Benchmark: Evidence-Based Practice Project PICOT Paper

Benchmark: Evidence-Based Practice Project PICOT Paper

Benchmark: Evidence-Based Practice Project PICOT Paper

Patient safety and quality care in the care environment are two central themes that have received much attention recently. Various healthcare professionals and stakeholders have focused on efforts to ensure that the patients receive quality care and safe care. In addition, efforts have been made towards ensuring that such care is accessible (Marsch et al., 2022). However, various incidences in the care environment still threaten patient safety and compromise the quality of care offered by healthcare professionals such as nurses. One of such problems is patient falls. Patient falls and injuries that result from them are common in the medical and surgical wards, which pose a substantial threat to patient safety. The purpose of this assignment is to describe the population demographics, the proposed intervention, and implementation timeline, and how synthesized or applied data is used in supporting the population health management for the selected population.

The Population’s Demographics and Health Concerns

The population under consideration is hospitalized adult patients in the medical-surgical wards. Patients in the medical-surgical wards usually receive care pre or post-surgical procedures. Therefore, they are more susceptible to falls due to their conditions. Various health concerns among these patients predispose them to the risk of falls; hence there is a need to address the falls. Acute care patients normally display an increased risk of falls resulting from newly altered mobility, history of previous falls, medication side effects, or altered mental status, among other factors (Cuttler et al., 2017)

The Proposed Evidence-Based Intervention

As highlighted earlier, patient fall is a common phenomenon, especially among patients in the medical-surgical wards. Therefore, the Fall Tailored Interventions for Patient Safety (TIPS) toolkit is the proposed evidence-based intervention. This intervention applies bedside tools in communicating patient-specific risk factors for falls and then applies a patient-centered fall prevention plan. This toolkit also offers the patient care teams the relevant information required in routine engagement in the process of fall prevention (Duckworth et al., 2020). The intervention leverages health information technology to engage patients and their families in the process of fall prevention. There are three modalities that can be used depending on the workflow of an environment. They include a bedside display capable of displaying a bedside poster automatically generated from reuse data, a laminated poster, or a poster generated from the electronic health record.

The proposed intervention incorporates health policies and goals supporting health care equity. For instance, its major focus is to ensure that patients in the surgical-medical wards are protected from fall incidences and are safe. Since these patients are more susceptible to falls, preventing or reducing the fall incidences helps in lowering disparities hence achieving health equity. The result is better health outcomes among this group of patients.

Comparison of the Intervention to Previous Research or Practice

The adverse impacts of patient fall mean that a lot of attention has been focused on strategies for prevention and control. Therefore, previous research has been done in this area exploring various interventions. One of the most common interventions in the literature is the use of bed alarms. Bed alarms have been used in such a way that the nurses are notified through bed alarms when a patient engages in an action that can next lead to a fall when a patient falls or when a patient leaves their bed (Cortés et al., 2021). Therefore, nurses can quickly get to the bedside and prevent falls in time. The use of bedside alarms has been successful in most cases but is also hampered by false alarms. Other measures include reorientation strategies, use of patient walking aids, patient education on fall risk, and nonslip footwear.

The Expected Outcome

The implementation of the proposed intervention is expected to lead to various outcomes. One of the major outcomes includes reduced rates of falls among adult patients admitted to the medical-surgical units. Another outcome is improved knowledge of the Fall Tailored Interventions for Patient Safety (TIPS) toolkit since nurses will get training before applying the fall prevention tool in the medical-surgical setting. The other outcome is the possible organization-wide adoption of the proposed intervention to be used as a new protocol for preventing patient falls. This will depend on how best the intervention works in reducing the rates of falls among these patients.

The Timeline for Implementation and Evaluating the Outcome

Timeline is key in the implementation and evaluation of an evidence-based practice project (Yoo et al.,2019). Therefore the proposed timeline for this project is 24 weeks. During this duration, various vital activities will be performed related to the project, such as a comprehensive literature review, project implementation, and evaluation. This time will also be sufficient for training the nursing staff working in the medical-surgical units. Evaluation of the outcomes will be key in determining how well the intervention has worked in reducing the rates of patient falls. In addition, the evaluation of the processes and strategies used during the project will be carried out to ascertain how well they have worked.

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The Application of Genetic, Genomic, and Epidemiologic Data, Social Determinants of Health and Nursing Science

The population health management for patients admitted at the medical-surgical wards requires the use of data from various sources, tools, and evidence. Nursing science plays a critical role in the formulation of practical concepts and theories that are critical in managing the conditions such as patient falls (Younas & Quennell, 2019). As such, nursing science offers scientific strategies for improving the healthcare outcomes related to patient falls among adult patients in the medical-surgical wards. Social determinants of health also play a role. For example, how social-economic status and beliefs could impact the use of the intervention among these patients. The epidemiological data involves determining the frequency of patient falls and the possible causes, hence formulating appropriate strategies to prevent and control falls. The genetic and genomic data may not have an impact on patient falls as falls happen due to a patient’s prevailing condition or the environment where the patient is.

Conclusion

Patient safety in the care environment should be at the center stage of patient care. The implication is that the nursing staff and other healthcare professionals have to use effective strategies that ensure patient safety in the care environment. Therefore, patient falls among the adult population admitted at the medical-surgical wards have been taken into consideration and a PICOT formulated around it. Furthermore, this write-up has explored a further discussion or description of the PICOT question in terms of population demographics and health concerns, a description of the proposed intervention, comparison of the intervention with previous research, the expected outcome, and the timeline for implementing and evaluating the outcome.

References

Cortés, O. L., Piñeros, H., Aya, P. A., Sarmiento, J., & Arévalo, I. (2021). Systematic review and meta-analysis of clinical trials: In–hospital use of sensors for prevention of falls. Medicine, 100(41). https://dx.doi.org/10.1097%2FMD.0000000000027467

Cuttler, S. J., Barr-Walker, J., & Cuttler, L. (2017). Reducing medical-surgical inpatient falls and injuries with videos, icons, and alarms. BMJ Open Quality, 6(2), e000119. https://doi.org/10.1136/bmjoq-2017-000119.

Duckworth, M., Adelman, J., Belategui, K., Feliciano, Z., Jackson, E., Khasnabish, S., … & Dykes, P. C. (2019). Assessing the effectiveness of engaging patients and their families in the three-step fall prevention process across modalities of an evidence-based fall prevention toolkit: an implementation science study. Journal of Medical Internet Research, 21(1), e10008. https://doi.org/10.2196/10008

Marsch, A., Khodosh, R., Porter, M., Raad, J., Samimi, S., Schultz, B., … & Smith, G. P. (2022). Implementing Patient Safety and Quality Improvement in Dermatology Part 1: Patient Safety Science. Journal of the American Academy of Dermatology. https://doi.org/10.1016/j.jaad.2022.01.049.

Yoo, J. Y., Kim, J. H., Kim, J. S., Kim, H. L., & Ki, J. S. (2019). Clinical nurses’ beliefs, knowledge, organizational readiness and level of implementation of evidence-based practice: The first step to creating an evidence-based practice culture. PloS one, 14(12), e0226742. https://doi.org/10.1371/journal.pone.0226742.

Younas, A., & Quennell, S. (2019). Usefulness of nursing theory‐guided practice: An integrative review. Scandinavian Journal of Caring Sciences, 33(3), 540-555. https://doi.org/10.1111/scs.12670

Appendix

PICOT Question
P	Population	Hospitalized adult patients in the medical-surgical ward.
I	Intervention	Fall Tailored Interventions for Patient Safety (TIPS) Toolkit
C	Comparison	Routine fall prevention protocols
O	Outcome	Reduced incidences of falls and injuries
T	Timeframe	24 weeks.
PICOT	Among hospitalized adult patients in the medical-surgical ward (P), does the utilization of the Fall Tailored Interventions for Patient Safety (TIPS) Toolkit (I), as compared to routine fall prevention protocols (C) help reduce the incidences of falls and injuries (O) within 24 weeks (T)?
Problem Statement Create a problem statement for your PICOT. You will use this problem statement throughout your final written paper.	Falls and associated injuries among hospitalized patients are widespread in most medical and surgical wards, posing a serios threat to the safety of the patient. Accidental falls account for most reported incidences in hospitals complicating roughly 2% of hospital stays. According to Dykes et al. (2020), the rate of falls among hospitalized patients in the United States ranges from approximately 3–5 per 1000 bed-days. The incidences of falls depend on the characteristic of the unit, with patients hospitalized in the medical-surgical unit being at high risk as compared to those in the intensive care unit (Lucero et al., 2019). Consequently, studies have also reported that approximately 25% of reported falls among hospitalized patients normally result in injury, whereas 2% causes fractures. Acute care patients normally display an increased risk of falls resulting from newly altered mobility, history of previous falls, medication side effects, or altered mental status among other factors (Cuttler et al., 2017). Despite the cause, the increasing incidences of falls are becoming very costly, with increased morbidity and mortality rates from fall-associated injuries and fractures. The lack of significant fall prevention intervention despite years of struggle has contributed to the frustrations among healthcare workers, researchers, and patients at risk. It is thus time to adapt nurse-led evidence-based interventions like the TIPS tool which have proven to be effective in the reduction of fall incidences among adults in the medical-surgical ward (Tzeng et al., 2021). The facility where I work utilizes the morse fall scale (a score of 25 or higher is considered high risk), a red rose is placed on the patient’s chart as well on their door, and a red risk band is applied.

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Write a 750-1,000-word paper that describes your PICOT.
1. Describe the population’s demographics and health concerns.
2. Describe the proposed evidence-based intervention and explain how your proposed intervention incorporates health policies and goals that support health care equity for the population of focus.
3. Compare your intervention to previous practice or research.
4. Explain what the expected outcome is for the intervention.
5. Describe the time for implementing the intervention and evaluating the outcome.
6. Explain how nursing science, social determinants of health, and epidemiologic, genomic, and genetic data are applied or synthesized to support population health management for the selected population.
7. Create an Appendix for your paper and attach the PICOT. Be sure to review feedback from your previous submission and revise your PICOT accordingly.

You are required to cite at least four to six peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

This is Final Picot
PICOT Question
P Population Hospitalized adult patients in the medical-surgical ward.
I Intervention Fall Tailored Interventions for Patient Safety (TIPS) Toolkit
C Comparison Routine fall prevention protocols
O Outcome Reduced incidences of falls and injuries
T Timeframe 24 weeks.
PICOT
Among hospitalized adult patients in the medical-surgical ward (P), does the utilization of the Fall Tailored Interventions for Patient Safety (TIPS) Toolkit (I), as compared to routine fall prevention protocols (C) help reduce the incidences of falls and injuries (O) within 24 weeks (T)?

Problem Statement
Create a problem statement for your PICOT. You will use this problem statement throughout your final written paper.
Falls and associated injuries among hospitalized patients are widespread in most medical and surgical wards, posing a serios threat to the safety of the patient. Accidental falls account for most reported incidences in hospitals complicating roughly 2% of hospital stays. According to Dykes et al. (2020), the rate of falls among hospitalized patients in the United States ranges from approximately 3–5 per 1000 bed-days. The incidences of falls depend on the characteristic of the unit, with patients hospitalized in the medical-surgical unit being at high risk as compared to those in the intensive care unit (Lucero et al., 2019). Consequently, studies have also reported that approximately 25% of reported falls among hospitalized patients normally result in injury, whereas 2% causes fractures. Acute care patients normally display an increased risk of falls resulting from newly altered mobility, history of previous falls, medication side effects, or altered mental status among other factors (Cuttler et al., 2017). Despite the cause, the increasing incidences of falls are becoming very costly, with increased morbidity and mortality rates from fall-associated injuries and fractures. The lack of significant fall prevention intervention despite years of struggle has contributed to the frustrations among healthcare workers, researchers, and patients at risk. It is thus time to adapt nurse-led evidence-based interventions like the TIPS tool which have proven to be effective in the reduction of fall incidences among adults in the medical-surgical ward (Tzeng et al., 2021). The facility where I work utilizes the morse fall scale (a score of 25 or higher is considered high risk), a red rose is placed on the patient’s chart as well on their door, and a red risk band is applied.

References
Cuttler, S. J., Barr-Walker, J., & Cuttler, L. (2017). Reducing medical-surgical inpatient falls and injuries with videos, icons, and alarms. BMJ Open Quality, 6(2), e000119. https://doi.org/10.1136/bmjoq-2017-000119
Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., Ergai, A., Lindros, M. E., Lipsitz, S. R., Scanlan, M., Shaykevich, S., & Bates, D. W. (2020). Evaluation of a Patient-Centered Fall-Prevention Tool Kit to Reduce Falls and Injuries. JAMA Network Open, 3(11), e2025889. https://doi.org/10.1001/jamanetworkopen.2020.25889
Lucero, R. J., Lindberg, D. S., Fehlberg, E. A., Bjarnadottir, R. I., Li, Y., Cimiotti, J. P., … & Prosperi, M. (2019). A data-driven and practice-based approach to identify risk factors associated with hospital-acquired falls: applying manual and semi-and fully-automated methods. International journal of medical informatics, 122, 63-69. https://doi.org/10.1016/j.ijmedinf.2018.11.006
Tzeng, H.-M., Jansen, L. S., Okpalauwaekwe, U., Khasnabish, S., Andreas, B., & Dykes, P. C. (2021). Adopting the Fall Tailoring Interventions for Patient Safety (TIPS) Program to Engage Older Adults in Fall Prevention in a Nursing Home. Journal of Nursing Care Quality, Publish Ahead of Print. https://doi.org/10.1097/ncq.0000000000000547