NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

Name

Capella university

NURS-FPX 8030 Evidence-Based Practice Process for the Nursing Doctoral Learner

Prof. Name

Date

Critical Appraisal of Evidence-Based Literature

Falls among older adult patients remain a critical patient safety issue with considerable implications for health outcomes. Such incidents not only lead to serious injuries and fractures but also escalate healthcare expenses due to extended hospital stays and additional treatments, placing financial pressure on healthcare systems (Mikos et al., 2021). The occurrence of patient falls in acute care units, including at Henry Ford Hospital (HFH), represents a significant challenge with detrimental effects on both patient recovery and the utilization of healthcare resources. Heikkilä et al. (2024) emphasized that inpatient falls prolong hospitalizations, increase the risk of patient harm, and negatively influence recovery trajectories. This assessment offers a critical evaluation of relevant literature addressing the problem of patient falls in clinical settings.

PICO(T) Question

The PICO(T) question guiding this review is: In an acute care unit, does the implementation of a standardized patient fall prevention bundle, compared to existing fall prevention practices, reduce the incidence of falls among elderly patients within 12 weeks? This inquiry focuses on determining whether a structured fall prevention bundle—encompassing risk assessments, staff and patient education, environmental modifications, and assistive devices—can effectively lower fall rates among elderly inpatients over a specified timeframe, compared to current practices.

Thesis Statement

The central argument of this review posits that introducing a standardized fall prevention bundle within acute care settings will substantially reduce fall occurrences among older adults over 12 weeks, thereby enhancing patient safety and healthcare quality outcomes. Furthermore, it will positively influence organizational performance and reinforce the institution’s reputation. This thesis underscores the importance of evidence-based, systematically evaluated strategies in preventing inpatient falls and highlights the need for their integration into healthcare policy and practice.

Critical Appraisal and Selection of Tool

For evaluating the selected literature, the Joanna Briggs Institute (JBI) critical appraisal checklist for systematic reviews and research syntheses was chosen. This tool assesses the methodological rigor and trustworthiness of studies and is particularly suitable for intervention-based research such as fall prevention initiatives. The appraisal tool evaluates several domains, including the clarity of research questions, appropriateness of inclusion criteria, study design suitability, data collection robustness, quality assessment processes, result validity, and potential publication bias (Munn et al., 2012). Its comprehensive framework ensures a reliable appraisal of research strengths and limitations, making it an ideal choice for assessing peer-reviewed studies relevant to inpatient fall prevention.

Annotated Bibliography

Strini, V., Schiavolin, R., & Prendin, A. (2021). This systematic review investigated fall risk assessment scales applied in healthcare settings. The study’s credibility is reflected in its comprehensive search strategy, which utilized databases like MEDLINE, The Cochrane Database, and CINAHL while adhering to specific inclusion criteria, including language and publication date parameters. The researchers detailed their data extraction methods, ensuring replicability and transparency. Their findings contribute valuable insights into existing fall risk tools, including the Johns Hopkins Fall Risk Assessment Tool (JHFRAT), supporting patient safety by facilitating effective fall risk screening. Using the JBI checklist, the article demonstrated strength in defining research questions, applying appropriate study designs, and presenting reliable data collection procedures.

Morris, M. E., et al. (2022). This study conducted a meta-analysis and systematic review of hospital-based fall prevention interventions. Its rigor is evident in its extensive literature search, explicit eligibility criteria, and systematic data analysis methods. The authors complied with established systematic review standards, including the Cochrane and PRISMA guidelines. The review evaluated interventions such as patient education, environmental adjustments, wearable sensors, and risk assessments. Using the JBI appraisal checklist, this research showed excellence in clearly defining objectives, implementing rigorous data collection, assessing study bias, and offering evidence-based recommendations for fall prevention, making it a valuable resource for improving hospital safety practices.

NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

Parsons, R., et al. (2023). This scoping review explored inpatient fall prediction models, incorporating machine learning applications. Its robust methodology involved a broad database search, including PubMed, CINAHL, IEEE Xplore, and EMBASE, combined with well-defined inclusion criteria and data extraction protocols. The review followed the O’Malley and Arksey framework for scoping reviews and received high ratings on the JBI checklist for clarity of objectives, study design, and data analysis. The study’s relevance lies in highlighting how predictive models can aid fall prevention by identifying high-risk patients based on physical and cognitive assessments, contributing to improved clinical decision-making.

Odasso, M. M., et al. (2021). This systematic review assessed clinical practice guidelines for fall prevention and management among older adults in acute care. It displayed strong methodological quality through comprehensive database searches (e.g., MEDLINE, PubMed, PsycINFO) and the use of the AGREE-II tool for evaluating guidelines. Following PRISMA guidelines, the study maintained high standards in data collection and analysis. Utilizing the JBI checklist, the review effectively assessed the methodological soundness of included guidelines, focusing on interventions such as gait assessment, fracture management, footwear modifications, and environmental adjustments. Its findings enhance understanding of best practices in fall prevention within healthcare systems.

Giovannini, S., et al. (2022). This narrative review analyzed fall risk factors, screening approaches, and management strategies, including rehabilitation protocols. The study was methodologically sound, following SANRA standards for narrative reviews and presenting clear objectives and structured literature searches. The authors emphasized risk factors like medication effects, cognitive impairments, and gait abnormalities. Using the JBI checklist, the review rated highly for transparency, credibility, and bias mitigation. It contributes to fall prevention literature by offering adaptable interventions suitable for various clinical settings, supporting patient safety through tailored, evidence-based strategies.

References

Giovannini, S., Brau, F., Galluzzo, V., Santagada, D. A., Loreti, C., Biscotti, L., & Bernabei, R. (2022). Falls among older adults: Screening, identification, rehabilitation, and management. Applied Sciences, 12(15), 7934. https://doi.org/10.3390/app12157934

Heikkilä, M., Lantta, T., Anttila, M., & Kontio, R. (2024). Fall prevention interventions and hospital inpatients: A systematic review. Journal of Clinical Nursing, 33(1-2), 112–129. https://doi.org/10.1111/jocn.16728

Mikos, M., Jędrzejewska, B., Rypicz, Ł., & Ślusarska, B. (2021). Analysis of risk factors and consequences of falls among hospitalized older patients. International Journal of Environmental Research and Public Health, 18(12), 6314. https://doi.org/10.3390/ijerph18126314

NURS FPX 8030 Assessment 3 Critical Appraisal of Evidence-Based Literature

Morris, M. E., Webster, K., Jones, C., Hill, A. M., Haines, T., McPhail, S., Kiegaldie, D., Slade, S., Jazayeri, D., Heng, H., Shorr, R., Carey, L., Barker, A., & Cameron, I. (2022). Interventions to reduce falls in hospitals: A systematic review and meta-analysis. Age and Ageing, 51(5), afac077. https://doi.org/10.1093/ageing/afac077

Munn, Z., Moola, S., Riitano, D., & Lisy, K. (2012). The development of a critical appraisal tool for use in systematic reviews addressing questions of prevalence. International Journal of Health Policy and Management, 3(3), 123–128. https://doi.org/10.15171/ijhpm.2014.71

Odasso, M. M., Kamkar, N., Pieruccini-Faria, F., Osman, A., Sarquis-Adamson, Y., Close, J., & Kobusingye, O. (2021). Evaluation of clinical practice guidelines on fall prevention and management for older adults: A systematic review. JAMA Network Open, 4(12), e2138911. https://doi.org/10.1001/jamanetworkopen.2021.38911

Parsons, R., Blythe, R. D., Cramb, S. M., & McPhail, S. M. (2023). Inpatient fall prediction models: A scoping review. Gerontology, 69(1), 14–29. https://doi.org/10.1159/000525727

Strini, V., Schiavolin, R., & Prendin, A. (2021). Fall risk assessment scales: A systematic literature review. Nursing Reports, 11(2), 430–443. https://doi.org/10.3390/nursrep11020041