Evidence-Based Practice Project: Evaluation of Literature
Sonia Khadar
Grand Canyon University
NUR-550-0501
Dr. Arvayo
August 16th, 2023
Evidence-Based Practice Project: Evaluation of Literature
Introduction
Falls amongst the veteran population in acute care surroundings are a crucial therapeutic concern explored in this research review. Such falls have serious consequences, including the possibility of bodily harm, extended hospital stays, increased healthcare expenses, and a possible decline in the general well-being of veterans. The emphasis is on evaluating the efficacy of an educational intervention designed for registered nurses (RNs) and nursing assistants (NAs) to lessen falls in acute care surroundings in response to this urgent issue. This review's primary goal is to thoroughly assess recent studies over the last five years to ascertain whether these educational initiatives have significantly decreased the incidence of falls among veterans. This evaluation is based on the PICOT question: "For the veteran population in acute care settings, does implementing an educational intervention for RNs and NAs on falls reduction lead to a decrease in the incidence of falls compared to standard care within the last five years?"
Search Methods
A thorough and organized process was used to find relevant literature for this study. Using a clever combination of keywords and Boolean operators pertinent to the senior population, acute care settings, falls prevention, educational interventions, registered nurses, and nursing assistants, major medical databases such as PubMed, CINAHL, and MEDLINE were carefully examined. The inclusion criteria were explicitly created to cover papers written in English, published within the last five years, and focusing on instructional initiatives aimed at RNs and NAs in acute care settings. The explicit goal was to talk about fall prevention in the context of caring for veterans. The review intended to include a variety of quantitative and qualitative research approaches to fully capture the many aspects of these educational programs' performance. The chosen articles were then further analyzed to offer information on the efficiency of these interferences in lowering the occurrence of falls among veterans, as well as viewpoints from the healthcare professionals involved and firsthand accounts from the veterans regarding fall prevention initiatives.
Synthesis of the Literature
In their qualitative study, King et al. (2018) studied nurses' involvements with fall deterrence in hospice settings and patient care strategies. The study shed light on nurses' concerns when implementing a strict communication strategy for fall prevention. Inadvertently limiting patient mobility to conform to the "zero falls" target frequently has unforeseen repercussions. The study's results highlight the value of patient-centered therapies and the requirement for unit-specific solutions. This is consistent with the suggested training intervention for RNs and NAs, which highlights evidence-based fall prevention measures suited to acute care settings and ultimately supports the safety of veterans.
A quasi-experimental investigation on the effects of an educational intervention on nurses' assessments of fall risk was carried out by Montejano-Lozoya et al. in 2020. With systematic assessment training, the intervention group experienced significantly fewer falls than the control group. These findings support the suggested strategy, which calls for specialized training programs for nurses to improve the identification of patients at risk for falls and to reduce such risks.
To determine the effects of a nursing intervention on fall risk indicators in senior people with arterial hypertension, Moreira et al. (2021) conducted a clinical trial. The study showed a significant decrease in diseases and risk variables linked to falls, demonstrating the efficacy of the nursing intervention. This aligns with the goal of the suggested educational intervention, which is to lower the risk of falls among veterans receiving acute care by providing specialized instruction and interventions.
Slater (2019) conducted a quality improvement campaign in a specialized care unit that targeted RNs with teaching interventions on patient mobility and fall prevention. Despite the intervention's enhanced knowledge among RNs, no appreciable decline in fall rates was seen. The study's findings emphasize the need for more research and possible adjustments to improve the efficiency of the suggested educational involvement in reducing veteran falls (Slater, 2019).
To ascertain the effect of occupational therapist-delivered fall prevention education on nursing staff self-efficacy in long-term care institutions, Leverenz and Lape (2018) undertook a pilot study. The instructional program dramatically raised nursing assistants' self-efficacy regarding falls. This data supports the suggested educational intervention (Leverenz & Lape, 2018), which aims to improve the self-efficacy and knowledge of RNs and NAs working in acute care settings regarding fall prevention.
For elderly residents of the neighborhood, Ong et al.'s thorough study of fall prevention education was published in 2021. The analysis showed that fall prevention education effectively raised risk awareness, knowledge, and adoption of preventive actions within this population. The study supports the goal of the suggested educational intervention: to improve veterans' understanding of and activities related to fall preclusion in acute care locations.
Innab (2022) investigated how Saudi Arabian nurses perceived fall risk influences and anticipation measures in acute care locations. The study emphasized the value of nurse education. It showed that nurses who had received more education and had taken part in fall prevention training were more knowledgeable of risk factors and prevention tactics. These results support the objective of the suggested educational intervention, which is to improve RNs' and NAs' comprehension of and application of fall prevention techniques for the veteran population.
To determine the scope and caliber of educational interventions for healthcare professionals to avoid falls, Shaw et al. (2020) did a scoping review. The study highlighted the value of healthcare professional education in preventing falls while also highlighting the absence of defined guidelines for instructional design. The article's emphasis on improving educational interventions is consistent with the educational intervention suggested to reduce falls among veterans in acute care settings.
Comparison of Articles
Utilizing educational interventions to address fall prevention across various groups and healthcare settings is the overarching theme of the publications under evaluation. Although study populations, techniques, and outcomes can vary, one aspect that unites them all is education's crucial role in raising knowledge, awareness, and self-efficacy about fall prevention. After taking part in educational interventions, participants consistently demonstrated greater comprehension of fall risk factors and preventive actions, according to research like Leverenz & Lape (2018), Ong et al. (2021), and Innab (2022). Additionally, nurses and nursing assistants are crucial in implementing successful fall prevention programs among healthcare workers.
The overriding topic of empowerment via education, which repeatedly surfaces as a tactic to reduce fall risks and improve patient safety, underlies these publications. The research explores several facets of fall prevention education, including community-based education for senior citizens (Ong et al., 2021), interventions for healthcare professionals (Slater, 2019), and interventions for long-term care institutions (Leverenz & Lape, 2018). The approaches used range from qualitative studies that explore healthcare professionals' perspectives to systematic evaluations that evaluate the overall effect of fall prevention education (King et al., 2018; Shaw et al., 2020). Despite these disparities, there is still a shared focus on the advantageous effects of educational interventions.
Collectively, the publications support the value of educational interventions in preventing falls, verifying their contribution to raising awareness, self-efficacy, and preventative behaviors. However, variations in study populations, environments, and methodology serve as a reminder of the complexity of fall prevention strategies. The studies emphasize the value of healthcare professionals in putting these techniques into practice while stressing the necessity for specially designed interventions adapted to particular circumstances. Although the benefits are clear, certain drawbacks should be acknowledged, including sample size, intervention variability, and reliance on self-reported data. These articles offer insightful information for developing focused instructional fall prevention treatments to increase patient safety in various healthcare settings significantly.
Suggestions for Future Research
The evaluation of the literature finds gaps and suggests areas for further research on fall prevention and educational interventions. First, investigations into the long-term viability of the beneficial results seen after educational interventions are required. The creation of interventions with long-lasting effects will be guided by understanding whether the information and behaviors acquired through these interventions endure over time. The effectiveness of instructional initiatives in various demographic and cultural situations can also be better understood by examining numerous populations outside of older persons and different healthcare settings.
Second, comparative assessments of various intervention types are necessary to identify the best strategies regarding knowledge retention, behavior modification, and overall fall prevention outcomes. Evidence-based recommendations for creating treatments that have the most significant possible impact could result from this research. Additionally, using technical advancements to deliver fall prevention education, such as digital tools or online platforms, is an attractive field for research. Insights for reaching wider audiences and boosting engagement might come from evaluating the viability and effectiveness of utilizing technology in educational initiatives.
Future studies should examine the long-term effects of educational interventions, research other demographics, and environments, compare different intervention types, utilize technological advancements, and address implementation challenges. These directions for research will considerably advance the development of successful and flexible interventions to be used in various settings and fall prevention tactics.
Conclusion
In conclusion, the research emphasizes the critical role that educational interventions have in reducing falls among different populations, underscoring the significance of healthcare professionals, and boosting knowledge, self-efficacy, and preventive behaviors. Although studies use various techniques, environments, and intervention types, their overall conclusions highlight the necessity of individualized educational strategies, long-term sustainability analysis, and research of varied populations. This corpus of research lays the groundwork for therapies that prevent falls and urges more studies to improve methods and raise patient safety.
References
Innab, A. M. (2022). Nurses' perceptions of fall risk factors and prevention strategies in acute care settings in Saudi Arabia. Nursing Open, 9(2). https://doi.org/10.1002/nop2.1182
King, B., Pecanac, K., Krupp, A., Liebzeit, D., & Mahoney, J. (2018). Impact of Fall Prevention on Nurses and Care of Fall Risk Patients. The Gerontologist, 58(2), gnw156. https://doi.org/10.1093/geront/gnw156
Leverenz, M., & Lape, J. (2018). Education on Fall Prevention to Improve Self-Efficacy of Nursing Staff in Long Term Care: a Pilot Study. Internet Journal of Allied Health Sciences and Practice, 16(3). https://doi.org/10.46743/1540-580x/2018.1744
Montejano-Lozoya, R., Miguel-Montoya, I., Gea-Caballero, V., Mármol-López, M. I., Ruíz-Hontangas, A., & Ortí-Lucas, R. (2020). Impact of Nurses’ Intervention in the Prevention of Falls in Hospitalized Patients. International Journal of Environmental Research and Public Health, 17(17), 6048. https://doi.org/10.3390/ijerph17176048
Moreira, R. P., Guerra, F. V. G., Ferreira, G. de O., Cavalcante, T. F., Felício, J. F., Ferreira, L. C. C., & Guedes, N. G. (2021). Effects of the nursing intervention Fall Prevention in older adults with arterial hypertension using NANDA‐I, NIC, and NOC. International Journal of Nursing Knowledge. https://doi.org/10.1111/2047-3095.12346
Ong, M. F., Soh, K. L., Saimon, R., Wai, M. W., Mortell, M., & Soh, K. G. (2021). Fall prevention education to reduce fall risk among community-dwelling older persons: A systematic review. Journal of Nursing Management, 29(8). https://doi.org/10.1111/jonm.13434
Shaw, L., Kiegaldie, D., & Farlie, M. K. (2020). Education interventions for health professionals on falls prevention in health care settings: a 10-year scoping review. BMC Geriatrics, 20(1). https://doi.org/10.1186/s12877-020-01819-x
Slater, T. (2019). Reducing falls through an education intervention to increase nurse-promoted mobility in hospitalized patients. Nurse-promoted mobility in hospitalized patients. https://ir.library.louisville.edu/cgi/viewcontent.cgi?article=1026&context=dnp
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