NURS FPX 8030 Assessment 2 Evidenced-Based Literature Search and Organization
NURS FPX 8030 Assessment 2 Evidenced-Based Literature Search and Organization
Name
Capella university
NURS-FPX 8030 Evidence-Based Practice Process for the Nursing Doctoral Learner
Prof. Name
Date
Problem Statement and Patient Safety Issue
Ensuring patient safety remains a fundamental priority within healthcare organizations, as it directly correlates with improved patient outcomes. Among various safety concerns, preventing patient falls is a key focus area. At Henry Ford Hospital (HFH), patient falls pose a significant challenge, particularly among elderly individuals admitted to acute care units. Consequences of such incidents include traumatic head injuries, contusions, and bone fractures. Recent safety data from Leapfrog (2024) reveal a fall rate of 0.164 per 1,000 discharges in 2023, with a hip fracture incidence of 0.09 due to inpatient falls. These figures underscore the pressing need for effective interventions to reduce fall rates. Despite implementing existing fall prevention protocols, falls remain a persistent safety threat, contributing to increased morbidity, mortality, and financial strain. Approximately 30–35% of inpatient falls lead to injury, extending hospital stays by an average of 6.3 days and adding approximately \$4,000 per incident in medical expenses (Mikos et al., 2021).
PICOT Question
In an acute care setting, does implementing a standardized patient fall prevention bundle, compared to the current fall prevention practices, decrease the incidence of falls among elderly patients within a 12-week period?
- Population (P): Elderly patients hospitalized in the acute care unit at HFH
- Intervention (I): Standardized patient fall prevention bundle comprising risk assessments, education for patients and staff, environmental adjustments, and provision of assistive devices
- Comparison (C): Existing fall prevention strategies
- Outcome (O): Reduction in the number of falls among elderly patients
- Timeframe (T): 12 weeks
Narrative of Search Strategy
A structured, systematic literature search was conducted to address the PICOT question regarding the effectiveness of a comprehensive patient fall prevention bundle in reducing fall rates among older inpatients at HFH. The search began with the development of relevant keywords, including “patient fall,” “fall prevention intervention,” and “fall prevention bundle effectiveness.” These terms guided the search across reputable databases such as Cochrane Library, CINAHL, and PubMed, focusing on articles published within the past five years. Filters ensured access to full-text, open-access studies. To broaden the search, appropriate MeSH (Medical Subject Heading) terms were utilized (DeMars & Perruso, 2022).
Inclusion criteria encompassed English-language publications emphasizing hospital-based fall prevention strategies aligned with the PICOT components. Articles were excluded if they addressed irrelevant populations, were conducted outside hospital settings, were protocol papers, or were published more than five years ago. The PRISMA diagram in the Appendix details this process (Shaffril et al., 2021).
Identify Databases Searched
Systematic searches were conducted in the Cochrane Library, CINAHL, and PubMed databases to retrieve high-quality evidence on inpatient falls among elderly populations.
Initial Search Results
The preliminary database searches yielded 32 articles, all published within the last five years.
Screening
Articles underwent an initial screening phase to remove duplicates and ineligible records through automation tools and title/abstract reviews. Four articles were excluded during this step.
Eligibility
A total of 27 articles proceeded to full-text evaluation for eligibility, focusing on their relevance to patient fall prevention interventions in acute care environments.
Excluded Studies
Five studies were removed at the eligibility stage due to factors such as language limitations, study population mismatch, or being protocol papers.
Included Studies
The final review incorporated 16 peer-reviewed articles, which collectively examined the efficacy of fall prevention bundles and related interventions in addressing the fall rates among elderly inpatients. These studies reflected diverse methodologies, such as randomized controlled trials and systematic reviews, directly supporting the PICOT framework.
PRISMA Flow Diagram
The accompanying PRISMA diagram outlines the entire selection process from identification through study inclusion within the systematic review.
Appropriate Databases and Robust Keywords
To obtain comprehensive evidence on the effect of fall prevention bundles, searches were executed in databases such as CINAHL, PubMed, and the Cochrane Library. Key search terms included “patient fall,” “fall prevention intervention,” and “fall prevention bundle effectiveness,” strategically combined using Boolean operators “AND” and “OR” to optimize search results (Albasha et al., 2023). These databases were selected for their extensive coverage of medical and nursing research, ensuring access to credible, peer-reviewed evidence.
Inclusion and Exclusion Criteria for Articles
The inclusion criteria prioritized studies published in the last five years, in English, and those focusing on elderly populations in hospital acute care settings similar to HFH. Eligible studies needed to evaluate patient fall prevention bundles incorporating risk assessment, education, environmental modifications, and assistive equipment, reporting outcomes specifically related to fall rate reductions (Heng et al., 2020). Articles were excluded if they addressed irrelevant populations, non-hospital settings, protocol papers, or lacked rigorous methodologies. After applying these criteria, approximately 30–32 articles were initially shortlisted for further assessment. The final selection included studies of various designs, such as systematic reviews and randomized controlled trials, all providing empirical evidence supporting fall prevention strategies among elderly inpatients.
References
Albasha, N., Ahern, L., O’Mahony, L., McCullagh, R., Cornally, N., McHugh, S., & Timmons, S. (2023). Implementation strategies to support fall prevention interventions in long-term care facilities for older persons: A systematic review. BioMed Central Geriatrics, 23(1), 47. https://doi.org/10.1186/s12877-023-03738-z
NURS FPX 8030 Assessment 2 Evidenced-Based Literature Search and Organization
DeMars, M. M., & Perruso, C. (2022). MeSH and text-word search strategies: Precision, recall, and their implications for library instruction. Journal of the Medical Library Association, 110(1). https://doi.org/10.5195/jmla.2022.1283
Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A.-M., & Morris, M. E. (2020). Hospital falls prevention with patient education: A scoping review. BioMed Central Geriatrics, 20(1). https://doi.org/10.1186/s12877-020-01515-w
Leapfrog. (2024). Henry Ford Hospital- Hospital details table. Hospitalsafetygrade.org. https://www.hospitalsafetygrade.org/table-details/henry-ford-hospital
Mikos, M., Banas, T., Czerw, A., Banas, B., Strzępek, L., & Curyło, M. (2021). Hospital inpatient falls across clinical departments. International Journal of Environmental Research and Public Health, 18(15), 8167–8167. https://doi.org/10.3390/ijerph18158167
Shaffril, H. A., Samsuddin, S. F., & Abu Samah, A. (2021). The ABC of systematic literature review: The basic methodological guidance for beginners. Quality & Quantity, 55, 1319-1346. https://doi.org/10.1007/s11135-020-01059-6
