NURS FPX 8045 Assessment 6 Synthesis of the Evidence: Substantiating an Intervention for Obesity

Name

Capella university

NURS-FPX 8045 Doctoral Writing and Professional Practice

Prof. Name

Date

Synthesis of Evidence Substantiating an Intervention

A practice gap discovered in Cass Regional Medical Center (CRMC) is poor communication regarding the patient’s fall risk among the care team. The gap exists within the inpatient and emergency departments. It leads to the failure to implement fall prevention strategies on time and increases patient safety risks. Addressing this issue is crucial to enhancing collaborative care and reducing fall incidents. 

Among the various interventions available, the TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) Toolkit has been chosen to fill this communication gap. TeamSTEPPS is an enhanced framework developed by the Agency for Healthcare Research and Quality (AHRQ) designed to improve team communication, foster teamwork, and enhance patient outcomes (AHRQ, n.d.). Through these tools, it will be easier for CRMC to improve care team collaboration to address any identified fall risk. The revised PICOT question is as follows: For nursing staff working in emergency and inpatient departments (P), how does implementing AHRQ’s TeamSTEPPS communication toolkit (I), compared to the current practice of no structured communication protocols (C), affect the rate of patient falls (O) within twelve weeks (T)?  

Critical Review of Literature

Identification of Literature 

In the CRMC, the TeamSTEPPS toolkit will be used to eliminate communication breakdowns in care delivery, especially regarding the issue of falls. Fifty charts were reviewed to understand current communication practices; it was acknowledged that there was no systematic way to enhance team communication and collaboration to enhance patient safety. Some literature reviews affirm using the TeamSTEPPS toolkit in improving patient safety, particularly in inpatient falls.

The five studies selected for this literature review are as follows. The article by Costar and Hall (2020) summarizes 20 studies on different interventions aimed at enhancing teamwork in hospital organizations and using the TeamSTEPPS toolkit, characterized by the maintenance of consistent communication and patient safety gains, for example, the reduction of fall rates. Cunha et al. (2021) examined the feasibility of using a TeamSTEPPS-based intervention for enhancing team communication strategies for fall prevention in elderly hospitalized patients.

It was found that decision-making in implementing individual preventive interventions and communication to prevent falls was improved. DM and Yuanasika (2023) also assessed the impact of TeamSTEPPS interventions on increasing teamwork, communication, and patient safety culture among healthcare workers. Hassan et al. (2024) examined the effectiveness of TeamSTEPPS training on newly graduated nurses. Particularly, findings emphasized the amalgamation of the TeamSTEPPS training into the nursing curriculum to foster better communication patterns and patient safety quality. Shi et al. (2024) showed that TeamSTEPPS helped enhance teamwork, safety activities, and clinical outcomes. The outcomes demonstrate that the program helps to improve the quality, safety, and staff communication in the healthcare setting.

Critical Review of Chosen Studies

The TeamSTEPPS toolkit is suggested to decrease the rates of falls in CRMC. Five articles from peer-reviewed journals provide evidence for using this toolkit to increase care team communication and collaboration, thus increasing patient safety and decreasing fall rates. The systematic review by Costar and Hall (2020) focuses on TeamSTEPPS interventions in healthcare to enhance teamwork and its effects on clinical outcomes. The study intended to establish the practices that facilitate teamwork and result in positive job changes. The study reviewed 20 articles using quasi-experimental designs in a variety of hospitals.

Although no specific theoretical framework was declared, the review identifies performance support tools such as checklists and team training programs created with the help of the AHRQ’s TeamSTEPPS toolkit as a key method. Based on the Johns Hopkins appraisal tool, the type of the study is Level II (Systematic review of quasi-experimental studies). Findings showed changes in teamwork, clinical processes, and patient safety regarding fall rates, which decreased in the post-intervention phase. The article by Costar and Hall (2020) supports implementing TeamSTEPPS intervention in the project as it encourages using checklists and other training programs to improve communication for fall prevention at CRMC.

NURS FPX 8045 Assessment 6 Synthesis of the Evidence: Substantiating an Intervention for Obesity

Cunha et al. (2021) assess the impact of a TeamSTEPPS®-based intervention on enhancing the health team practices and behaviors for preventing falls in hospitalized elderly patients. The purpose was to evaluate changes in team practices by training in communication, leadership, monitoring, and mutual support. A cross-sectional, parallel design with quantitative and qualitative data collection was used with nurses and nursing aides in a Portuguese hospital. The conceptual framework of TeamSTEPPS® guided the intervention and was structured around five key domains: training, communication, leadership, monitoring, and support between the formal and informal caregivers.

Johns Hopkins has classified this study as Level III (quasi-experimental with mixed methods). The study enumerated advancements in communication, decision-making, and better risk management, specifically preventing fall incidents. The study proves that CRMC can benefit from TeamSTEPPS® to improve teamwork, identify fall risk factors, and incorporate appropriate preventive measures for fall-risk patients.

DM & Yuanasika (2023) described the effects of TeamSTEPPS interventions on improving teamwork, communication, and safe patient care. The goal was to assess the impact of TeamSTEPPS with six studies from 2018 to 2023 using tools such as the Hospital Survey of Patient Safety Culture Questionnaire and the Patient’s Adverse Events Questionnaire. The study used quantitative methods to evaluate the frequency of interprofessional communication and safety culture changes. TeamSTEPPS conceptual foundation was used to enhance teamwork and communication.

NURS FPX 8045 Assessment 6 Synthesis of the Evidence: Substantiating an Intervention for Obesity

According to Johns Hopkins, the evidence is Level III, non-experimental, systematic reviews. The study revealed enhanced coordination, collaboration, and communication among healthcare delivery system practitioners. DM and Yuanasika (2023) show that CRMC should incorporate TeamSTEPPS into the fall prevention program to enhance sustainable communication plans and team dynamics. Hassan et al. (2024) evaluated the perception of newly graduated nurses on teamwork and patient safety culture before and after the implementation of TeamSTEPPS. The purpose was to assess the impact of TeamSTEPPS on improving teamwork and safety culture using a pretest-posttest quasi-experimental study of 132 nurses. The theoretical foundations for the training are based on TeamSTEPPS, a teamwork and communication tool.

The study was considered Level II according to the evidence hierarchy of Johns Hopkins, which included experimental studies. Research results showed positive changes in the nurses’ attitude toward teamwork and patient safety, with a large effect size to evaluate the effectiveness of TeamSTEPPS in enhancing teamwork and safety culture perceptions. Hassan et al. (2024) reinforce that CRMC should incorporate strategies into the nursing training, especially for staff nurses new to the health organization and patients’ safety culture.

NURS FPX 8045 Assessment 6 Synthesis of the Evidence: Substantiating an Intervention for Obesity

In the article under discussion, Shi et al. (2024) assess the effect of TeamSTEPPS on patient safety and healthcare delivery in a hospital facility. The objective was to evaluate the impact of TeamSTEPPS on patient safety. Quantitative data were compared to pre-and post-TeamSTEPPS intervention. The theoretical foundation for the study is TeamSTEPPS, which focuses on team communication. Findings revealed that the evidence-based TeamSTEPPS program effectively integrates clinical practice with teamwork skills to improve team performance in healthcare, enhancing medical quality, safety, and overall effectiveness. The study is critically appraised as Level II evidence from Johns Hopkins and reveals improvements in safety and teamwork. To increase understanding and awareness of TeamSTEPPS, this article can help CRMC improve team dynamics and safety and decrease fall rates of high-risk patient populations.

Synthesis of Literature Using MEAL Plan

Introducing the TeamSTEPPS toolkit as an evidence-based intervention for improving care team communication, teamwork, and patient safety by AHRQ should be used in CRMC’s fall prevention project. The integration of the five articles is as follows. TeamSTEPPS promotes increased interprofessional coordination and clinical practice measures using guides such as checklists, leadership development, and support (Costar & Hall, 2020). The program has enhanced ways of recognizing high-risk patients for falls, the decision-making process, and applying strategies to prevent fall accidents among hospitalized patients (Cunha et al., 2021).

Another article points out its efficiency in developing a safety culture, especially with newly graduated nurses, by enhancing perceptions of teamwork and risk (Hassan et al., 2024). Combining clinical activities with communication solutions has been useful for lowering adverse events such as fall rates and improving safety culture in healthcare organizations (Shi et al., 2024). TeamSTEPPS is efficacious for enhancing internal communication between the teams and patient safety, emphasizing reducing the falling rates.

Evaluating the Quality of Evidence

The collected evidence focuses on the strong methods of systematic reviews and quasi-experimental study designs, which show that training with TeamSTEPPS raises teamwork, communication, and patient safety outcomes. Almost all the research focuses on tangible objectives such as decreasing fall incidences, developing a strong safety culture, and improving teamwork, which guarantees relevance to practice. However, some limitations include the small sample sizes analyzed, the use of survivor bias in data collection, and the short duration of follow-up in some cases, thereby restricting the generality of the findings.

Altogether, the evidence is of high quality and points to the effectiveness of TeamSTEPPS as an intervention, although there needs to be more studies on the long-term effects. More research has to be done on implementing TeamSTEPPS in different types of healthcare organizations and dealing with the issues related to newly graduated or high turnover staff. As for supplementary approaches of TeamSTEPPS, other interventions are inclined to focus on simulation-based team training. Some questions remain unanswered: how best can the implementation of the solution be continued and sustained? Further studies must address its proper adoption and implementation in current practice.

Conclusion

In conclusion, the TeamSTEPPS intervention demonstrates strong potential for improving teamwork, communication, and patient safety, particularly reducing fall rates. The TeamSTEPPS intervention effectively enhances safety culture and team dynamics in healthcare settings, supported by evidence from systematic reviews and quasi-experimental studies. While the literature highlights its success, gaps remain in long-term sustainability and adaptation across diverse environments. Additional research and exploration of complementary strategies, such as simulation-based training, could further strengthen its implementation. Integrating TeamSTEPPS into practice at CRMC offers a promising approach to addressing fall prevention and fostering a safer, more collaborative care environment for patients and staff.

References

AHRQ. (n.d.). TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety). Www.ahrq.gov. https://www.ahrq.gov/teamstepps-program/index.html

Costar, D. M., & Hall, K. K. (2020). Improving team performance and patient safety on the job through team training and performance support tools: A systematic review. Journal of Patient Safety, 16(3), S48–S56. https://doi.org/10.1097/pts.0000000000000746 

NURS FPX 8045 Assessment 6 Synthesis of the Evidence: Substantiating an Intervention for Obesity

Cunha, L. F. C. da, Baixinho, C. L., Henriques, M. A., Sousa, L. M. M., & Dixe, M. dos A. (2021). Evaluation of the effectiveness of an intervention in a health team to prevent falls in hospitalized elderly people. Revista Da Escola de Enfermagem Da USP, 55. https://doi.org/10.1590/s1980-220×2019031403695 

DM, R. R., & Yuanasika, D. (2023). Team effectiveness intervention using TeamSTEPPS in healthcare: A literature review. Jurnal Aisyah: Jurnal Ilmu Kesehatan, 8(3). http://dx.doi.org/10.30604/jika.v8i3.2199 

Hassan, A. E., Mohammed, F. A., Zakaria, A. M., & Ibrahim, I. A. (2024). Evaluating the effect of TeamSTEPPS on teamwork perceptions and patient safety culture among newly graduated nurses. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-01850-y 

Shi, Y., Miao, S., Fu, Y., Sun, C., Wang, H., & Zhai, X. (2024). TeamSTEPPS improves patient safety. BMJ Open Quality, 13(2), e002669–e002669. https://doi.org/10.1136/bmjoq-2023-002669 

Appendix

 

Citation Conceptual Framework Design/Method Sample/Setting Major Variables Studied and their Definition Measurement Data Analysis Findings Appraisal: Worth to Practice (Strength, Weakness, Evidence Level) Costar and Hall (2020) TeamSTEPPS Toolkit Systematic Review (Quasi-Experimental Studies) 20 articles across hospitals Teamwork, clinical outcomes, fall rates Checklists, TeamSTEPPS program Synthesis of studies Improved teamwork, reduced fall rates Strength: Comprehensive, well-supported by data; Weakness: No clear theoretical framework; Evidence Level: II Cunha et al. (2021) TeamSTEPPS® Quasi-Experimental Study, Mixed Methods Nurses, nursing aides, Portuguese hospital Team practices, behaviors, communication, leadership TeamSTEPPS training program Quantitative & qualitative Enhanced communication, leadership, fall prevention Strength: Clear conceptual framework; Weakness: Limited sample size; Evidence Level: III DM and Yuanasika (2023) TeamSTEPPS Systematic Review 6 studies from 2018-2023 Communication, patient safety culture, teamwork TeamSTEPPS tools (Survey, Questionnaires) Synthesis of studies Improved communication, better safety culture Strength: Extensive review; Weakness: Non-experimental; Evidence Level: III Hassan et al. (2024) TeamSTEPPS Pretest-Posttest Quasi-Experimental Study 132 nurses, hospital Teamwork perceptions, safety culture TeamSTEPPS Teamwork Perceptions Questionnaire Statistical analysis (effect size) Significant improvement in teamwork & safety culture Strength: Large sample, clear results; Weakness: Pretest-posttest design limitations; Evidence Level: II Shi et al. (2024) TeamSTEPPS Pretest-Posttest Quasi-Experimental Study Hospital setting Patient safety, teamwork, medical quality Quantitative data comparison (pre-post) Statistical analysis Improved team performance, patient safety Strength: Strong theoretical basis; Weakness: Single hospital study; Evidence Level: II

NURS FPX 8045 Assessment 6 Synthesis of the Evidence: Substantiating an Intervention for Obesity