Nursing Research Utilization Project Proposal

A study was done at a 1,300 bed urban facility over a 13-week period. The purpose of the study was to describe the causes of inpatient falls in hospitals (Hitcho, et al., 2004). All falls were reported except falls in the psychiatry service and during physical therapy sessions. During the 13-week period, a total of 183 patients at an average age of 63.4 years old fell. Of the total number of falls 79% were unassisted, 85% happened in the patient room, 59% occurred during the evening or overnight shift, 19% were while walking, and 50% were elimination related (p. 732). In this study it was identified that many patients did not use their call bell before getting up because they did not believe they needed assistance. It was stated that, “perhaps patients need to be better educated on the effects that a new environment, decreased activity, medications, tests, and treatments can have on patients’ energy and ability to ambulate safely” (p. 737). The findings of this study showed that falls not only happen in the elderly, but in the younger population as well. Patients that fall in hospitals are often unaided and are due to elimination needs. To prevent falls and decrease injury rates, more studies need to be done.

The following paper is a written critique of the following research article “Improving the evaluation of risk of fall through clinical supervision: an evidence” (Cruza, Carvalhoa, Lopesb, 2016). The purpose of this critique is to analyze, evaluate, and review each section of the above stated quantitative research article. This quantitative, descriptive and correlational study focuses on improving patient safety and quality of nursing care by improving the evaluation of a patients' fall risk using the Morse Fall Scale (MFS) assessment tool in practice under the implementation of a clinical supervision model. (CS)

As a nurse we want to ensure that our patients receive a high quality of care. Patients should feel safe and satisfied while hospitalized. Many hospitals are continually looking for answers and implementation to significantly reduce the inpatient fall incidents. According to Bechdel et al (2014), the top priority of health care organizations nationwide is to reduce and eliminate falls within the clinical care settings. One of the serious problems in acute care hospital is the patient’s fall. The unfamiliar environment, acute and co-morbid illnesses, prolonged bedrest, polypharmacy, and the placement of tubes and catheters are common challenges that place patients at risk of falling. Most of the falls that I have encountered while working involves

Patient falls in hospitals are a critical problem and are used as a standard metric of nursing care quality. According to the Joint Commission, thousands of patients fall in hospitals each year. Approximately 30-50% of falls result in injuries and prolonged hospital stays. Any patient in a hospital is at risk for falling and certain measures should be in place to prevent this. Preventing falls and injuries are not only important for the patient, but also for their families, the hospital, health care team, and insurance companies. It is estimated the average cost of a hospital admission due to a fall is $20,000 and by 2030, an estimated $54 billion will be spent on health care costs due to falls. The purpose of this paper is to explore the risk factors of falls in hospitals and interventions used to combat this problem.

Problem: Patient falls have long been a common and serious problem in hospitals across the nation, causing

This work has significance because staff and patient education can help prevent falls. Specific interventions decrease falls. Nurses have a responsibility to their patients and their facility to be competent and confident in their abilities to do all that they can to prevent falls. Facilities have the responsibility to provide the tools and the training that is required to carry out fall prevention

Patient falls in hospitals continue to be a major and costly problem. The definition of a patient fall is an unplanned descent to the floor, assisted or unassisted, with or without injury to the patient. The authors of this article wanted to investigate the effect “missed nursing care” has on patient fall rates and patient outcomes. The authors also looked at hospital staffing as it relates to patient falls and nursing staff having enough time to carry out all nursing responsibilities.

Capan, K., & Lynch, B. (2007). Reports from the field: patient safety. a hospital fall assessment and intervention project. Journal of Clinical Outcomes Management: JCOM, 14(3), 155-160.

In the healthcare system, Core Measure sets are used to measure quality care. It consists of pneumonia, heart attack, immunizations, emergency department, sepsis, for infection prevention, and others. Evidence-based treatments are used to prevent occurrences using structures, processes, and outcomes. In nursing, they have adopted a similar method of performance measures, known as nursing-sensitive indicators. It includes falls, and this indicator is implemented in each unit of the hospital and managed by the manager and educator along with others like CAUTI and CALBSI. According to the American Hospital Association article (2015) “Falls with Injury,” Patient falls-an unplanned descent to the floor with or without injury to the patient affects between 700,000 and 1,000,000 patients each year.”

Nurses help to ensure patient safety, which includes preventing falls and fall-related injuries (Quigley, Neily, Watson, Wright, & Strobel, 2017). The general population is at risk for falls and fall-related injuries, more specifically the elderly, 65 and over (Quigley, Neily, Watson, Wright, & Strobel, 2017). Patient falls are one of the top events for hospitals and long-term care facilities due to loss of physical function or cognition (Quigley, Neily, Watson, Wright, & Strobel, 2017). Fall-related injuries are a serious health issue for the elderly population (Quigley, Neily, Watson, Wright, & Strobel, 2017). Nurses make a major contribution to patient safety by assessing fall risk and designing patient-specific fall prevention

For the literature review an electronic search was undertaken of articles published in English using the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed and Cochrane databases from 2009 to 2013 were searched for medical subject heading terms, both individual terms and combination of the following

Tzeng and Yin (2008) state that nurses assume the responsibility and are liable when a patient falls in their care. Nurses spend the most time with patients at their bedside; however, nurses don’t have any

Ge Li, MD, PhD; Lucy Y. Wang, MD; Jane B. Shofer, MS; Mary Lou Thompson, PhD; Elaine R. Peskind, MD; Wayne McCormick, MD, MPH; James D. Bowen, MD; Paul K. Crane, MD, MPH; Eric B. Larson, MD, MPH

The procedures were conducted using the format of questionnaires. The questions on the questionnaire were based on these four main areas: cause of falls, nursing staffs intervention in fall prevention, routines of documentation and report, and experiences and reactions of nursing staff related to fall incidents. The 64 questions were distributed into four different categories of people. The four different categories are registered nurse, enrolled nurses, unskilled nurses’ aid and other professions (Struksness et al., 2011, p.3 ). Out of the 64 questions, 7 were background questions. The other 57 questions were distributed among the four main areas of fall. 28

The first quantitative study analyzed was conducted by Dabney and Kalisch in 2015 and surveyed 729 patients. The purpose of the study was to continue researching for any correlation between patient outcomes and nurse staffing. They analyzed patient reports of missed nursing care and determined if there was a relationship between patient reports and the nurse staffing levels. The design and sample include data that was obtained in the study of patient reports of missed nursing care and compared it to the level of nurse staffing. The sample was made up of 729 patients on 20 units in 2 hospitals. The 20 units consisted of 12 medical units with 420 participants, 6 surgical units with 255 participants, and 2 rehabilitation