiting generalizability Ranking: Level III (Johns Hopkins Evidence Appraisal Tool).
Garcia et al. (2021)	No formal, conceptual framework was identified; general themes of barriers and enablers in fall prevention.	A narrative review of 10 studies	Nurses working in healthcare settings	Barriers and enablers of fall prevention; Perceptions of nurses on recommended interventions	Literature review, no formal quality assessment	Thematic synthesis of 10 studies	Key barriers include a lack of communication and interprofessional collaboration. Nurses’ perceptions highlight challenges in implementing fall prevention strategies due to these factors.	Strengths: Comprehensive synthesis of studies on barriers in fall prevention relevant to healthcare settings;  Weaknesses: No formal quality assessment of included studies.  Ranking: Johns Hopkins Level V
Lakbala et al. (2024)	Root Cause Analysis (RCA) – a systematic method for investigating the underlying causes of patient falls and developing effective prevention strategies.	Narrative review, systematic search of articles published from January 2005 to March 2023 across multiple databases.	Literature from studies published within the specified date range; no specific sample or setting for review as it is a synthesis of existing research.	Patient-related factors, environmental factors, organizational and process factors, staff and communication factors. Communication issues were emphasized in 18% of studies related to falls.	Systematic search and review of articles related to inpatient fall; a five-stage framework for data analysis.	Data from various studies were analyzed using a five-stage framework analysis method to synthesize findings across studies.	The study found that 18% of inpatient falls were related to staff and communication factors, highlighting the importance of addressing these issues in fall prevention strategies. It also identified factors contributing to falls, including patient-related, environmental, and organizational aspects.	Strengths: Provides a comprehensive overview of fall prevention strategies and emphasizes the importance of communication in preventing falls.  Weaknesses: Lack of primary data collection, as it is a narrative review.  Ranking: Level V (Johns Hopkins appraisal tool).
Singh et al. (2020)	No specific conceptual framework was mentioned, but the focus on fall prevention and communication strategies is a guiding framework.	Document analysis of fall prevention/management policies and procedures at six Canadian tertiary rehabilitation hospitals.	Six tertiary care rehabilitation hospitals across five provinces in Canada.	Pre-fall policies: fall risk assessment and prevention strategies.  Post-fall policies: recovery, incident reporting, and classification.  Communication practices: ensuring effective communication among healthcare teams.	Review hospital policies, categorizing them into pre-fall, post-fall, and communication practices.	Content and thematic document analysis.	Identified disparities in fall prevention/management practices across hospitals. Emphasized the importance of communication in fall prevention and post-fall strategies.	Strengths: Offers practical insights into existing policies and the role of communication in fall prevention.  Weaknesses: Limited generalizability due to focus on specific hospitals.  Ranking: Level IV (Johns Hopkins appraisal tool).

NURS FPX 8045 Assessment 5 Nursing Project Proposal & Communication Assessment