NR 439 Week 3 Problem/PICOT/Evidence Search (PPE) Worksheet

Name

Chamberlain University

NR-439: RN Evidence-Based Practice

Prof. Name

Date

Problem/PICOT/Evidence Search (PPE) Worksheet

Name:
Date:

Problem Statement

Patient falls are among the most frequently reported adverse events during hospital stays, leading to injuries in approximately 30% of cases. The Centers for Medicare & Medicaid Services (CMS) have identified falls as a preventable healthcare-acquired condition. As the medical-surgical inpatient population continues to age, there is an increased risk of falls within this demographic (Godlock, Christiansen, & Feider, 2016). When a patient suffers a fall, the consequences can extend beyond physical harm to include emotional distress for the patient and their families, along with heightened financial burdens for healthcare facilities. Serious injuries from falls can lead to extended hospital stays, unplanned surgeries, and even fatalities (Williams, Szekendi, & Thomas, 2014). Consequently, it is crucial to implement effective fall risk assessments and prevention strategies. The primary goal of a fall prevention program is to minimize both the frequency and severity of patient falls while encouraging the highest level of patient independence possible (Schub & Karakashian, 2018). Establishing a fall prevention plan in collaboration with a patient safety team has been shown to reduce the fall rate from 1.90 to 0.69 falls per 1,000 occupied bed days (Godlock et al., 2016).

Clinical Nursing Practice Problem

In identifying a quality or safety clinical priority area, the nursing practice problem I have selected is the prevention of patient falls. This issue is critical because falls not only pose immediate physical risks to patients but also lead to longer-term emotional and psychological consequences. My rationale for prioritizing this problem stems from the significant impact that fall-related injuries have on patient outcomes and hospital resource utilization. Preventing falls is essential to enhance patient safety and promote a culture of care within healthcare facilities.

Clinical Nursing PICOT Question

Using the NR439 Guide for Writing PICOT Questions, the following PICOT question has been formulated:
Among adult inpatient medical/surgical patients (P), does performing a fall risk assessment and implementing a fall prevention plan (I) decrease the occurrence of falls in inpatient medical/surgical units (O) compared to previous fall rates where no fall prevention plan was implemented (C) over 6 months (T)?

PICOT Elements	Definition
P – Patient Population	Adult inpatient medical/surgical patients
I – Intervention	Perform a fall risk assessment and implement a fall prevention plan
C – Comparison	Compared to previous fall rates where no fall prevention plan was implemented
O – Measurable Outcome	Decrease the occurrence of falls in inpatient medical/surgical units
T – Time Frame	Over 6 months

Evidence Retrieval Process and Summary

In searching for evidence pertinent to the selected nursing practice problem, I utilized the Chamberlain College of Nursing library to locate relevant studies. The evidence discovered involved research conducted in inpatient settings that highlighted improvements in fall occurrences following the implementation of targeted interventions. I chose this evidence because it specifically addressed nursing interventions and nurse training’s role in enhancing patient outcomes. Furthermore, the studies were peer-reviewed and published in nursing journals within a five-year timeframe.

Godlock, G., Christiansen, M., & Feider, L. (2016). Implementation of an Evidence-Based Patient Safety Team to Prevent Falls in Inpatient Medical Units. MEDSurg Nursing. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=112911528&site=eds-live&scope=site
Schub, T., & Karakashian, A. (2018). Fall Prevention Plans: Implementing. CINAHL Nursing Guide. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=nup&AN=T703871&site=eds-live&scope=site

NR 439 Week 3 Problem/PICOT/Evidence Search (PPE) Worksheet

Williams, T., Szekendi, M., & Thomas, S. (2014). An Analysis of Patient Falls and Fall Prevention Programs Across Academic Medical Centers. Journal of Nursing Care Quality. Retrieved from https://chamberlainuniversity.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=23842442&site=eds-live&scope=site

Implications of the Evidence

From the reviewed evidence, I learned that any intervention aimed at preventing falls is preferable to having no intervention at all. Various factors contribute to falls, including medications, diagnoses, and physical limitations; however, the consistent finding is that nursing interventions significantly reduce fall occurrences. Falls have severe implications for patients and can lead to substantial financial burdens for healthcare facilities, resulting in longer stays, unplanned surgeries, and even death (Williams et al., 2014). As highlighted by Godlock, Christiansen, and Feider (2016), a fall prevention plan developed in collaboration with a patient safety team can effectively lower fall rates significantly. Therefore, I believe the nursing evidence-based practice committee should prioritize their next research project on fall prevention strategies for inpatients.

Evidence Search Terms

Falls in inpatient facilities
Fall prevention
Fall risks in hospitals
Evidence-based study for fall prevention
Hospital fall rates

Evidence Search Strategies

Full Text: Ensured access to complete articles.
Selected Publication Dates: Limited search to articles published within the last 10 years.
Academic or Scholarly (Peer-Reviewed) Journals: Focused on quality research.
Selected Key Terms from PICOT Question: Utilized relevant keywords to refine searches.