Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example

Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example

Patient falls are a major global health issue that has a negative impact on health outcomes. The most frequent adverse events in the delivery of healthcare are patient falls, with between 2% and 17% of hospitalized patients in the US experiencing falls. Notably, difficulties associated with falls are more common in elderly persons (those 65 years of age and above) (Vaishya & Vaish, 2020). A common risk factor for falls among the elderly in a hospital setting includes aging difficulties, such as impaired vision and hearing, decreased reflexes, dementia, age-related muscle loss, and comorbidities like hypertension and diabetes.(Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

Accordingly, nurses are essential providers who can stop falls among elderly patients in hospitals. While providing the security required to ensure that patients do not face medical issues while receiving care, nurses provide care to hospitalized patients (Appeadu & Bordoni, 2022). Therefore, nurse-led interventions will be essential to reducing the risk of falls among senior hospital patients while also enhancing their health outcomes. One of the key methods for preventing falls has been advocated: evidence-based hourly rounding. Hourly rounding enhances the interactions between patients, clinicians, and patients, enhancing safety and patient outcomes. The intervention entails routine observation of patients and their surroundings to spot potential dangers while keeping tabs on their health. This paper critiques qualitative research articles selected as literature support for the research topic and PICOT question.(Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

PICOT Question

Among Elderly patients (65 years and above) (P) does hourly rounding (I) compared to the use of bed alarms (C) lead to few to zero fall incidences (O) during hospitalization (T)? (Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

Background of Studies

Zadvinskis et al. (2019) and Anu (2021) have been selected as quantitative literature support for the research topic and PICOT question. Zadvinskis et al. (2019) investigate how nurse-sensitive structures and processes, including work engagement, fall risk frequency, purposeful rounds frequency, and patient falls are related. The researchers inquire whether purposeful rounding and patient risk of falls discussion and work engagement lead to decreased falls. The article hypothesizes that strong work engagement is linked to a better nurse-assessed quality of care. The study also recognizes that previous research adopted self-reported outcome measures, limiting research generalizability and internal validity. With increasing falls and fall-related injuries in healthcare facilities, it is imperative to explore potential risk factors and interventions. Nurses would benefit more from more evidence-based interventions at their disposal, stressing the significance of this research study. (Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

Anu (2021) explores the relationship between hourly rounding and fall prevention among older patients in long-term care. The researcher seeks to answer whether education on hourly rounding provided to nursing staff compared to no education on hourly rounding reduces the number of falls among residents in the LTC units over ten weeks. According to Anu (2021), long-term care facilities are experiencing an increased rate of falls and fall-related injuries, raising the cost of care and hospitalization rates. The researcher considers hourly rounding as a proactive evidence-based intervention that can help nurses identify patients’ needs early. Early identification and intervention are integral to improved fall prevention outcomes. The primary aim is improving patient safety through effective education and hourly rounding. This article is significance to nursing as it offers insights into an evidence-based intervention to help reduce falls and fall-related injuries that impact care quality and safety. (Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

How the Articles Support the Nursing Practice Problem

Zadvinskis et al. (2019) and Anu (2021) provide valuable insights into patient falls in healthcare facilities and the potential impact of hourly rounding in reducing falls and fall-related risks. The articles directly support the nursing practice problem and PICOT question because the studied research problem and selected interventions are aligned. Zadvinskis et al. (2019) explore the relationship between nurses’ structural process (work engagement and frequency of purposeful rounding) and outcome indicators. Anu (2021) explores the effectiveness of education on hourly rounding in reducing the number of falls. Because the problem and intervention selected align, the findings of the two articles can directly help answer the PICOT question by demonstrating the effectiveness of hourly rounding in addressing patient falls.  (Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

Regarding how the intervention and comparison group compare, the PICOT question identifies hourly rounding as the intervention to address falls among older patients 65 years and over. Zadvinskis et al. (2019) select multiple independent variables, including work engagement, fall risk discussion, and purposeful rounds frequency in 41 nursing units from 7 hospitals. Anu (2021) selects hourly rounding as the intervention and staff members and residents as the study group. None of the selected studies focuses on falls among individuals 65 years and older, although the selected interventions align with that of the PICOT question.  (Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

Method of Studies

Zadvinskis et al. (2019) adopt a descriptive, cross-sectional survey design in 41 nursing units from seven hospitals. A descriptive cross-sectional study allows the study of a condition and potentially related factors at one point in time for a specific population. The researchers shared a survey with nurses, including the Utrecht Work Engagement Scale. The study obtained fall data from the National Database of Nursing Quality Indicators reports. Anu (2021) adopts a process improvement approach that took 10 weeks. The researcher collected data from staff members aged 18-60 years. The study also obtained data from 41 residents. Staff members obtained education on hourly rounding and hourly rounding log documentation before intervention implementation. The facilities’ falls database provided data regarding pre and post-fall rates. Zadvinskis et al. (2019) provide data that can help reduce patient falls and related complications, but the sample was selected from a single region, limiting inference to other areas. Anu (2021) provides valuable information to help improve the quality and safety of nursing care, but the sample size is small, limiting generalizability. (Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

Results of Studies

Zadvinskis et al. (2019) found that work engagement (WE) scores were high for nurses who participated more in purposeful rounding. Highly engaged nurses conducted more purposeful hourly rounding and fall risk discussions during the bedside report than minimally engaged nurses. However, there was a 6% increase in fall injuries post-frequent purposeful rounding. This result implies that work engagement was not associated with patient falls. Per the findings, nurses should follow the hourly purposeful rounding for improved outcomes in fall prevention.(Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

Anu (2021) found that hourly rounding grossly decreased falls by 36%. Post-intervention, the nursing homes experienced 15 falls compared to 41 falls pre-intervention. The relationship between hourly rounding and fall prevention was statistically significant (P-values = -<0.0001 and t-value = -5.81). The article is relevant to nursing practice as it offers insights into the implementation of hourly rounding programs to reduce falls and fall-related injuries that lower the quality of nursing services.(Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

Ethical Considerations

Research work follows ethical considerations, which are a set of guidelines and principles that guide and inform research designs and practices. Research studies involving human participants should ensure voluntary participation by obtaining informed consent and protect participants from potential harm from physical and psychological factors and other factors like data breaches (Barrow et al., 2022). Informed consent involves giving participants vital research information, including potential risks and benefits, medical procedures or treatments, clinical trials, participants’ roles, data protection solutions, and engagement rules to help them make participation decisions. Protecting research participants’ rights elevates research validity and helps maintain scientific integrity. Zadvinskis et al. (2019) and Anu (2021) obtained informed consent from the participating groups to ensure voluntary participation. The studies also avoided collecting personally identifying data to protect participants’ privacy and confidentiality.   (Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

Conclusion

Purposeful hourly rounding has been proposed as a potential intervention to prevent falls and fall-related injuries. Zadvinskis et al. (2019) and Anu (2021) adopt hourly rounding as an intervention to address falls among hospitalized patients and residents. Zadvinskis et al. (2019) explored the relationship between nurses’ structural process (work engagement and frequency of purposeful rounding) and outcome indicators and found that work engagement scores were high for nurses who participated more in purposeful rounding. Anu (2021) explored whether education on hourly rounding would help reduce the number of falls among residents. These articles are relevant to the research topic, and they will help answer the PICOT question as they offer evidence on the effectiveness of implementing hourly rounding programs to reduce falls and fall-related injuries that lower the quality of nursing services.(Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

References

Anu, J. A. (2021). Hourly Rounding and fall prevention among the elderly in long-term care: a change process. Journal of geriatric medicine, 3(1), 1-5. https://doi:10.30564/jgm.v3i1.2614(Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

Appeadu, M. K., & Bordoni, B. (2022). Falls and fall prevention in the elderly. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560761/(Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

Barrow, J. M., Brannan, G. D., & Khandhar, P. B. (2022). Research ethics. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK459281/

Vaishya, R., & Vaish, A. (2020). Falls in Older Adults are Serious. Indian journal of orthopaedics, 54(1), 69–74. https://doi.org/10.1007/s43465-019-00037-x(Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

Zadvinskis, I. M., Carr, J., Schweitzer, K. E., Patil, N., Clifton, W. D., & Ebert, K. E. (2019). The impact of nursing work and engagement on patient falls. JONA: The Journal of Nursing Administration, 49(11), 531-537. https://doi: 10.1097/NNA.0000000000000808(Research Critique on Patient Falls as a Global Health Issue Comprehensive Nursing Paper Example)

https://www.ncbi.nlm.nih.gov/