While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone change proposal project, the literature review enables students to map out and move into the active planning and development stages of the project.
A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Statement Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
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 required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.
Literature Evaluation Table
Student Name:
Change Topic (2-3 sentences): Awareness creation to increase the number and skills of healthcare providers with the aim of reducing or preventing falls and their related injuries.
Criteria | Article 1 | Article 2 | Article 3 | Article 4 |
Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
|
Natalie Callis, Applied nursing research link: https://www.sciencedirect.com/science/article/pii/S0897189715001056 |
Guirguis-Blake, J. M., Michael, Y. L., Perdue, L. A., Coppola, E. L., & Beil, T. L. Link: https://jamanetwork.com/journals/jama/article-abstract/2678103 |
Joseph, A., Henriksen, K., & Malone, E. (2018). Health Affairs. Link: https://www.healthaffairs.org/doi/pdf/10.1377/hlthaff.2018.0643 |
Shaw & Kiegaldie, |
Article Title and Year Published
|
Falls prevention: Identification of predictive fall risk factors, (2016)
|
Interventions to Prevent Falls in Older Adults. Updated Evidence Report and Systematic Review for the US Preventive Services Task Force (2018)
|
The Architecture Of Safety: An Emerging Priority For Improving Patient Safety (2018) | Educating hospital patients to prevent falls: protocol for a scoping review (2019) |
Research Questions (Qualitative)/Hypothesis (Quantitative), : and Purposes/Aim of Study
|
Provide a comprehensive literature review in an attempt to synthesize research evidence regarding the risk factors that contribute to patient falls in healthcare facilities.
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To systematically review the literature regarding the effectiveness and harms of fall prevention interventions in community-dwelling older adults to inform the US Preventive Services Task Force.
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The goal of the study is to summarize the key findings linking safety outcomes, healthcare falls and infection, injuries and medical errors. In addition, the article reviews facility designs, legislation in safety and quality improvement and the role of the different stakeholders in healthcare.
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To explore the implementation of patient education in reducing falls as captured in research. This includes the content of patient education, the education design and the outcomes or results of patient education.
|
Design (Type of Quantitative, or Type of Qualitative)
|
Qualitative | Qualitative and quantitative | Narrative review | Systematic review |
Setting/Sample
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Review of existing documentation | Randomized clinical trials of interventions to prevent falls in community-dwelling adults 65 years and older. | Review of existing documentation. 45 publications reviewed | PubMed, CINAHL, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine Database, PsychINFO, Education Resources Information Center. 34 publications reviewed |
Methods: Intervention/Instruments
|
Literature review | Literature review, Randomized clinical trials | Literature review | Literature review. Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) |
Analysis
|
Descriptive analysis | Random-effects meta-analysis and independent review by two reviewers. | Content analysis | Narrative analysis, thematic analysis. |
Key Findings
|
Communication failure, insufficient orientation and supervision, poor leadership and failure to observe safety protocols or procedure present patients with heightened risks for falling | Awareness and exercise trials had a significant reduction in the number of falls. | Education healthcare providers and creating sufficient support for relatives significantly reduce falls and their associated injuries. | There is a positive association between patient education and reduction in falls. |
Recommendations
|
Need to train both healthcare givers on the risk factors of falls including psychological changes and organizational physical infrastructure. | Development of projects geared towards Increasing awareness and exercise to reduce the number of falls. | Need to increase research on falls and patient safety beyond inpatient to outpatient and long-time care. | There is a need for further research regarding the design of patient education. |
Explanation of How the Article Supports EBP/Capstone Project
|
Provides an analysis of the potential risk factors which is useful in developing EBP interventions | The article provides important insights into the effectiveness of interventions aimed at reducing falls. | The article provides evidence from numerous sources with a focus on EBP projects hence rich in insights on EBP | The review maps the key elements regarding effective education of patient to prevent falls and provide insights on educational interventions that can help patients mitigate falling within hospitals |
Criteria | Article 5 | Article 6 | Article 7 | Article 8 |
Author, Journal (Peer-Reviewed), and
Permalink or Working Link to Access Article
|
Tricco, Thomas, Veroniki, Hamid, Cogo, Strifler & Riva, (2017). https://jamanetwork.com/journals/jama/article-abstract/2661578 |
Vlaeyen, Stas, Leysens, Van der Elst, Janssens, Dejaeger, & Milisen, International journal of nursing studies: https://www.sciencedirect.com/science/article/abs/pii/S0020748917300305 |
Cameron, Dyer, Panagoda, Murray, Hill, Cumming & Kerse. Cochrane database of systematic reviews. Link: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD005465.pub4/abstract |
Robalino, S., Nyakang’o, S. B., Beyer, F. R., Fox, C., & Allan, L. M. (2018) Systematic reviews Link: https://link.springer.com/article/10.1186/s13643-018-0697-6 |
Article Title and Year Published
|
Comparisons of interventions for preventing falls in older adults: a systematic review and meta-analysis. (2017) | Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators. (2017)
|
Interventions for preventing falls in older people in care facilities and hospitals. (2018)
|
Effectiveness of interventions aimed at improving physical and psychological outcomes of fall-related injuries in people with dementia: a narrative systematic review (2018)
|
Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study
|
Assessing the potential effectiveness of the interventions used in reducing falls. What types of fall-prevention programs may be effective for reducing injurious falls in older people? | To identify the facilitators and barriers to fall prevention interventions in residential care facilities | To conduct an assessment of the interventions designed to reduce fall incidences among older people in hospitals and care facilities. | Assessing the effectiveness of interventions for improving the psychological and physical wellbeing of people suffering from dementia and who have sustained an injury due to falling
|
Design (Type of Quantitative, or Type of Qualitative)
|
A systematic review, meta-analysis | Quantitative Systematic review | Quantitative Systematic review | Systematic review |
Setting/Sample
|
54 publications and 41596 | Five databases (MEDLINE, EMBASE, CINAHL, PsycINFO, and Web of Science | Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (August 2017); Cochrane Central Register of Controlled Trials (2017, Issue 8); and MEDLINE, Embase, CINAHL and trial registers to August 2017. Recorded 95 trials (138,164 participants), | MEDLINE, CENTRAL, Health Management Information Consortium, EMBASE, CINAHL, Web of Science, Allied and Complementary Medicine Database, and Physiotherapy Evidence Database (PEDro).
Hospital wards |
Methods: Intervention/Instruments
|
Literature review. Randomized clinical trials | Two independent reviewers. Mixed-Method Appraisal Tool for quality appraisal. | Literature review, Randomized clinical trials | Bespoke excel use in data extraction. Independent literature review. Cochrane risk of bias tool |
Analysis
|
Network meta-analysis, pair-meta analysis and independent review | Thematic and descriptive analysis | Thematic and descriptive analysis, GRADE used to assess the quality of data | Narrative synthesis, Thematic analysis. |
Key Findings
|
Increasing awareness, clinical quality-level improvement and exercise result in reduced falls. | Improved communication, physical infrastructure, awareness and adequate training facilitate EBP while staff shortage, huge workloads, skill deficiency and stress act as barriers. | There is inadequate support to show that vitamin D supplementation, exercises and multifactorial interventions had any impact on reducing falls | There was a high variability bin the outcomes of the studies due to focus on specific areas leading to a huge heterogeneity |
Recommendations
|
The values of caregivers and patients influence the choice and preference for intervention. There is a need for additional research on the same. | Need to consider organizational and local factors such as the social factors that influence the behaviour of individuals within a community when designing an EBP project | There is a need to develop strategies that address both the risk of falling and provide interventions to reduce the number of people who fall. | Need for studies that allow for a meta-analysis by ensuring reduced heterogeneity of the selected studies. |
Explanation of How the Article Supports EBP/Capstone
|
Provides evidence regarding the potential for EBP projects to succeed based on a detailed review. | The study provides a wide list of the potential facilitators and barriers to the EBP project | The study analyses the evidence-based strategies that have been used in the past and their effectiveness in reducing falls. | The article provides evidence regarding the performance of intervention programs which is crucial to the EBP study. |
References
Callis, N. (2016). Falls prevention: Identification of predictive fall risk factors. Applied nursing research, 29, 53-58.
Cameron, I. D., Dyer, S. M., Panagoda, C. E., Murray, G. R., Hill, K. D., Cumming, R. G., & Kerse, N. (2018). Interventions for preventing falls in older people in care facilities and hospitals. Cochrane database of systematic reviews, (9).
Guirguis-Blake, J. M., Michael, Y. L., Perdue, L. A., Coppola, E. L., & Beil, T. L. (2018). Interventions to prevent falls in older adults: updated evidence report and systematic review for the US Preventive Services Task Force. Jama, 319(16), 1705-1716.
Joseph, A., Henriksen, K., & Malone, E. (2018). The architecture of safety: An emerging priority for improving patient safety. Health Affairs, 37(11), 1884-1891.
Robalino, S., Nyakang’o, S. B., Beyer, F. R., Fox, C., & Allan, L. M. (2018). Effectiveness of interventions aimed at improving physical and psychological outcomes of fall-related injuries in people with dementia: a narrative systematic review. Systematic reviews, 7(1), 31.
Shaw, L., & Kiegaldie, D. (2019). Educating hospital patients to prevent falls: protocol for a scoping review.
Tricco, A. C., Thomas, S. M., Veroniki, A. A., Hamid, J. S., Cogo, E., Strifler, L., … & Riva, J. J. (2017). Comparisons of interventions for preventing falls in older adults: a systematic review and meta-analysis. Jama, 318(17), 1687-1699.
Vlaeyen, E., Stas, J., Leysens, G., Van der Elst, E., Janssens, E., Dejaeger, E., … & Milisen, K. (2017). Implementation of fall prevention in residential care facilities: A systematic review of barriers and facilitators. International journal of nursing studies, 70, 110-121.
Falls and Related Injuries
Nanah Kamara
GCU
Falls and Related Injuries
Nurses, being the initial contacts for patients in any most health facilities and the fact they interact or engage with patients more when compared to other providers of care constitute a critical component of the healthcare system. Consequently,nurses play a much huge rolein making sure that the healthcare system provides not only safe care but also and care of high standard or quality(Sato, Hase, Osaka, Sairyo & Katoh, 2018). However one of the major healthcare or nursing issue over the years is the fall and associated injuries which have proved not only difficult for healthcare providers and facility to manage.
For instance, and according to DuPree, Fritz-Campiz & Musheno, (2014),Unintentional falls constitute the highest cause of non-fatal injuries among people over 65 years in the US. Moreover, one in every three individuals above 65 years falls at least one time in a given year. In addition, injuries from falls cause the highest number of accidental deaths among people 65-year-old and above(Tricco, Thomas, Veroniki, Hamid, Cogo, Strifler & Riva, 2017). Such statistics coupled with the extent of the costs associated with fall call for proper intervention to reduce falls and their associated injuries. For instance, the government spends billions of dollars on fall and their associated injuries on treating falls. The prevention of fall would provide increased funds for investment in other social programs aimed at improving both healthcare and addressing social or communal problems(Zakrajsek, Schuster, Wells, Williams & Silverchanz, 2018).
In addition, falls and their related injuries are responsible for almost 15% of the recorded hospitalization. This increases the burden of healthcare providers especially given the numerous stressors like staff shortage, huge workloads, leadership problems and personal factors among others. An increase in falls and associated injury, therefore, is detrimental to the provision of quality care as captured under the healthy 2020 program goal of reducing deaths that result from falls.
Despite this falls are very complex and difficult to manage or prevent. Given the implications that falls bear on the patients, the healthcare providers and the healthcare system as a whole(Joseph, Henriksen & Malone, 2018), there has been increased There has been an increased research focus towards fall prevention and reduction strategies. As a result, there exist a significant amount of literature regarding the reduction and prevention of falls. However, the literature regarding the topic I inconclusive and hence makes the study both significant and relevant.
Given the background to the association between falls, their associated injuries and improved nursing, this study seeks to explore whether indeed whether awareness creation regarding falls and the available strategies can improve the practice of nursing and consequently better healthcare provision and patient outcomes. To achieve this, the study will be developed using the procedures of evidence-based solutions which involve problem identification, data collection, data analysis and report writing. The PICOT question for the study was whether the creating of awareness regarding safety measures, tools and systems and policies among nurses reduces the prevalence of falls and the related injuries.
The preceding section provides a breakdown of the components in the PICOT question for the study.
P: P or in the population for the study will be nurses
I: Intervention– the development and implementation ofan awareness program for nurses.
C: Comparison- Nurses who do not go through the awareness programs.
O: Outcome-Reduced falls, Increased awareness among nurses.
T:Time- 6 months
In conducting the study, a literature review of available documentation regarding awareness creation and hospital falls was carried out with a focus on obtaining data to answer the PICOT question. To ensure that the information collected was not only valid but also accurate, relevant and reliable all sources selected for the study had to have been peer-reviewed. In addition, the sources had to have been developed recently to provide information that was up to date.
References
DuPree, E., Fritz-Campiz, A., & Musheno, D. (2014). A new approach to preventing falls with injuries. Journal of nursing care quality, 29(2), 99-102.
Guirguis-Blake, J. M., Michael, Y. L., Perdue, L. A., Coppola, E. L., & Beil, T. L. (2018). Interventions to prevent falls in older adults: updated evidence report and systematic review for the US Preventive Services Task Force. Jama, 319(16), 1705-1716.
Joseph, A., Henriksen, K., & Malone, E. (2018). The architecture of safety: An emerging priority for improving patient safety. Health Affairs, 37(11), 1884-1891.
Sato, N., Hase, N., Osaka, A., Sairyo, K., & Katoh, S. (2018). Falls among Hospitalized Patients in an Acute Care Hospital: Analyses of Incident Reports. The Journal of Medical Investigation, 65(1.2), 81-84.
Tricco, A. C., Thomas, S. M., Veroniki, A. A., Hamid, J. S., Cogo, E., Strifler, L., … & Riva, J. J. (2017). Comparisons of interventions for preventing falls in older adults: a systematic review and meta-analysis. Jama, 318(17), 1687-1699.
Zakrajsek, A., Schuster, E., Wells, C., Williams, J., & Silverchanz, P. (2018). CAREGIVERS OF OLDER ADULTS DURING CARE TRANSITIONS: INSIGHTS INTO POSITIVE ASPECTS OF CAREGIVING. Innovation in Aging, 2(suppl_1), 896-896.