Benchmark -Evidence-Based Practice Project: Literature Review

NUR-550 Benchmark -Evidence-Based Practice Project: Literature Review

Alcohol use disorder (AUD) remains a challenging problem for many Americans aged over eighteen years. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcohol use disorder (AUD) entails a condition characterized by the inability to stop or control alcohol use despite the adverse social, occupational, and health effects. Nurse practitioners, especially psychiatry nurses, are responsible for developing evidence-based care interventions to help patients with AUD (Rombouts et al., 2019). The NIAA asserts that close to 15 million individuals in the country suffer from AUD (National Institute on Alcohol Abuse and Alcoholism, n.d.). As direct caregivers, nurses are ideally positioned to improve patient outcomes by translating research into practice.

Hello! Nursing shortages continues to be an ongoing problem, and our patients are affected greatly when we continue to work short. Our patients are growing sicker and are requiring more time and care. Our nursing workload is increasing and the time that we are able to spend with our patients is decreased. When we have such as heavy workload, our time being spent collaborating with our patients and with the physician, decreases. This is where medical errors can happen and can lead to a poor communication amongst the interdisciplinary team, including our patients. Our patient’s quality of care decreases as well. Our patients are at a great risk for infection and poor outcomes when we are not able to spend time understanding and caring for their needs. Our nurses are having to take on such a great deal of workload that we are seeing an increase in our nurse burnout. Our nurses are being burned out by limited resources and shortages; our nurse satisfaction rates are going down. When nurses are feeling unsatisfied with their jobs, our patients care is also affected. Our nurses are not able to practice at the highest level that they can when they are feeling burned out, and unsatisfied with their positions. This is leading to an increase in workload and an increase in errors as well.  We are not able to spend our time and kn

Benchmark Evidence Based Practice Project Literature Review

Benchmark Evidence Based Practice Project Literature Review

owledge in using our critical thinking skills. We may not be able to notice with the decrease in time spend on patient care when something may be going on with our patients.

PICOT Question/Statement

In individuals from low socioeconomic status and poor educational levels suffering from alcohol use disorder (AUD) (P), does offering behavioral treatments and coordinated care with other providers (I) compared to non-interventions (C) lead to improvement in handling of alcohol withdrawal symptoms and treatment of alcohol use disorder (0) within 12 months (T)?

Search Methods

Nursing literature should be sourced from current and scholarly evidence. Articles should have the appropriate features and examine the study topic in depth using the PICOT as the guidance. The main search approach involved searching different journal databases that include MEDLINE/PubMed, CINAHL, and Cochrane Library for clinical trial and observation studies. Embase and ScienceDirect were also considered. Keywords included alcohol use disorder (AUD), behavioral treatments, coordinated care, and alcohol withdrawal symptoms. Articles used have been published in the last five years and centered on translational research.

Synthesis of Literature

Ray et al. (2021) deployed a qualitative review of treatment interventions for AUD and the current development. After discussing how to use translational research in developing AUD treatment, Ray et al. (2021) found that transitional research models can help stakeholders develop new AUD treatment interventions and translate the knowledge to patient care. Accordingly, stakeholders are advised to consider translational research in developing AUD treatment interventions. The article supports the EBP practice project proposal by showing the significance of translational research in developing treatment interventions.

Hass-Koffler and Schank (2020) evaluated the present translational research into neurobiological targets in alcohol and substance use

Evidence-Based Practice Project Literature Review

Evidence-Based Practice Project Literature Review

disorder treatment. The study was qualitative research (systematic literature review) where the scholars integrated preclinical and clinical neuroscience research to reduce the knowledge gap, identify and describe new treatment models and enhance translational efforts in advancing downstream recovery pathways for those suffering from AUD. Hass-Koffler and Schank (2020) found a need to develop more personalized treatment approaches and increased research on effective interventions for alcohol and substance use disorder treatment. The article supports the EBP project proposal by showing the need for stakeholders to work together and apply translational science findings to develop better interventions.

Click here to ORDER an A++ paper from our MASTERS and DOCTORATE WRITERS: Benchmark -Evidence-Based Practice Project: Literature Review

Louise et al. (2020) synthesized and evaluated the effectiveness of implementing programs to treat individuals with drug and alcohol problems using the Consolidated Framework for Implementation Research (CFIR) approach. The study was a systematic review implying that it evaluated the current existing evidence from previous study articles on alcohol use disorder (AUD). Louise et al. (2020) found that it is important to have a more insightful understanding of the effective interventions in helping individuals with AUD. The article supports the EBP project by shedding more light on barriers that practitioners face even when using EBP interventions in treating individuals with AUD in their clinical settings and offer divergent perspectives on what practitioners can do to enhance the efficacy of the existing integrated models.

Heilig et al. (2019) hypothesized that few medications exist to treat alcohol addiction, making the problem a medical condition. The primary method in the study is the use of neuroscience studies on alcohol addiction. The authors are keen on the development of neuroscience interventions to help treat these individuals. Key outcomes include the identification of different approaches that clinicians can deploy to treat the condition. The article supports the EBP project proposal by showing the various approaches/interventions that clinicians can deploy to ensure that they understand how to tackle AUD.

De Beaurepaire et al. (2019) examined the use of Baclofen as a treatment intervention for alcohol use disorder (AUD). They qualitatively reviewed information and integrated it to show the efficacy of Baclofen and its potential side effects.  De Beaurepaire et al. (2019) analyzed data from different settings where Baclofen has been used among patients with the condition. The key findings include the acceptable use of Baclofen, the ensuing side effects of the drug for individuals suffering from AUD, and recommended cautious use of Baclofen in treating AUD because of its safety reasons. The article offers an insightful analysis of one of the treatment interventions for the issue of AUD.

Wood et al. (2020) examined the role and efficacy of clinical champions in drug and alcohol and mental health practices. In this systematic review search (13 different studies), Wood et al. (2020) majored in different settings based on the need to get information on the role and efficacy of clinical champions in mental health settings. The main finding was that clinical champions are essential in facilitating practice changes and facilitate overcoming system barriers, and improved staff engagement and motivation. The article is relevant and highlights the need for stakeholders to understand the role and efficacy of clinical champions in treating different mental health challenges associated with alcohol use disorder (AUD).

Slade et al. (2021) used a case study approach to demonstrate how preclinical data and evidence from studies can be transitioned to help health populations with substance use disorder problems. They used hypotheses generated from the preclinical rodent studies to prove their efficacy in clinical settings and if they have a public health impact. Slade et al. (2021) found that clinicians and other stakeholders can leverage big data to make critical decisions and translate findings from preclinical studies to have effects in public health situations. The article is essential in underscoring the importance of different types of translational research in knowing AUD treatment barriers.

Thompson et al. (2017) evaluated drug therapy for alcohol dependence 12 months after initial diagnosis in primary care settings. They collected data from 39,980 participants with incidence diagnosis of alcohol dependence for 13 years. Thompson et al. (2017) found that treatment for alcohol dependence is haphazard. There is no demonstrated efficacy of the different approaches using drugs on alcohol dependence. The article is important and sheds more insight into the barriers that many individuals with alcohol dependence face in their efforts to get better clinical management of their condition.

Comparison of Articles

Broadly, all articles are translational research expanding knowledge on interventions for AUD and treatment barriers, among other focus areas. The primary theme is the need to increase the use of translational research types’ findings in public health situations to help individuals with substance use disorders. Concerning methods, qualitative and quantitative approaches differentiate the articles. Slade et al. (2021) and Thompson et al. (2017) are qualitative articles since they use a case study model and quantitative model with open cohort, respectively. Other studies are qualitative and mainly systematic literature reviews. De Beaurepaire et al. (2019), Heilig et al. (2019), Louise et al. (2020), Ray et al. (2021), and Chen et al. (2020) conducted a systematic literature review. Hass-Koffler and Schank (2020) performed a literature review of scientific literature in the specific areas of research about AUD.

On conclusions, there is a general observation that translational research should be used as the basis for developing treatment interventions in both quantitative and qualitative articles. However, more evidence from high-quality studies such as randomized controlled trials has been suggested in the systematic reviews. Indeed, dependence on systematic reviews is the main limitation in qualitative studies.  Thompson et al. (2017) provided findings that are not generalizable since the sample was not homogeneous. Although comprehensive, Slade et al. (2021) claimed that the case study could not substitute traditional progress. By agreeing that translational research can be the basis for finding public health solutions, no controversy was noted in the articles.

Recommendations for Future Research

To maximize the application of translational research, there is a need for more research from high-quality randomized control studies to demonstrate the efficacy of combining interventions like drug interventions and psychosocial approaches to enhance treatment of alcohol dependency. It is also important to explore more strategies and approaches among stakeholders to enhance clinical management of the patient population diagnosed with AUD. Cautious use of Baclofen in treating AUD because of its safety reasons. Further research on making patients understand the current use of the drug and others approved for AUD is crucial.


Nurses are uniquely positioned to recognize, prevent, and treat patients with AUD. They are trained to initiate and develop therapeutic relationships with a diverse range of patients and their families. Nurses promote healthy behavior and self-care education to patients. In addition, nurse practitioners play a vital role in the screening and management of AUD in primary care, using their skills and knowledge to help patients struggling with AUD. The interventions used should be evidence-based. The increasing use of translational research implores nurse practitioners to have the capacity to identify their types and designs in comparison to the traditional research methods and types that include qualitative and quantitative.


Cheng, H. Y., McGuinness, L. A., Elbers, R. G., MacArthur, G. J., Taylor, A., McAleenan, A., … & Kessler, D. (2020). Treatment interventions to maintain abstinence from alcohol in primary care: systematic review and network meta-analysis. BMJ371.

De Beaurepaire, R., Sinclair, J., Heydtmann, M., Addolorato, G., Aubin, H. J., Beraha, E. M., … & Agabio, R. (2019). The use of baclofen as a treatment for alcohol use disorder: a clinical practice perspective. Frontiers in psychiatry9, 708.

Haass-Koffler, C. L., & Schank, J. R. (2020). Translational Research in the Neurobiological Mechanisms of Alcohol and Substance Use Disorders. Neurotherapeutics17(1), 1-3.

Heilig, M., Augier, E., Pfarr, S., & Sommer, W. H. (2019). Developing neuroscience-based treatments for alcohol addiction: A matter of choice?. Translational Psychiatry9(1), 1-11.

Louie, E., Barrett, E. L., Baillie, A., Haber, P., & Morley, K. C. (2020). Implementation of evidence-based practice for alcohol and substance use disorders: protocol for systematic review. Systematic reviews9(1), 1-6.

National Institute on Alcohol Abuse and Alcoholism (NIAAA). (n.d.). Alcohol Use Disorder.

Ray, L. A., Grodin, E. N., Leggio, L., Bechtholt, A. J., Becker, H., Feldstein Ewing, S. W., … & Koob, G. F. (2021). The future of translational research on alcohol use disorder. Addiction biology26(2), e12903. doi:10.1111/adb.12903

Rombouts, S. A., Conigrave, J., Louie, E., Haber, P. & Morley, K. C. (2019). Evidence-based

models of care for the treatment of alcohol use disorder in primary health care settings: protocol for systematic review. Systematic Reviews, 8(275).

Slade, E., Dwoskin, L. P., Zhang, G. Q., Talbert, J. C., Chen, J., Freeman, P. R., … & Bush, H. M. (2021). Integrating data science into the translational science research spectrum: A substance use disorder case study. Journal of Clinical and Translational Science5(1).doi:

Thompson, A., Ashcroft, D. M., Owens, L., van Staa, T. P., & Pirmohamed, M. (2017). Drug therapy for alcohol dependence in primary care in the UK: A Clinical Practice Research Datalink study. PloS One12(3), e0173272.

Wood, K., Giannopoulos, V., Louie, E., Baillie, A., Uribe, G., Lee, K. S., … & Morley, K. C. (2020). The role of clinical champions in facilitating the use of evidence-based practice in drug and alcohol and mental health settings: A systematic review. Implementation Research and Practice1, 2633489520959072.

Patient safety and improved quality of care requires providers and organization to use evidence-based practice (EBP) interventions to tackle issues that may cause adverse events like patient falls. Patients in medical-surgical units are susceptible to falls because of their delicate nature. The Centers for Medicare and Medicaid Services (CMS) considers falls as never events since they are preventable (Melnyk et al., 2022). Falls lead to increased stay in hospitals, poor patient outcome and serious fractures and head injuries that can lead to death. The use of bundled care approach through TIPS (tailoring interventions for patient safety) is considered one of the most effective ways to reduce and prevent falls in medical-surgical settings. The purpose of this literature review paper of the EBP project is to compare articles on the use of TIPS toolkit to reduce and prevent falls in medical-surgical settings.

PICOT Statement and Question

Nationwide, patient falls while in hospitals, particularly in medical-surgical units, are a leading cause of permanent disability and even death. Further, hospitalization increases one’s fall risk as close to three percent of patients fall while in hospitals. Nearly 30% of those who experience falls sustain injuries with a rise in the number of days in hospitals by close to 7 days. Again, under Medicare, the CMS does not reimburse falls and hospitals cannot get a Magnet designation when their fall rates are not below the national average (Khasnabish et al., 2020). The implication is that hospital managers and leaders must seek ways, through the use of evidence-based practice, to reduce the occurrence of falls. The use of TIPS toolkit is considered one of the most effective ways to reduce and mitigate falls and their occurrences as well as effects on patients in medical-surgical units.

PICOT Question

Among hospitalized adult patients in medical-surgical units (P) does the use of TIPS toolkit as a bundled care approach (I) compared to normal falls prevention approach (C) reduce the prevalence of falls (O) within 6 months (T)?

Search Methods

The evidence-based practice process implores researchers to seek evidence from previous research articles when doing their literature to obtain findings that support their proposed projects or interventions. The use terms, phrases and words associated with the topic under investigation and exploring databases to generate scholarly sources are some of the standard search strategies that one can deploy to attain relevant evidence. The study employed these strategies, starting with key terms and words in different databases. These included PubMed, Cochrane and Google Scholar as well as CINAHL. The strategy also entailed the use of CRAAP approach that involves searching for articles which are current, relevant, accurate, authoritative and purposeful to the area or topic under investigations (Melnyk et al., 2022). Using this criteria, the paper identified the reviewed articles and describes how they support the proposed EBP project to reduce and prevent the occurrence of falls in medical-surgical settings.

Research Synthesis

Article 1

The first article by Dykes et al. (2020) evaluates the use of a patient-centered fall prevention TIPS to lower falls and their associated injuries. Using non-randomized controlled trials with the study set in 14 medical units in Boston and New York, the researchers show a positive link between the intervention and a decline in number of falls. The researchers are categorical that nurse-led interventions can reduce injurious falls through providing information to families on fall management and prevention. The article demonstrates the efficacy of using TIPS as an intervention as depicted by the PICOT question.

Article 2

The second article by Tzeng et al. (2021) focuses on the impact of using TIPS program in reducing falls among older adults in nursing homes. Using a mixed method approach in a 15-bed nursing unit, the findings from the study shows that fall TIPS can reduce the rate of falls, especially injurious falls among older patients or adults. The TIPS program entails different approaches that include patient education and creating awareness about the harmful effects of falls. The article is critical to the EBP proposed project as it illustrates the increased role of TIPS initiative to reduce falls as depicted in the PICOT question. The article supports the EBP project since it shows that TIPS as an intervention is effective.

Article 3

In this article by Morris et al. (2022) the researchers conduct a systematic review of literature and meta-analysis on diverse interventions that can reduce falls. The researchers identify a host of interventions based on the data collected from the 43 studies that met their inclusion criteria. The findings show that tailoring or customization of interventions leads to reduced rates of falls for patients in such facilities. These interventions are effective when they consider the different components and factors impacting patient situations. As such, the article supports the EBP proposed project by demonstrating the effectiveness of diverse and tailored interventions for patients based on their level of acuity.

Article 4

The fourth article by Heng et al. (2020) is a scoping review of how hospitals can use patient education as a strategy to prevent falls. The researchers focused on 43 articles when analyzing the different approaches in patient education that confer benefits to patients to reduce their susceptibility to falls. The analysis shows that patient educational interventions can reduce falls that lead to injuries and bruises as well as lacerations and fractures. The study recommends the need to deploy TIPS as an effective approach to reducing and mitigating falls among patients. The article supports the EBP proposed project as it shows the need for diverse interventions like different approaches to educating patients on fall risks that they may be exposed to in their activities of daily living.

Article 5

In their article, LeLaurin et al. (201) aim at familiarizing different stakeholders about the benefits as well as the cons of various types of research studies on testing fall prevention interventions. The researchers opine that organizations and providers should focus on diverse interventions, one point at a time, to attain their efficacy and impact on patient fall management. The study’s findings are categorical that the effectiveness of each type of interventions depends on a host of factors. Therefore, customizing or tailoring these interventions is essential to attaining quality outcomes and helping patients avoid and reduce their susceptibility to falls. The article is important in the EBP project as it shows the need for tailoring each intervention to suit patient needs and situations.

Article 6

The article by Dykes et al. (2019) focuses on the effectiveness of tailoring interventions through a collaborative approach among providers. Using a qualitative approach or design, the article demonstrates that fall TIPS program is effective in reducing and preventing falls in diverse patient settings. The study is emphatic that TIPS model is important for providers to reduce and prevent falls. The article supports the EBP proposed project as it illustrates the importance of customizing interventions to meet patient needs and reduce susceptibility to falls.

Article 7

In this article by Cuttloer et al. (2018), the researchers aim at reducing inpatient falls in medical-surgical settings through technology-enabled TIPS initiative. The researchers use a four-minute video to provide patient education and collect their views on the implementation based on their situation. The findings are consistent that TIPS initiatives reduce and prevent falls. Therefore, the article supports the EBP project by showing that tailoring interventions is essential in addressing patient falls in medical-surgical settings.

Article 8

In their study, Bargmann et al. (2020) evaluates the effects of implementing a multicomponent fall prevention program to improve patient safety because of risks associated with falls. Set in a 26-bed medical surgical telemetry unit, the study shows that these interventions are effective in reducing falls and risks associated with falling for fragile patients. The article supports the EBP project since it is categorical that TIPS model reduce and prevents the occurrence of falls.

Comparison of the Articles

The reviewed articles share certain aspects in their research findings and also differ in other areas. for instance, all the articles agree that tailoring interventions on falls is an effective strategy that all providers and facilities should leverage in their settings. Again, the article agree that the TIPS model gives hospitals and providers increased leeway to implement interventions that are appropriate to their facilities based on their cost and other components. Thirdly, all the articles demonstrate that multiple interventions are complementary to the efforts and policies developed by organizations to reduce and prevent falls in their articles.

None of the article demonstrates controversies but all agree conclusively that more studies are required to provide significant outcomes. The articles also share limitations like timelines to conduct the studies, use of same settings and need for beet support from management and other stakeholders (Khasnabish et al., 2020). The articles do not have significant differences as they are emphatic that these diverse interventions are necessary in reducing falls, especially injurious falls among older patients.

Suggestions for Future Research

An analytical perspective of the eight articles and others demonstrate the need for more research to tackle some of the gaps. For instance, the articles do not offer a standard TIPS approach that can be used across all facilities, irrespective of their patient’s acuity and needs. As such, it is important to have more studies on the development of a standardized tool or approach to falls based on the nature of the respective setting, from medical-surgical units to outpatient facilities.


Falls are a major health issue that impact overall quality of care and life for patients, especially the elderly admitted to medical-surgical units. The use of TIPS toolkit; either patient-centered or nurse-driven, is critical to reducing these falls because of their adverse effects like injuries and long-term fractures and disabilities. The articles are emphatic that using TIPS allows providers to offer the most effective interventions to reduce and prevent their occurrence. The review illustrates that sufficient evidence exists to support the proposed interventions based on the TIPS framework to reduce falls.


Bargmann, A. L., & Brundrett, S. M. (2020). Implementation of a multicomponent fall

prevention program: Contracting with patients for fall safety. Military medicine, 185(Supplement_2), 28-34.

Cuttler, S. J., Barr-Walker, J., & Cuttler, L. (2018). Reducing medical-surgical inpatient falls and

injuries with videos, icons and alarms. BMJ open quality, 6(2), e000119.

DOI: 10.1136/bmjoq-2017-000119

Dykes, P. C., Adelman, J. S., Alfieri, L., Bogaisky, M., Carroll, D., Carter, E., … & Spivack, L.

  1. (2019). The fall TIPS (tailoring interventions for patient safety) program: A collaboration to end the persistent problem of patient Falls. Nurse Leader, 17(4), 365-370.

Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., Ergai, A., Lindros,

  1. E., Lipsitz, S. R., Scanlan, M., Shaykevich, S., & Bates, D. (2020). Evaluation of a Patient-Centered Fall-Prevention Tool Kit to Reduce Falls and Injuries. JAMA Network Open, 3(11), e2025889.

Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A. M., & Morris, M. E. (2020). Hospital

falls prevention with patient education: a scoping review. BMC geriatrics, 20, 1-12. DOI:

Khasnabish, S., Burns, Z., Couch, M., Mullin, M., Newmark, R., & Dykes, P. C. (2020). Best

practices for data visualization: creating and evaluating a report for an evidence-based fall prevention program. Journal of the American Medical Informatics Association, 27(2), 308-314. DOI: 10.1093/jamia/ocz190.

LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: state of the

science. Clinics in geriatric medicine, 35(2), 273-283. DOI: 10.1016/j.cger.2019.01.007

Melnyk, B. M., & Fineout-Overholt, E. (2022). Evidence-based practice in nursing &

            healthcare: A guide to best practice. Lippincott Williams & Wilkins.

Morris, M. E., Webster, K., Jones, C., Hill, A. M., Haines, T., McPhail, S., … & Cameron, I.

(2022). Interventions to reduce falls in hospitals: a systematic review and meta-analysis. Age and Ageing, 51(5), afac077.

Tzeng, H.-M., Jansen, L. S., Okpalauwaekwe, U., Khasnabish, S., Andreas, B., & Dykes, P. C.

(2021). Adopting the Fall Tailoring Interventions for Patient Safety (TIPS) Program to Engage Older Adults in Fall Prevention in a Nursing Home. Journal of Nursing Care Quality,