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Evidence-Based Practice Project: Evaluation of Literature Table

NUR 550 Evidence-Based Practice Project: Evaluation of Literature Table

Evidence-Based Practice Project: Evaluation of Literature Table

Research articles and research is extremely significant in the nursing field and practice as a whole. Nurses work directly with patients on a daily basis and because of this, they are the most aware of the needs of the patient. They are also the most informed about what procedures and policies favor the quality of patient care given and what needs to be adjusted to better cater to their needs. Rigorous research is extremely important for nursing students and nurses to keep up with at every stage of their career. This is because it advances nursing practice like aiding in the shaping of healthcare policy which leads to overall advancements in health all around the globe not just within the United States.

For example, the National Institute of Nursing Research is dedicated to finding new knowledge on disease prevention, disability, illness symptom management, and improvement of end-of-life care (“Importance of research in Nursing: UNCW online,” 2016). In terms of the application of research in the modern world, the importance of research can be seen with the occurrence of the pandemic of COVID-19. The world experienced a complete lockdown and incredible spike of deaths in the past two years due to a virus that has no cure and still does not hold a cure rather than a vaccine that aims to slow and decrease the spread and prevalence of the disease. It is due to research that a vaccine could be created and that nurses and other medical professionals found out what treatment methods and care plans work best to treat this disease.

Literature Evaluation Table

Learner Name:

PICOT:

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Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article 
Article Title and Year Published

 

Research Questions/ Hypothesis, and Purpose/Aim of Study

 

Design (Quantitative, Qualitative, or other)

 

Setting/Sample

 

Methods: Intervention/ Instruments

 

Analysis/Data Collection

 

Outcomes/Key Findings

 

Recommendations

 

Explanation of How the Article Supports Your Proposed EBP Practice Project Proposal
Alotaibi, Y. K. & Federico, F.

Saudi Medical Journal 38(12):1173-1180. doi: 10.15537/smj.2017.12.20631

10.15537/smj.2017.12.20631

The impact of health information technology on patient safety

2017

 

The purpose of the study was to review current scientific evidence on the effects of various health information technologies on enhancing patient safety. The study is a systematic review of existing evidence from previous scientific research on the different types of technologies and their effects on patient safety. The authors sampled previous studies based on set criteria: systematic reviews, meta-analysis and randomized clinical trials. The interventions used include ascertaining the study designs meta-analysis and randomized clinical trials. The authors used published and non-published studies from January 2017. The authors collected data from the various studies on different components of health information technology using certain key words like electronic medical records and Clinical Decision Support among others. The outcomes from the study indicates that health information technology improves patient safety as it reduced medication errors, mitigates adverse drug reactions and improves compliance to set guidelines in practice. The authors recommend the need for healthcare organizations to choose a technology that will them better as some technologies have limited evidence about their efficacy in improving patient safety outcomes. The article supports the proposed EBP project proposal as it shows the need to integrate health information technology in healthcare to mitigate medication errors. The article offers an in-depth review of the existing evidence that supports implementing better interventions to reduce and prevent medication administration errors.
Trimble AN, Bishop B, Rampe N.

American journal of health-system pharmacy: AJHP: official journal of the American Society of Health-System Pharmacists. 2017;74:70-75.

DOI: 10.2146/ajhp150726

Medication errors associated with transition from insulin pens to insulin vials

2017

The purpose of the paper was to show the root-cause of insulin administration errors that occurred after a facility’s transition from insulin pens to vials. The article describes the process improvement initiatives in the facility to prevent future errors. The study design is qualitative as it is an observational study. The setting was a 450-bed community hospital. The intervention was use of root-cause analysis to identify the causes of the three medication errors that occurred after the transition. The authors collected data from observing the administration of insulin to patients from using pens to insulin vials. The findings show that different factors cause medication administration errors like insufficient nursing education, non-adherence to medication administration policies and procedures, and issues related to electronic health records. The authors recommend the implementation of improvement initiatives to prevent the medication errors from occurring in the future like giving education to nurses and performance of safety rounds among other interventions. The article is essential as it provides primary research findings about the issues that cause medication administration errors. The article will enhance evidence of the EBP project implementation as it validates use of technologies to reduce and prevent medication administration errors.
Härkänen, M., Vehviläinen-Julkunen, K., Murrells, T., Rafferty, A. M., & Franklin, B. D.

Research in Social and Administrative Pharmacy, 15(7), 858-863.

https://doi.org/10.1016/j.sapharm.2018.11.010

Medication administration errors and mortality: Incidents reported in England and Wales between 2007 ̶ 2016

2019

The purpose of the study was to analyze medication administration errors occurring in acute care that leads to death, identify the drug involved, and a description of the features of the medication administration errors. The study used existing reports in acute care about medication administration errors registered during the period. The setting was acute care practices or areas in England and Wales. The intervention focused on the characteristics of the medication administration errors in the facilities under review. The authors collected data from reported medication administration errors in acute care settings between 2007 and 2016. The findings suggest that a majority of errors in medication administration occur in wards and among patient aged over 75 years. The most prevalent group was omitted medicine or ingredient. The authors record the need to focus on avoidance of dose omission and administration of drugs for patient over 75 years. The article also recommends safe administration of parenteral anticoagulants and antibacterial medicines The article is essential in addressing the issue of different types of medication administration errors and where they happen. The article will offer in-depth analytical base to extract more evidence for the project.
Barakat, S. & Franklin, B. D.

Pharmacy (Basel), 8(3):148.  doi: 10.3390/pharmacy8030148

An Evaluation of the Impact of Barcode Patient and Medication Scanning on Nursing Workflow at a UK Teaching Hospital.

2020

The aim of the study was to investigate the effects of Barcode medication administration (BCMA) on nursing activity and workflow. The study used qualitative design as they employed observational approach. The setting was in two surgical wards at a large acute facility in London. The intervention was the implementation of BCMA in one acute ward and the other without the BCMA. The study collected data from observation for ten consecutive weekdays and another ten weekdays after the implementation of the BCMA. The article’s findings include increased workflow, patient verification and medication administration efficiencies. The authors recommend more research to determine the effect of BCMA on timelines of medication administration. The article is essential as it is a primary study on how integration of technology (BCMA) can enhance the medication process and reduce the possibility of medication administration errors. The article is important to the project as it gives more details on the need to implement health information technology in healthcare settings.
Alomari, A., Sheppard-Law, S., Lewis, J. & Wilson, V.

The Journal of Clinical Nursing, 29(17-18): 3403-3413.

https://doi.org/10.1111/jocn.15374

Effectiveness of Clinical Nurses’ interventions in reducing medication errors in a pediatric ward.

2020

The aim and objective of the study were to evaluate the impacts of bundle interventions which nurses can use to reduce medication administration errors. The authors also wanted to enhance nursing practice’s perception on medication administration process. The article used a quantitative research design based on three phases of action research. The setting was a specialized pediatric medical ward. The sample included six pediatric nurses as part of the Action Research team. The project had multiple interventions like additional questions about parental involvement, quality and safety meeting each month and more time-space before nurses could end their shifts. The study collected data during all the phases of action research. The article shows that after implementing the interventions, the facility reduced medication errors by close to 60% despite an increase in patients and the number of prescribed medications The article recommends the need to have clinically based nurses to participate in action research to enable them have practice reflection, develop and implement bundle interventions and have reduced cases of medication administration errors The article is important as it demonstrates the role that action research plays in enhancing patient safety and quality of care. The article will be useful in understanding different ways to implement research to reduce medication administration errors.
Devin, J., Cleary, B. J. & Cullinan, S.

BMC Systematic Reviews, 9(275). https://doi.org/10.1186/s13643-020-01510-7

The impact of health information technology on prescribing errors in hospitals: a systematic review and behavior change technique analysis

2020

The aim of the study was to assess the impact of health information technologies to reduce prescribing errors in hospitals. The study also focused on identification of behavior change techniques to HIT implementation and lead to a reduction in these errors. The article used a qualitative design as it reviewed existing research from different journal databases. The settings were multiple as all studies were from previous research findings. The intervention is the study was the use of behavioral change techniques associated with effective models to reduce medication administration errors. The authors collected data from studies that met the selection criteria on different components of HIT like modifications of HIT. The findings show that prescribing HIT is related to a reduction in prescribing errors in different healthcare settings. The study recommends the need for effective use of behavioral change techniques to integrate HIT in prescribing to reduce medication errors. The article is important to the EBP project as it shows the need to integrate behavioral change techniques for effective implementation of health information technology to reduce and prevent medication errors. The article will be used to offer detailed evidential account of implementing better HIT and training of individual employees for effective implementation.
Zadvinskis, I. M., Smith, J. G., & Yen, P. Y.

JMIR medical informatics, 6(2), e38. doi: 10.2196/medinform.8734

Nurses’ experience with health information technology: Longitudinal qualitative study

2018

The aim of the study was to explore the experiences and perceptions of nurses in implementation of information technology over time in their facilities The authors used a phenomenological approach for the longitudinal qualitative study to comprehend nurses’ perceptions The sample comprised of clinical nurses who worked on a medical-surgical unit in an academic center The instrument in the study was use of time points; 3,9, and 18 months after implementing different HITs in the unit. The study’s data was compiled from the sampled nurses over the period of implementation in the medical-surgical unit. The findings demonstrate two types of factors that facilitate HIT adoption; personal and organizational level issues. Nurses changed their perceptions about HIT after implementation. The authors recommend that organizations should implement and invest in health information technologies and refine their policies to mirror nursing practice and enhance systems to focus on patient safety. The article offers more relevant and appropriate information and data on implementing HIT to reduce medication administration errors that are caused by personal and organizational issues. The article will offer more insights on personal level issues to integrate HIT in nursing practice.
Naidu, M.  and Alicia, Y.L.Y. 

Health, 11, 511-526. https://doi.org/10.4236/health.2019.115044

Impact of Bar-Code Medication Administration and

Electronic Medication Administration Record System in Clinical Practice for an Effective Medication Administration Process

2019

The purpose of the study was to assess the use of barcode medication administration (BCMA) and electronic medication administration record (e-MAR) usage outcomes, clinical practices, policies and processes that impact nurses in their medication administration duties in their practice environment. The authors conducted an annotated literature review on the implementation of innovations to enhance patient safety. The authors conducted a review of literature and used samples and settings in those studies to understand the phenomenon under investigation. The interventions include the use of HIT, clinical practices and policies, and processes affecting nurses administering medications in their clinical setting. The article uses data from previous studies on the medication administration errors identified by the researchers. The findings show that compliance to BCMA and e-MAR improves patient safety and a significant reduction in reported errors. The incorporation also improves efficiency of the BCMA system The authors recommend the need for healthcare providers and organizations to embrace innovation as a way of reducing and preventing medication administration errors in their clinical practice. The article is important as it shows the need to embrace technology and innovations that improve care delivery and efficiency. The article will be essential in offering more data and information on how innovation can offer better solutions to clinical practice problems and enhance patient safety and outcomes.
Jheeta, S. & Franklin, B. D.

BMC Health Services Research, 17(547). https://doi.org/10.1186/s12913-017-2462-2

The impact of a hospital electronic prescribing and medication administration system on medication administration safety: an observational study.

2017

The goals of the study were to compare the prevalence and types of medication administration errors, documentation of discrepancies between ePA system and paper data. The researchers also focused on making observable changes to the medication administration process using certain interventions The authors conducted an observational qualitative study. The setting was an elderly medicine ward in an English hospital. The interventions included pre and post-ePA implementation time-points, and observation of nurses during the medication administration rounds; five days before and after implementation. The authors collected data from the observations and documented medication administration errors in 428 potential occasions for errors. The findings show that no alterations in rates of medication errors. However, the implementation encourages the occurrence of certain errors but mitigates others. The ePA implementation leads to significant increase in documentation of discrepancies. The authors recommend the need to adopt ePA as a way of mitigating certain types of medication administration errors. The article would be important to the EBP project since it contains data on different aspects of HIT that can be implemented to reduce and prevent medication administration errors. The study will enhance the project’s recommendations for better use of the outcomes.
Anazi, A. A. (2021).

Health Informatics Journal, 27(1), 1460458220987276. https://doi.org/10.1177/1460458220987276

Medication reconciliation process: Assessing value, adoption, and the potential of information technology from pharmacists’ perspective.

2021

The purpose of the study was to address elements linked to medication reconciliation process as part of medication administration, the hurdles, and role of information technology in healthcare. The authors also focused on the requisite functionalities to achieve optimal medication reconciliation process. The authors used a descriptive, cross-sectional study through a survey to examine opinions by pharmacists on the medication reconciliation process and the role of information technology in improving the process. The sample included 319 respondents that practiced medication reconciliation process. The interventions included the use of electronic health records (EHRs), and the use of electronic medication registration as the necessary technology instruments to implement medication reconciliation process. The authors collected data from the opinions of pharmacists and even nurses that participated in the surveys. The findings from the study emphasized the need for having well-designed medication reconciliation process through the help of information technology approaches. The authors suggest the initiation of policies to mandate sharing of data necessary in creating a compiled medication list for individual patients. The authors emphasize the importance of medication reconciliation as part of enhancing patient safety in hospitals. The article is essential as it gives a different perspective from other healthcare professionals on the importance of implementing medication reconciliation process to minimize occurrence of medication administration errors.

 

 

Learner Name:

The need for patient safety and improved quality of care implores organizations and providers to leverage evidence-based practice (EBP) interventions to address any issues that can lead to occurrence of adverse events in healthcare settings and impact patient outcomes. Falls and incidences of falling among adult patients in medical-surgical settings remain a healthcare safety challenge that requires effective interventions. Falls are considered sentinel and never events by the Centers for Medicare and Medicaid Services (CMS) because they are preventable through institution of different measures aimed at addressing their adverse effects (Cerilo et al.,2022). Falls lead to increased cost of care and stay, poor patient outcomes and in some cases, serious head injuries and fractures that can cause death (Khasnabish et al., 2020). The purpose of this literature evaluation table is to present different research articles on falls and assess their application in medical-surgical settings. The use of TIPS toolkit is considered as one of the ways to reduce and prevent the occurrence of falls in different healthcare settings.

PICOT:

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)?

 


Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article 
Article Title and Year Published

 

Research Questions/ Hypothesis, and Purpose/Aim of Study

 

Design (Quantitative, Qualitative, or other)

 

Setting/Sample

 

Methods: Intervention/ Instruments

 

Analysis/Data Collection

 

Outcomes/Key Findings

 

Recommendations

 

Explanation of How the Article Supports Your Proposed EBP Practice Project Proposal
Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., Ergai, A., Lindros, M. E., Lipsitz, S. R., Scanlan, M., Shaykevich, S., & Bates, D.

JAMA Network Open, 3(11), e2025889. https://doi.org/10.1001/jamanetworkopen.2020.25889

Evaluation of a Patient-Centered Fall-Prevention Tool Kit to Reduce Falls and Injuries.

2020

 

The purpose of this study was to evaluate if a fall-prevention toolkit which engages patients and families in fall-prevention process during hospitalization leads to a reduction in falls and injurious falls. The researchers used a nonrandomized controlled trials based in the stepped wedge design. The setting comprised of 14 medical units in academic centers in Boston and New York. The participants were all hospitalized patents in the participating settings; the patients were 37 231. The instrument was a nurse-based fall-prevention tool kit that links evidence-based measures to patient-focused risk factors. The method incorporated continuous patient and family engagement preventing occurrence of falls. The study collected data based on the rate of patient falls and injurious falls in every 1000 patient-days on the units. The study analyzed the data using Poisson regression to estimate the frequency of falls in the facility. The outcome of the study shows a positive correlation between the intervention and a reduction in falls. The article also found that the nurse-driven intervention reduced injurious falls by enabling the families to have sufficient information on different ways to prevent and reduce falls. The study recommends the use of a nurse-led and patient-centered fall-prevention tool kit to reduce the rates of falls and injurious falls. The authors assert that providers can have different modalities to implement and integrate the intervention to reduce falls in medical-surgical units. The article supports the EBP as it shows that the proposed intervention is based on evidence and is effective in reducing the rate of falls and injurious falls among hospitalized patients. The article will offer more information about the effectiveness and efficacy of fall prevention interventions tailored to the needs of a patient.
Tzeng, H.-M., Jansen, L. S., Okpalauwaekwe, U., Khasnabish, S., Andreas, B., & Dykes, P. C.

Journal of Nursing Care Quality, https://doi.org/10.1097/ncq.0000000000000547

Adopting the Fall Tailoring Interventions for Patient Safety (TIPS) Program to Engage Older Adults in Fall Prevention in a Nursing Home

2021

The focus of the study was to evaluate the impact of fall (TIPS) program on prevention of falls and fall-associated injuries among older adults in nursing home. The study used mixed method comprising of qualitative and quantitative approaches at various levels of the research gathered findings. The study occurred in a 15-bed subacute nursing care unit. The instrument entailed using fall TIPS initiative customized to setting The approach comprised of providing clinical decision support to prevent falls. The article collected both qualitative and quantitative data based on the respective tools used. These included recording of monthly fall rates among patients within certain period for effective analysis. The findings after the implementation of the Fall TIPS show that the rate of falls and injurious falls reduced with clinical significance. The researchers attribute the reduction in falls to awareness among patients, information offered to patients on the TIPS poster and other interventions like self-transfer. The article recommends the implementation of Fall TIPS initiative in healthcare settings to lower falls and injurious fall incidents among older adult residents in nursing homes and other areas of care delivery. The article also recommends the need for larger studies in different healthcare settings to assess the overall effectiveness of such interventions. The article supports the proposed EBP practice project proposal by demonstrating that the intervention is sound and based on evidence. The proposed EBP project focuses on reducing falls in medical-surgical unit and this study is categorical that such revelations are important to illustrate the efficacy of the Fall TIPS framework.
Morris, M. E., Webster, K., Jones, C., Hill, A. M., Haines, T., McPhail, S., … & Cameron, I.

Age and Ageing, 51(5), afac077. https://doi.org/10.1093/ageing/afac077

Interventions to reduce falls in hospitals: a systematic review and meta-analysis.

2022

The aim of the study was to enquire the effects of falls prevention interventions on fall rates and the risk of falling in healthcare facilities The study is mixed as it uses a systematic review and meta-analysis. The participants in the study were hospitalized adults The intervention entailed staff and patient education, modification of the environment, use of assistive devices, development of policies and systems, medication management and rehabilitation as well as management of cognitive impairment The researchers collected data from 43 studies that satisfied the inclusion criteria and 23 were included in the meta-analyses. The findings show that the use of tailored interventions leads to a reduction in rates of falls and injurious falls. The outcomes also suggest that the use of multi-factorial interventions led to a positive impact on patient care. The study recommends the use of patient and staff education as approaches that can have positive effects on hospital falls. The use of chair alarms, bed alarms, and wearable sensors and scored risk assessment tools did not reduce falls. The study will be used in the EBP project proposal to demonstrate the need to use TIPS toolkit for both patients and staff with the aim of reducing and preventing the occurrence of falls and injurious falls in medical-surgical settings.
Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A. M., & Morris, M. E.

BMC geriatrics, 20, 1-12. DOI: https://doi.org/10.1186/s12877-020-01515-w

Hospital falls prevention with patient education: a scoping review.

2020

The aim of the scoping review was to examine the content, design, and outcomes concerning patient education approaches to prevent hospital falls. The paper evaluates the significance of patient education to prevent falls and suggests for hospitals to implement in their clinical settings. The study uses a methodological model developed by Arksey and O’Mallet and refined by Joanna Briggs Institute. The researchers evaluated 43 articles in their analysis based on different interventions on patient education like face-to-face and educational tools. The interventions included direct face-to-face education, educational tools, patient-focused consumer materials and hospital systems, policies and procedures The researchers collected and analyzed data from existing studies. These included studies on falls or education associated outcomes before and after patient fall prevention education. The findings from the article illustrate the effectiveness of the interventions that use patient education to reduce falls related to injuries like bruises, lacerations and fractures.

 

The study recommends the implementation of patient-centered prevention education as part of the TIPS approach to reducing falls in healthcare settings. The study observes that well-designed education initiatives can enhance knowledge and self-perception of risk and empower patients to lower their risk of falling while in hospitals. The study is essential to the EBP project proposal since it illustrates the significance of having a patient-centered toolkit or intervention to reduce and prevent the occurrence of falls among hospitalized patients. The article will offer more information on the efficacy of the TIPS model to reduce and prevent falls.
LeLaurin, J. H., & Shorr, R. I.

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

Preventing falls in hospitalized patients: state of the science.

2019

The aim of this study was to familiarize the audience with the strengths and the cons of different types of research used in testing fall prevention approaches or interventions. The article uses a review of existing literature or systematic review to highlight different studies on fall prevention in healthcare settings. The researchers evaluate different articles based on their approaches to reducing falls in healthcare settings. These include quality improvement studies, randomized studies, and non-randomized studies a well as single fall prevention interventions and multifactorial one among others. The interventions include focusing on single approaches as well as use multifactorial interventions. The researchers collected and analyzed data from the different types of studies that they evaluated. The researchers focused on both single and multifactorial interventions to reduce and prevent patient falls. The findings show that different interventions are effective based on a host of factors. Again, the study notes that single interventions are more practical compared to multifactorial interventions in prevention of falls. The study recommends the implementation of all interventions, especially those emanating from research and are effective based on the healthcare setting. The study notes that the implementation of any of the interventions is the most essential for any patient safety initiative. The article is essential to the EBP project proposal as it offers sufficient research evidence on the efficacy of the different interventions to prevent and reduce falls in healthcare settings.
Dykes, P. C., Adelman, J. S., Alfieri, L., Bogaisky, M., Carroll, D., Carter, E., … & Spivack, L.

B.

Nurse Leader, 17(4), 365-370. https://doi.org/10.1016/j.mnl.2018.11.006

The fall TIPS (tailoring interventions for patient safety) program: A collaboration to end the persistent problem of patient Falls

2019

The aim of the article was to offer information to nurse leaders concerning evidence about the efficacy and effectiveness of the Fall TIPS program and how they can create collaborative teams as well as access resources to support implementation at their facilities. The article uses a qualitative approach to the issue and proposes the integration of different teams to enhance the implementation of the intervention. The researchers assess and appraise different articles since the development of the Fall TIPS in Boston and how organizations are leveraging it to offer care. The main intervention is the implementation of the Fall TIPS initiatives in different settings to reduce and prevent the occurrence of falls. The researchers evaluate data from the existing studies for analysis. They do not collect any data since they only review existing studies’ findings. The findings show that implementing a fall TIPS program can reduce and prevent the occurrence of falls in different care settings. The researchers are categorical that since its implementation, it has led to a significant reduction and prevention of falls. The researchers recommend the use of TIPS in healthcare settings to reduce the occurrence of falls, especially in critical care settings with hospitalized adult patients The resource is essential as it highlights the use of TIPS as an effective intervention in mitigating risks that may lead to falls. The resource will be used in the EBP project to demonstrate the need for TIPS as a way to reduce and prevent the occurrence of patient falls.
Cuttler, S. J., Barr-Walker, J., & Cuttler, L.

BMJ open quality, 6(2), e000119.

DOI: 10.1136/bmjoq-2017-000119

Reducing medical-surgical inpatient falls and injuries with videos, icons and alarms

2018

The focus of this article was to determine the effectiveness of patient education videos and visual signs with bed exit alarms to reduce falls among hospitalized medical-surgical inpatients. The study used a performance improvement model based on historic control The participants were adults in medical-surgical units. The main intervention was a four-minute video for patients’ viewing by trained volunteers. The second intervention was having icons of risk factors and interventions on the patients’ bedsides. The third intervention was having a bed alarm for those confused patients at risk of falling. The researchers collected and analyzed data based on the incidences in every 1000 patient days for patient falls, and falls with an injury and those with serious injuries The findings show that these interventions reduced all different types of falls in every 1000 patient days. However, icons were not fully implemented. The study recommends more studies, especially multicenter randomized controlled trials to confirm the effectiveness of icons and video interventions o reduce falls. The article is critical to the EBP proposed project as it demonstrates that the use of TIPS toolkit is effective but requires increased involvement and integration of all stakeholders.
Bargmann, A. L., & Brundrett, S. M.

Military medicine, 185(Supplement_2), 28-34.

https://doi.org/10.1093/milmed/usz411

Implementation of a multicomponent fall prevention program: Contracting with patients for fall safety

2020

The study aimed at the implementation of a multicomponent fall prevention program to enhance patient safety from falls and associated risks The researchers developed a multicomponent approach to fall prevention that comprised of literature and use of a patient fall safety agreement in the facility. The setting for the research was a 26-bed medical-surgical telemetry unit in a 352-bed level 1 trauma center. The center caters to both civilian and military beneficiaries. The interventions include a patient fall safety agreement among the providers and EBP fall prevention bundle. The researchers collected and analyzed data after four months to assess the rate of falls in the unit. They also collected data from an incentive program aimed at increasing adherence to patient safety approaches. The findings from the study show that the agreements facilitated dialogue among nurses and other providers as well as patients. The findings show that these interventions lead to a reduction in patient falls within the facility The study recommends the implementation of this intervention since it creates a collaborative environment for nurses and other professionals to carry out safe and quality patient care. The article is essential to the EBP project because it shows the use of these interventions leads to a decrease in the number of falls in the unit. It also demonstrates the efficacy of using multiple components to reduce and prevent falls in acute care settings.
Duckworth, M., Adelman, J., Belategui, K., Feliciano, Z., Jackson, E., Khasnabish, S., … & Dykes, P. C.

Journal of medical internet research, 21(1), e10008.

DOI: 10.2196/10008

Assessing the Effectiveness of Engaging Patients and Their Families in the Three-Step Fall Prevention Process Across Modalities of an Evidence-Based Fall Prevention Toolkit: An Implementation Science Study

2019

The focus of the research was to determine the efficacy of fall TIPS tool in engaging patients through three-step fall prevention interventions The researchers used random audits through a questionnaire. They also used the audits to measure adherence. They also used a case-control approach to understand the prevalence of patients using Fall TIPS to experience falls The researchers utilized a randomized control trial with a sample size of over 10,000 subjects. The intervention entailed conducting fall risk assessments, developing a tailored fall prevention plan, and implementing the plan consistently along other well accepted standards and precautions The researchers collected data from the feedback offered by the participants in the site of the study. They analyzed the data using different fall modalities to assess the effectiveness of the intervention. The findings show that each Fall TIPS modality led to the engagement of patients in the fall prevention process. The researchers assert that Fall TIPS modalities can enhance effective control of falls ad ensure that patients do not suffer from them. The researchers recommend the use of the three modalities by healthcare organizations in different settings based on their abilities and one that aligns with the organizational culture. The article is important to the EBP proposed project as it illustrates that importance of using the TIPS model as an intervention to reduce and prevent the occurrence of falls in medical-surgical units. The intervention is important since it demonstrates the need for better patient outcomes.
Carter, E. J., Khasnabish, S., Adelman, J., Bogaisky, M., Lindros, M. E., Alfieri, L., … & Dykes, P.

OBM Geriatrics, 4(2), 1-21.

DOI:10.21926/obm.geriatr.2002119.

Adoption of a Patient-Tailored Fall Prevention Program in Academic Health Systems: A Qualitative Study of Barriers and Facilitators.

2020

The aim of this study was to evaluate the facilitators and barriers to the adoption of Fall TIPS in healthcare settings. The researchers used a multisite qualitative design. The setting comprised of 11 hospitals that represented three academic health systems that had implemented Fall TIPS. The researchers identified 50 patients and 71 staff for the focus groups. The interventions included interviews and focus groups where 71 nurses were analyzed. The researchers collected data from these two cohorts and analyzed them using a conventional content analysis approach. The findings show that the use of Fall TIPS led to increased levels of partnerships between nurses and patients. The fall prevention interventions were tailored to meet patient needs leading to better clinical decisions. The facilitators include motivation, use of residual fall prevention approaches and willfulness. The researchers recommend the implementation of Fall TIPS to improve patient safety and prevent the occurrence of falls. The article is essential as it shows the need for providers to integrate Fall TIPS where it works and leads to better patient safety measures.

 

Conclusion

The evaluation table is categorical that healthcare facilities and providers can mitigate falls through a raft of evidence-based practice (EBP) interventions like the Fall TIPS model. Existing literature is emphatic that these interventions are important in reducing falls and preventing their occurrence. The articles evaluated agree that while organizational challenges can arise in the implementation process, it is critical to evaluate all the aspects of the interventions to enhance adherence to the toolkit. The articles are important as they suggest implementation of the Fall TIPS framework across all areas of patient safety.

References

Cerilo, P. C., & Siegmund, L. A. (2022). Pilot testing of nurse led multimodal intervention for falls prevention. Geriatric Nursing, 43, 242-248. DOI: 10.1016/j.gerinurse.2021.12.002

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.

Thupawirot, Journal of Preventive Medicine Association of Thailand https://he01.tci-thaijo.org/index.php/JPMAT/article/view/173652,

 

Effects of discharge planning and telephone follow up on HbA1c and nursing service satisfaction of diabetic patients and nurse’s job satisfaction

Published: 2019

 

Discharge planning and telephone follow up improve health outcomes, satisfaction, and nurse’s job satisfaction.

The purpose of the study was to evaluate the beneficial effects of discharge planning and telephone follow up in HbA1C of diabetic patients, satisfaction, and nurses’ job satisfaction.

Quantitative design- it is an experimental study. Setting- Diabetes Center

Sample: 70 patients

Randomized experimentation- the experimental group utilized discharge planning and follow-up care via telephone and the control group received usual care. Data were collected via questionnaires and analyzed by mean, standard deviation, and t-tests. Self-management outcomes and satisfaction were higher in experimental group than control group. Discharge planning and telephone follow-up improve post-discharge diabetes care and should be implemented in diabetes centers The study confirms the valuable impacts of telephone follow-up by nurses to help patients prevent negative disease development such as diabetic foot ulcers.
Riangkam et al., Journal of Health Research, https://doi.org/10.1108/JHR-02-2021-0126 Effects of a mobile health diabetes self-management program on HbA1C, self-management and patient satisfaction in adults with uncontrolled type 2 diabetes: A randomized controlled trial

Published: 2021

Telephone follow-up is more effective than usual care in diabetes self-management.

The purpose of the study was to examine the effects of mobile health diabetes self-management program (MHDSMP) on diabetes behaviors, glycemic control, and self-management, among other factors.

Quantitative design- it is a three-arm parallel group, randomized controlled trial. Setting: medical center in Thailand

Sample: 129 patients (43 in each group)

Patients were randomly assigned to the MHDSMP, telephone follow-up, and usual care group. Outcomes were evaluated after three months.

 

Data were collected via questionnaires and descriptive statistics conducted (mean, standard deviation, and percentages) HbA1C decreased from 7.72 to 7.65% in the telephone follow-up group and from 7.89 to 7.72% in the usual care group. The MHDSMP group scored the best from 7.80 to 7.17% The MHDSMP program is the best post-discharge approach for patients with diabetes. Telephone follow-up has better outcomes than usual care. The article illustrates the statistical difference between telephone follow-up and usual care in diabetes management post-discharge. It recommends the use of telephone follow-up over usual care since it has better self-management outcomes.
Pichayapinyo, International Journal of Nursing Practice, https://doi.org/10.1111%2Fijn.12781 Feasibility study of automated interactive voice response telephone calls with community health nurse follow‐up to improve glycaemic control in patients with type 2 diabetes

Published: 2019

What are the effects of automated voice response calls and follow up notifications on diabetes control?

The study examined the feasibility and acceptance of self-care assistance program for poorly controlled T2DM.

Quantitative and qualitative (mixed-methods single-arm pre-post trial) Setting- primary care settings in suburban Thai provinces

Sample- 6 nurses and 35 type 2 diabetes patients

Patients received automated Interactive Voice Response (IVR) calls for about 5-10 minutes weekly for 12 weeks and feedback messages recorded. Data were collected via baseline questionnaires (quantitative) and semi-structured exit interviews (qualitative) Follow-up care helped to reduce the mean glycated hemoglobin by 0.9%. Other reported outcomes included high adherence to medication, frequent foot care, and reduced carbohydrate consumption. Primary care settings should intensify follow-up care programs via telephones and emails to improve foot care, adherence, and other positive outcomes. The article explains the benefits of telephone follow-up in improving foot care routine, which is critical in preventing diabetic foot ulcers/wounds.
Hanifi et al., Oman Medical Journal, https://doi.org/10.5001%2Fomj.2019.26 Effect of consultation and follow-up phone calls on biochemical indicators and intradialytic weight gain in patients undergoing hemodialysis

Published: 2019

What is the effect of consultation and follow-up phone calls in patients undergoing hemodialysis?

The study evaluated the effects of consultation and follow-up phone calls on biochemical indicators and intradialytic weight gain (IWG) in patients undergoing hemodialysis.

Quantitative design- it is a double-blind, randomized clinical trial. Setting: Zanjan, Iran

Sample: 86 patients

Patients were assigned into experimental and control group followed by 28 follow-up calls over 12 weeks. Interviews and chart reviews were used to collect data. Biochemical indicators were measured/analyzed at baseline and in 4th, 8th, and 12th week. There was a statistical significant difference (p < 0.050) at the 8th and 12th week. Consultation and follow-up phone calls are recommended for patients undergoing hemodialysis. The study demonstrates the benefits of follow-up phone calls by nurses to reduce the risk for diabetes adverse development like diabetic foot ulcers.
Li et al., Health Informatics Journal, https://doi.org/10.1177%2F1460458221997893 Home telemonitoring for chronic disease management: Perceptions of users and factors influencing adoption

Published: 2021

What is the effect of telemonitoring on the care of individuals living with chronic disease?

The study investigated the experiences of patients and clinicians in a care augmenting telemonitoring service.

A mixed-methods approach Setting: five Australian states

Sample: 56 patients and clinician groups

A multi-site trial evaluating perceived impacts. Data were collected via questionnaires and interviews and analyzed by researchers via Excel data analysis software Telemonitoring improved patients’ experiences post-discharge by empowering them with knowledge about symptoms to watch, health monitoring, self-care, and management of health condition. It helped nurses to be involved in patient care after discharge. Follow-up after discharge helps patients and nurses to prevent the development of chronic diseases such as diabetes to unmanageable levels. The article discusses the impacts of telephone monitoring to improve health management after discharge. Such knowledge helps to minimize risks that increase the risk of diabetic foot ulcers among diabetic patients.
Lemelin et al., Diabetes Technology & Therapeutics, https://doi.org/10.1089/dia.2019.0324 Improved glycemic control through the use of a telehomecare program in patients with diabetes treated with insulin

Published: 2020

Telehomecare has positive outcomes on standard after-clinic care for diabetic patients.

The study compared telehomecare and standard care outcomes on clinical efficacy, nursing interventions, and medical visits among diabetic patients.

Quantitative design-a prospective non-inferiority clinical trial. Setting: diabetes center outpatient clinic

Sample: 92 participants

Participants were assigned to experimental and control group. Outcomes at three months were compared to baseline. Health activities and adjusted feedback were recorded and analyzed via ANCOVA and univariate linear regression analysis. Telehomecare group was associated with a significant decline in A1c levels at three months. Nursing interventions such as communication and adherence were higher in telehomecare group than control group. Telehomecare characterized by frequent communication/monitoring from care providers is recommended. The study confirms the benefits of telephone care in improving health outcomes among patients with diabetes. This can help to reduce the risk for diabetic foot ulcers.
Ogunlana et al., International Journal of Qualitative Studies on Health and Well-being, https://doi.org/10.1080/17482631.2021.1945206 Qualitative exploration into reasons for delay in seeking medical help with diabetic foot problems

Published: 2021

Minimal knowledge and awareness delay reporting of foot symptoms in patients with diabetes.

The study explored the causes of delayed interventions/presentation of patients with diabetic foot ulcers.

Qualitative: it was an explorative qualitative study. Setting: diabetes foot clinic in Nigeria

Sample: 8 patients with diabetes

Researchers explored the lived experiences of patients with diabetes. Data were collected via in-depth interviews and analyzed thematically via deductive reasoning. Knowledge and awareness of foot challenges, risk perception, and health seeking behaviors hampered response towards diabetic foot development and complications. Enhancing knowledge and awareness and controlling negative health seeking behaviors are recommended to avoid delays in response towards diabetic foot development. The positive outcomes can be achieved through follow-up care. The article demonstrates the importance of improved knowledge and awareness to reduce the risk of diabetic foot complications. Nurses can intervene through follow-up calls.
Orozco‐Beltrán, Endocrinology, Diabetes & Metabolism, https://doi.org/10.1002/edm2.220 Healthcare experience among patients with type 2 diabetes: A cross‐sectional survey using the IEXPAC tool

Published: 2021

Experiences with care vary according to patients’ demographic variables and health care-related characteristics. The purpose of the study was to evaluate experience with health care among patients with T2DM Quantitative research design- a cross sectional survey. Setting: primary care centers in Spanish communities

Sample: 451 T2DM patients

A cross-sectional study- patients with T2DM were surveyed Researchers assessed patient experiences via Instrument for Evaluation of the Experience of Chronic Patients’ (IEXPAC) questionnaire. Multivariate analyses helped to analyze experiences and tools during follow-up care by nurses and physicians. Continuity of care score was high among patients who received a follow-up call or visit by a care provider. Follow-up calls and visits are effective methods for improving patient care experiences. The study emphasizes the need for follow-up calls to improve self-management, which is critical in preventing diabetic foot ulcers.