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PICOT Rounding and Patient Teaching to Prevent Hospital Falls

HomeEssaysNursingPICOT Rounding and Patient Teaching to Prevent Hospital Falls
Prevent Hospital Falls
20.04.2021
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Various researchers have produced a considerable body of literature that addresses patient fall prevention. However, preventing falls in the healthcare environment has always remained elusive. For that reason, it still causes various problems such as fractures and internal injuries, which require more time to manage. Consequently, patients find themselves spending more time in the hospital than initially determined. Moreover, falls can lead to physical disabilities, thus necessitating an appropriate approach to prevent them. A PICOT statement on patient rounding and awareness, critical analysis of two research articles, and a discussion of the integration of evidence into practice can help identify an appropriate approach to preventing hospital falls.

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PICOT Statement

Involving the patient in preventing hospital falls in healthcare settings is crucial as it can facilitate efforts aimed at reducing the prevalence of falls. According to Hill et al. (2016), patient education has played a vital role in enhancing patient participation in preventing hospital falls. Further, Jackson (2016) argues that patient rounding by nurses has proven to be useful in reducing the prevalence of falls in hospitals. However, Quigley (2016) argues that a consistent reduction of falls has been elusive and, therefore, healthcare providers must continue identifying appropriate ways of addressing the problem. Thus, the PICOT question would be: ‘For hospitalized patients (P), does patient education on falls during admission and frequent rounding during hospitalization (I), compared with usual nursing care (C), reduce the risk of patient falls (O) within four months? (T)’

Quantitative Research Critique

Background

The quantitative article considered for this research begins with a detailed explanation of the importance of preventing patient falls in healthcare settings. The background section provides a rational explanation on the significance of patient rounding to prevent hospital falls (Jackson, 2016). However, the researcher recognizes that avoiding the problem has been a challenge. Therefore, studying a collaborative approach in conjunction with patient rounding could help in determining a useful approach to reducing falls (Jackson, 2016). The background section orients the reader of the research problem appropriately and it helps in understanding that researchers are committed to reducing patient falls through using a multi-strategy approach.

The researcher cites different research articles concerning patient falls. Therefore, a reader of the article can make appropriate connections in literature and understand other efforts that other researchers have employed in the past to reduce patient falls. Jackson (2016) establishes the significance of this research by providing statistical data on patient falls and further explains the importance of healthcare providers in understanding it. The significance of the study leads to the objective of the research, which involves using a collaborative approach that includes patient rounding used to prevent patient falls. This aim of the investigation relates to the research question, which the researcher does not provide, but the explanation of the research shows that it is about the extent of the efficacy of the collaborative approach. Thus, the reader can proceed to the methodology section to assess the way this approach has helped reduce the prevalence of patient falls.

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Method

The article does not have a section on benefits or risks of the research. However, the reader can notice from the background section that patient fall reduction is the ultimate benefit for participants. Information about informed consent is not available, which can make the reader question credibility of the study. However, Jackson (2016) uses a patient-centered care nursing framework, which was useful as it helped prioritize the needs of patients. Jackson (2016) provides a clear explanation of variables and used a questionnaire as an instrument to assess the program after its implementation. An understandable explanation of the variables and a coherent justification for the program implementation can help the reader notice that the researcher employed reliable methods. Finally, Jackson (2016) used SPSS to analyze data, which was appropriate considering that the research was quantitative. Therefore, the reader can proceed to the results section to understand outcomes of the research since the methodology is appropriate.

Results

The results reveal a significant reduction in patient falls. Jackson (2016) provides statistical data, which the reader can analyze to understand the way the collaborative approach led to a reduced prevalence of hospital falls. Notably, the collaborative approach included patient rounding, which was critical in reducing patient falls. The results are valid since other researchers have also associated patient rounding with reducing the prevalence of patient falls. Furthermore, the results section reveals that patient documentation and efficient collaboration during the project reduced patient falls. However, the researcher utilized a small sample. Furthermore, ten participants were in one setting. Therefore, the findings are relevant, but their application is limited.

These findings apply to nursing practice because patient rounding, collaboration, and documentation are among the core duties of nurses. Nurses must, thus, prioritize frequent rounding and report patients’ problems to appropriate staff in order to identify risks for falls and to prevent them. However, other researchers should consider carrying out similar research in a larger institution or different settings to confirm these findings.

Ethical Considerations

The research article does not have a section that recognizes the welfare of participants. Additionally, Jackson (2016) does not discuss readiness of research participants in the study. Moreover, no section explains whether the researcher obtained informed consent. Ethical considerations are mandatory in any research due to their usefulness in protecting the researcher from any legal concerns and participants from exploitation. Thus, readers of the article may question the credibility of the findings.

Qualitative Article

Background

This research article begins by discussing patient falls as a serious problem in healthcare. The discussion presents to readers the significance of preventing patient falls in healthcare settings. Hill et al. (2016) further recognize various research studies that have associated patient education with a reduced prevalence of patient falls. The cited research articles were conducted within five years, thus indicating that patient awareness about the risks of falls could contribute immensely to reducing falls. However, Hill et al. (2016) identify that limited literature exists on perceptions of nurses about the educational intervention used to reduce the prevalence of patient falls. Recognition of this problem can help the reader of the article understand the gap in research about the educational intervention in spite of its importance.

The gap in available studies led to the identification of the research aim, which was to identify how the clinical staff responded to the program that reduced patient falls. The background section lacks a research question, but the reader can draw it from the aim of the study. Notably, Hill et al. (2016) present the importance of the study by identifying other educational interventions and the reader can proceed to the methodology stage to identify the way healthcare providers provided responses to the researchers about the interventions.

Methods

The researchers clarify that they used a qualitative approach, which was useful due to its appropriateness for understanding perceptions and attitudes of participants towards any given phenomenon. Hill et al. (2016) trained the clinical staff on the ways of supporting an educational program. This approach was useful since it could raise awareness of the clinical staff of the issue and help prevent patient falls, as well as further enhance their attitudes to supporting the program. Eventually, the researchers used focused group discussions to understand the responses of the participants regarding the training programs. The focus groups were appropriate since the researchers could understand the attitudes and beliefs of nurses about the educational program.

No explanation exists in the methodology section about the perspectives from which the study developed. However, a broad range of cited literature sources and credible sites reveals that reducing the prevalence of patient falls was the focus of the study. Hill et al. (2016) took 12 months to assess the responses of the participants, which was a significant limitation because the participants could have forgotten about the program. However, the researchers used similar participants, thus minimizing potential bias in the study. The researchers provide coherent information about the training of the clinical staff, patients, and evaluation of the clinical staff, hence making the methodology understandable.

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Results

The researchers explain that they conducted five focus groups in different hospitals, which was useful as it could reduce bias in responses and further enhance applicability of the findings. The identified themes included capability, impact, and behavior change. Hill et al. (2016) noticed that the clinical staff was capable of preventing patient falls after the evaluation of data. Furthermore, the clinical staff understood the contribution of patient education to preventing hospital falls. Thus, the clinical staff had positive attitudes that were relevant in motivating them to contribute to the efforts aimed at reducing patient falls. The reader can also notice that nurses were a part of the participants. Therefore, nursing training institutions and healthcare facilities can promote the training of nursing students and nurses respectively to help them to develop willingness to assist with preventing patient falls.

Ethical Considerations

This research followed the required protocols regarding ethical considerations. The reader can notice that the ethics committee approved the study and the research process guaranteed privacy of the participants. Thus, the reader can assume that the participants were willing to provide credible information, thus increasing reliability of the findings.

Proposed Evidence-Based Practice Change

The evidence presented in the articles suggests two interventions that can be useful in preventing patient falls. Jackson (2016) indicates that patient rounding is a useful approach to reducing the prevalence of patient falls. Additionally, Hill et al. (2016) demonstrate the way patient education is helpful in reducing hospital falls. However, research evidence about the efficacy of each intervention in a consistent matter is limited. Thus, nurses do not have an efficient and reliable method of reducing patient falls. For that reason, the PICOT question combines the two interventions, i.e. patient education and rounding used to prevent hospital falls. Therefore, nurses can apply these findings to teach patients about risks of falls in the healthcare environment during admission and then conduct rounding collaboratively during the patients’ hospital stay to assess any potential risks for falls. This approach that considers the evidence in the two articles can reduce patient falls significantly.

Conclusion

A considerable number of research studies have examined the issue of patient falls in healthcare settings. However, the problem remains persistent even though there exist proposed interventions to reduce their prevalence. Two research studies have analyzed the importance of patient rounding and patient education. Although the studies have limitations, nurses can use the evidence to utilize the two approaches during admission and the patient’s hospital stay. This strategy can reduce the rate of patient falls occurrence.

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