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

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

Student Name

Chamberlain University

NR-439: RN Evidence-Based Practice

Prof. Name:

Date

Problem/PICOT/Evidence Search (PPE) Worksheet

Name:
Date:

Problem and Background

Patient falls represent one of the most commonly reported adverse events during hospitalizations, resulting in injuries approximately 30% of the time. The Centers for Medicare & Medicaid Services classify falls as a preventable healthcare-acquired condition. A significant portion of the medical-surgical inpatient population comprises aging individuals, who are at a higher risk of falls (Godlock, Christiansen, & Feider, 2016). Falls often have severe physical and emotional implications for patients and their families, alongside increased financial burdens for healthcare facilities. Such events can extend hospital stays, necessitate unexpected surgeries, and even result in fatalities (Williams, Szekendi, & Thomas, 2014).

Given the profound consequences of patient falls, it is critical to implement robust fall risk assessments and prevention plans. The goal of these interventions is to minimize the incidence and impact of falls while promoting optimal patient independence (Schub & Karakashian, 2018). Research indicates that establishing a fall prevention plan with a patient safety team can reduce the fall rate from 1.90 to 0.69 falls per 1,000 occupied bed days (Godlock, Christiansen, & Feider, 2016).

Clinical Nursing Practice Problem

From the assignment guidelines, the clinical priority area selected is fall prevention in inpatient medical-surgical units. This issue is pivotal due to its direct impact on patient safety, quality of care, and healthcare costs. Addressing this problem can significantly enhance patient outcomes and reduce adverse events. My rationale for choosing this topic stems from its prevalence, the preventable nature of falls, and the measurable improvements observed with evidence-based interventions.

Clinical Nursing PICOT Question

PICOT Question:
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 six months (T)?

Defining PICOT Elements:
| Element | Definition |
|————-|————————————————-|
| P (Population) | Adult inpatient medical-surgical patients |
| I (Intervention) | Fall risk assessment and fall prevention plan implementation |
| C (Comparison) | Previous fall rates without a fall prevention plan |
| O (Outcome) | Reduction in falls in medical-surgical units |
| T (Time) | Over six months |

Evidence Retrieval Process and Summary

Evidence Relevance and Selection

The evidence retrieved from the Chamberlain College of Nursing library is highly relevant as it focuses on inpatient settings and demonstrates a direct correlation between nursing interventions and reduced fall rates. The studies highlight nursing-specific interventions, including risk assessments and tailored prevention strategies. I selected this evidence for its peer-reviewed nature, relevance to nursing practice, and publication within the past five years.

Key Evidence:

1. Godlock, G., Christiansen, M., & Feider, L. (2016). Implementation of an Evidence-Based Patient Safety Team to Prevent Falls in Inpatient Medical Units. MEDSurg Nursing.
2. Schub, T., & Karakashian, A. (2018). Fall Prevention Plans: Implementing. CINAHL Nursing Guide.
3. 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.

Implications of the Evidence

The findings emphasize that nursing interventions, particularly through fall prevention plans, significantly reduce fall rates. While the causes of falls are multifaceted—ranging from medication side effects to physical limitations—the implementation of structured prevention strategies consistently yields positive outcomes. For example, fall prevention plans facilitated by patient safety teams have reduced fall rates to as low as 0.69 per 1,000 occupied bed days (Godlock, Christiansen, & Feider, 2016). Based on this evidence, the nursing evidence-based practice committee should prioritize fall prevention as their next research focus to further refine and expand these interventions.

Evidence Search Terms and Strategies

References

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 Chamberlain University Library.

Schub, T., & Karakashian, A. (2018). Fall Prevention Plans: Implementing. CINAHL Nursing Guide. Retrieved from Chamberlain University Library.

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 Chamberlain University Library.