Research Article Appraisal

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The Clinical Issue and Research Questions Developed Using PICOT

Stephanie Ellis

West Coast University

NUR350 Research in Nursing

Dr. Sara Turpel

November 13, 2021

 

 

 

The Clinical Issue and Research Questions Developed Using PICOT

Background Information

Unintentional patient falls continue to be a concerning issue in nursing practice despite abundance of fall prevention strategies. A fall is an unplanned descent to the floor with or without injuries to the patient involve. Despite the exitance of fall prevention programs in most hospitals; the incidence of fall prevention is very high. Falls may result in devastating impact to the patient. Aside from the physical injuries that they cause to the patient, falls have psychological and social impact. Psychologically, the feeling of losing control over one’s own body increases the level of anxiety and depression to the individual. Moreover, the awareness of lost self-control has a negative impact to the individual’s self-confidence and by extension self-efficacy.

Importance of the Fall Prevention to Nursing

Nurses spends most of the time with patients. The importance of falls lies in its implication on healthcare outcomes. Increase of falls have a direct effect on the quality of care to the patient. In addition, fall related injuries have major economic impact on the healthcare institutions. Falls increase the cost of care, prolong hospital stays, and negatively affect other related measures of quality care. Conservative estimates place increment of cost as a result of care to between $1500 and $ 3500 for individuals with minor injuries and $9,000 to $ 24, 000 for individuals with moderate to severe injuries (Radecki, Reynolds, and Kara, 2018). Most of the healthcare providers recognize falls as a major impediment to providing quality and safe care. As a result, adoption and implementation of fall prevention strategies is common among different institution. In this clinical issue, hourly rounding is recommended for reduction of fall incidences in the hospital setting.

Population

The target population will be elderly patients in the critical care unit of the hospital. These population have a higher incidence of falls than any other population within the hospital. Targeting this population expected to significantly reduce the incidence of falls in the unit.

Intervention

The proposed intervention program involves the use of rounding hours to reduce the incidence of falls among the elderly in critical care units. The intervention will be carried out every hour form 6:00 am to 10:00 pm for each of the patients in the critical care unit.

Comparison

The comparison intervention will be the use of bedside posters in promoting patient and family engagement in fall prevention. This intervention has been in practice within the hospital over the last few years.

Outcome

It is anticipated that the interventions will improve the practice of rounding among nurses in the hospital. The intervention will also increase the data recorded for falls within the hospital. Imperatively, it is expected that rounding will significantly decrease the incidence of falls within the hospital setting.

Time

The proposed intervention will be implemented in a period of two months.

PICOT Questions

1. In elderly patients admitted in critical care units, how does rounding hours compared to the use of bedside posters promote patient and family engagement in influencing fall prevention over a period of two months?

2. Among elderly patients in the critical care unit, will the implementation of rounding hours be more effective as compared to the use of bedside posters to promoting patient and family engagement in reducing the incidence of falls two months after implementation?

3. In elderly patients admitted at critical care units, how will rounding hours compared to promote patient a family engagement influence fall prevent over a period of two months?

 

 

 

 

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