NUR-550 Translational Research Graphic Organizer

Translational Research Graphic Organizer

Grand Canyon University Translational Research Graphic Organizer-Step-By-Step Guide

 

This guide will demonstrate how to complete the Grand Canyon University  Translational Research Graphic Organizer assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.

 

How to Research and Prepare for Translational Research Graphic Organizer                                   

 

Whether one passes or fails an academic assignment such as the Grand Canyon University   Translational Research Graphic Organizer depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.

 

After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.

 

How to Write the Introduction for Translational Research Graphic Organizer                                   

 

The introduction for the Grand Canyon University   Translational Research Graphic Organizer is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.

 

How to Write the Body for Translational Research Graphic Organizer                                   

 

After the introduction, move into the main part of the Translational Research Graphic Organizer assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.

 

Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.

 

How to Write the Conclusion for Translational Research Graphic Organizer                                   

 

After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.

 

How to Format the References List for Translational Research Graphic Organizer                                   

 

The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.

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Our team of experienced writers is well-versed in academic writing and familiar with the specific requirements of the Translational Research Graphic Organizer assignment. We can provide you with personalized support, ensuring your assignment is well-researched, properly formatted, and thoroughly edited. Get a feel of the quality we guarantee – ORDER NOW. 

 

NUR-550 Translational Research Graphic Organizer

Nursing Practice Problem:

The selected nursing issue for the evidence-based practice (EBP) project is medication errors in nursing that happen due to staffing shortage. Medication errors are a significant problem in healthcare sector, especially at this time when there is nursing shortage and high nurse turnovers. With reduced number of nurses working in the healthcare sector, the susceptibility of patients to medication errors increases, particularly adverse drug events that can lead to death and prolonged stays in hospitals (Buerhaus et al., 2017). The project will focus on the effectiveness of implementation of health information technology compared to the conventional ways of medication management to mitigate medication errors in critically ill patients. The selection of critically ill patients as the population of interest emanates from their increased vulnerability to injuries that need high-risk medication and more use of intravenous infusions which raises the possibility of medication errors. Health information technology can play an essential role in enhancing efficiency of nurses to offer required care and reduce medication errors.

Comparing research designs is essential to enhancing better understanding of the application and nature. Through effective understanding, nurses can apply evidence-based research into clinical practice to address issues and offer improve patient care. As such, the translational research graphic organizer compares one translational study to quantitative study, and one translational study to qualitative study.

Comparison 1: Translational Research vs. Qualitative Research

Criteria	Peer-Reviewed Translational Article and Permalink/Working Link: Härkänen, M., Vehviläinen-Julkunen, K., Murrells, T., Rafferty, A. M., & Franklin, B. D. (2019). Medication administration errors and mortality: incidents reported in England and Wales between 2007 ̶ 2016. Research in Social and Administrative Pharmacy, 15(7), 858-863. https://doi.org/10.1016/j.sapharm.2018.11.010 Translational Research Type: T2	Peer-Reviewed Traditional Article and Permalink/Working Link: Barakat, S. & Franklin, B. D. (2020). An Evaluation of the Impact of Barcode Patient and Medication Scanning on Nursing Workflow at a UK Teaching Hospital. Pharmacy (Basel), 8(3):148.  doi: 10.3390/pharmacy8030148 Traditional Qualitative Research Type: Observational Research	Observations (Similarities/Differences)
Methodology	The researchers reported cases between 2007 and 2016 from the National Reporting and Learning System for England and Wales. The article also analyzes the deaths reported and categorizes drugs based on various parameters that include, year, age, location, and category of error using incidents’ initial classification.	The study was a comparative research with direct observation approach used in the two settings within acute surgical wards in UK hospital.	In both studies, the researchers use hypotheses to understand the phenomena under study. In both studies, the researchers actively participate in the research process. However, researchers can manipulate the outcomes and research design in qualitative study but cannot in translational research.
Goals	The study’s goals include analysis of medication administration errors reported in acute care that led to death, know the involved drugs, and offer a description of administration error features like location type of error and patient age.	The authors assert that little is known about the use of barcode medication administration. Therefore, the researchers sought to evaluate the effects of barcode patient and medication scanning on nursing flow at a teaching hospital in the UK.	In both studies, the researchers’ focus is to improve practice interventions on the issue of medication administration errors. Conversely, the translational research’s main focus is to enhance practice and not produce new knowledge. In this case, the translational research article seeks to improve reporting and knowledge about the effects of medication errors. However, the qualitative research seeks new knowledge about the use barcode scanning.
Data Collection	The authors collected data from incident reporting in acute care setting. The data came from the National Reporting and Learning System of England and Wales.	The researchers collected data on drug rounds through observation on different parameters that include duration, timelines of medication administration, identity of patients, verification of medications and the overall workflow patterns in the two facilities.	Both collect data from different sources. However, qualitative study uses primary data collected through observation while the translational study uses secondary data from the reporting mechanism used in England and Wales.

 

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Comparison 2: Translational Research vs. Quantitative Research

Criteria	Peer-Reviewed Translational Article and Permalink/Working Link: Flott, K., Nelson, D., Moorcroft, T., Mayer, E. K., Gage, W., Redhead, J. & Darzi, A. W. (2018).  Enhancing Safety Culture Through Improved Incident Reporting: A Case Study in Translational Research, Health Affairs, 37(11).  https://doi.org/10.1377/hlthaff.2018.0706 Translational Research Type:	Peer-Reviewed Traditional Article and Permalink/Working Link: Alomari, A., Sheppard-Law, S., Lewis, J. & Wilson, V. (2020). Effectiveness of Clinical Nurses’ interventions in reducing medication errors in a pediatric ward. The Journal of Clinical Nursing, 29(17-18): 3403-3413. https://doi.org/10.1111/jocn.15374 Traditional Quantitative Research Type: Action Research (AR) three-phase study.	Observations (Similarities/Differences)
Methodology	The article uses a case study approach to report on an initiative by two large healthcare organizations and providers on the effects of using a learning health systems cycle of interventions.	The article used a quantitative research method comprising of three phases of action research. The first phase focused on developing an overview of the medication practice while the second developed and implemented targeted interventions. The third phase evaluated the implemented interventions.	Both studies use unique methodologies based on the interests of the researchers. Both do not involve the researchers in designing the methodology and its implementation.
Goals	The goals of the study are enhancement of patient safety culture using improved reporting of incidents and learning to shape a more just organization culture.	The aims and objectives of the study was to evaluate the effects of bundle interventions that nurses can develop and implement to reduce medication administration error rates. The article also focused on enhancing nurses’ medication administration practice.	The translational study’s focus is to enhance patient safety culture through effective reporting. However, the quantitative study seeks developing new knowledge for nurses to reduce medication administration errors. The quantitative study also focuses on improving nurses’ understanding of the medication administration practice
Data Collection	The authors collected data from frontline-staff who implemented seven evidence-based interventions. Through observation, the researchers monitored and recorded reported incidents based on several indicators, including reported harms.	The researchers collected data from the six recruited clinical pediatric nurses as part of the action research team. Data collection comprised of medication incident data, medical policy audits using a questionnaire.	Both collect data from participants in different patient settings. Both show that data is an important part of any research as it validates the developed hypotheses.

 

Conclusion

The articles from translational research and traditional research approaches show the effects of the different study approaches in gathering data and evidence on medication errors. The articles demonstrate the need for researchers to use research designs that will lead to enhanced and quality findings to translate into evidence-based practice interventions in clinical practice. The implication is that translational and traditional research approaches differ while also agree on certain aspects of research.

References

Alomari, A., Sheppard-Law, S., Lewis, J. & Wilson, V. (2020). Effectiveness of Clinical Nurses’ interventions in reducing medication

errors in a pediatric ward. The Journal of Clinical Nursing, 29(17-18): 3403-3413.

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

Barakat, S. & Franklin, B. D. (2020). An Evaluation of the Impact of Barcode Patient and Medication Scanning on Nursing Workflow

at a UK Teaching Hospital. Pharmacy (Basel), 8(3):148.  doi: 10.3390/pharmacy8030148

Flott, K., Nelson, D., Moorcroft, T., Mayer, E. K., Gage, W., Redhead, J. & Darzi, A. W. (2018).  Enhancing Safety Culture Through

Improved Incident Reporting: A Case Study in Translational Research, Health Affairs, 37(11).

https://doi.org/10.1377/hlthaff.2018.0706

Härkänen, M., Vehviläinen-Julkunen, K., Murrells, T., Rafferty, A. M., & Franklin, B. D. (2019). Medication administration errors

and mortality: incidents reported in England and Wales between 2007 ̶ 2016. Research in Social and Administrative Pharmacy, 15(7), 858-863.

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

State the nursing practice problem for your evidence-based practice project. If your nursing problem has not yet been approved, make any required changes or revisions to your nursing practice problem prior to starting the assignment. Using your proposed topic, conduct a literature search and complete the tables below.

Nursing Practice Problem: The nursing practice problem is obesity among school-age children.

 

Comparison 1: Translational Research vs. Qualitative Research

Criteria	Peer-Reviewed Translational Article and Permalink/Working Link: Joseph, E. D., Kracht, C. L., St. Romain, J., Allen, A. T., Barbaree, C., Martin, C. K., & Staiano, A. E. (2019). Young children’s screen time and physical activity: Perspectives of parents and early care and education center providers. Global Pediatric Health, 6, 2333794X19865856. https://doi.org/10.1177%2F2333794X19865856 Translational Research Type: Translation to practice (T3)	Peer-Reviewed Traditional Article and Permalink/Working Link: Stiglic, N., & Viner, R. M. (2019). Effects of screentime on the health and well-being of children and adolescents: A systematic review of reviews. BMJ Open, 9(1), e023191. http://dx.doi.org/10.1136/bmjopen-2018-023191 Traditional Qualitative Research Type: systematic review of past literature.	Observations (Similarities/Differences)
Methodology	Four focus groups (3 parents and 1 ECE provider) were conducted and thematic analysis performed to identify themes and subthemes on children’s screen time and physical activity. Twenty-eight caregivers (21 parents and 7 ECE providers) participated in the research.	A systematic review of past studies on the evidence for health and well-being effects of screen time in children and adolescents was conducted. 13 reviews were identified.	Joseph et al. (2019) used focus groups while Stiglic and Viner (2019) did a literature review.
Goals	The primary goal was to seek input from caregivers on barriers and facilitators of physical activity and screen time to comprehensively address them and promote children’s health.	The study systematically examined the evidence of harms and benefits relating to screen time for children and young people’s health and well-being.	Joseph et al. (2019) examined how caregivers’ input regarding physical activity and screen time can be used to promote children’s health while Stiglic and Viner (2019) examined what past studies concluded regarding harms and benefits of screen time and children’s health and well-being.
Data Collection	Data for the study was obtained from focus groups containing twenty-eight caregivers. Focus groups were held between January and March 2017.	Stiglic and Viner (2019) searched electronic databases (Medline, Embase, PsycINFO and CINAHL) in February 2018.	Joseph et al. (2019) collected data from participants while Stiglic and Viner (2019) collected from peer-reviewed articles.

 

 

Comparison 2: Translational Research vs. Quantitative Research

Criteria	Peer-Reviewed Translational Article and Permalink/Working Link: Schwarzfischer, P., Gruszfeld, D., Socha, P., Luque, V., Closa-Monasterolo, R., Rousseaux, D., … & Grote, V. (2020). Effects of screen time and playing outside on anthropometric measures in preschool aged children. PloS One, 15(3), e0229708. https://doi.org/10.1371/journal.pone.0229708 Translational Research Type: research focused on outcomes in populations (T4)	Peer-Reviewed Traditional Article and Permalink/Working Link: Goncalves, W. S. F., Byrne, R., Viana, M. T., & Trost, S. G. (2019). Parental influences on screen time and weight status among preschool children from Brazil: a cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 1-8. doi: 10.1186/s12966-019-0788-3 Traditional Quantitative Research Type: A cross-sectional study. [experimental research]	Observations (Similarities/Differences)
Methodology	Schwarzfischer et al. (2020) assessed children of the European Childhood Obesity Project annually by questionnaire from 3 until 6 years of age with focus on playing outside (PO) and screen time.	A survey measuring sociodemographic data, weekday and weekend screen time, and parental self-efficacy for limiting screen time.	Both studies evaluated outcomes. However, Schwarzfischer et al. (2020) used questionnaires while Goncalves et al. (2019) did a survey.
Goals	Schwarzfischer et al. (2020) investigated the relationship between average time spent on playing outside and screen time and anthropometric measures (body weight, waist circumference, and height) at 3 and 6 years of age.	Goncalves et al. (2019) examined the relationships between parental screen time, self-efficacy to limit screen time, child screen time and child BMI in preschool-aged children.	Both researches examined the relationship between screen time and measures related to obesity such as weight gain. However, Schwarzfischer et al. (2020) focused on various anthropometric measures while Goncalves et al. (2019) focused on child BMI.
Data Collection	Body weight, waist circumference and height were measured at 3 and 6 years of age to calculate Body-Mass-Index z-Scores (zBMI) and waist-to-height ratio (WTH) of 526 children of CHOP. Schwarzfischer et al. (2020) applied linear, logistic and quantile regressions to test whether playing outside and screen time impacted anthropometric measures.	Height and weight were measured to derive BMI and BMI percentile. Goncalves et al. (2019) further used observed variable path analysis to examine the relationship between parental and child variables.	Schwarzfischer et al. (2020) measured zBMI and waist-to-height ratio while Goncalves et al. (2019) measured height and weight to derive BMI.

 

 

 

References

Goncalves, W. S. F., Byrne, R., Viana, M. T., & Trost, S. G. (2019). Parental influences on screen time and weight status among preschool children from Brazil: a cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 1-8. doi: 10.1186/s12966-019-0788-3

Joseph, E. D., Kracht, C. L., St. Romain, J., Allen, A. T., Barbaree, C., Martin, C. K., & Staiano, A. E. (2019). Young children’s screen time and physical activity: Perspectives of parents and early care and education center providers. Global Pediatric Health, 6, 2333794X19865856. https://doi.org/10.1177%2F2333794X19865856

Schwarzfischer, P., Gruszfeld, D., Socha, P., Luque, V., Closa-Monasterolo, R., Rousseaux, D., … & Grote, V. (2020). Effects of screen time and playing outside on anthropometric measures in preschool aged children. PloS One, 15(3), e0229708. https://doi.org/10.1371/journal.pone.0229708

Stiglic, N., & Viner, R. M. (2019). Effects of screentime on the health and well-being of children and adolescents: A systematic review of reviews. BMJ Open, 9(1), e023191. http://dx.doi.org/10.1136/bmjopen-2018-023191

Nursing Practice Problem: Falls are an important health issue in many areas of care provision with adverse consequences for patients experiencing them. These include getting bruises to more complex effects that include injuries, fractures, lacerations and in severe instances, death. The Centers for Disease Control and Prevention (CDC) asserts that about 1 million patient falls occur across healthcare facilities in the country and account for about 85% of hospital acquired conditions. Research studies on falls are essential for providers to develop relevant interventions aimed at improving overall quality of care. The purpose of this translational research graphic organizer paper is to compare traditional research approaches that include qualitative and quantitative articles to translational research articles on falls and prevention strategies that nurses alongside other providers can implement.

Comparison 1: Translational Research vs. Qualitative Research

Criteria	Peer-Reviewed Translational Article and Permalink/Working Link: Mayhob, M. M., & Amin, M. A. (2022). Fall Prevention Interventions: Tailored Approach versus Routine Interventions among Elderly Hospitalized Patients. American Journal of Nursing Research, 10(1), 26-33. DOI:10.12691/ajnr-10-1-4 Translational Research Type: T3 Type three research looks at ways of implementing guidelines and recommendations in general practice. As such, T3research produces knowledge concerning the working of interventions in practical situations	Peer-Reviewed Traditional Article and Permalink/Working Link: Carter, E. J., Khasnabish, S., Adelman, J. S., Bogaisky, M., Lindros, M. E., Alfieri, L., & Dykes, P. C. (2020). Adoption of a patient-tailored fall prevention program in academic health systems: a qualitative study of barriers and facilitators. OBM Geriatrics, 4(2), 15. http://dx.doi.org/10.21926/obm.geriatr.2002119 Traditional Qualitative Research Type: Multisite qualitative study	Observations (Similarities/Differences)
Methodology	The study uses a quasi-experimental design to conduct research in medical wards. The researchers also leveraged purposeful sampling approach. The researchers had two groups of participants in their respective categories each comprising of 54 individuals.	The researchers in this article used a multisite qualitative approach with patients coming from eleven different hospitals and had implemented fall TIPS successfully. The logic to using this approach was that compliance to TIPS reduces falls’ prevalence.	The use of an effective methodology is key to generating reliable and valid research findings. In this case, the two articles used different research methodologies. The translational research article deployed a quasi-experimental design. Conversely, the qualitative research used a multisite study design to conduct the trial.
Goals	The primary goal of this study was to compare the efficacy of tailored approach to fall prevention and the routine or normal interventions used by providers for hospitalized elderly patients.	The researchers in this study focused on identification of prevalent factors and barriers to the use of TIPS in healthcare facilities. The study advances that effective implementation of TIPS is critical to fall prevention but existence of barriers can lead to reduced compliance and ineffectiveness.	The goals of the two studies differed. The translational research article primary goal was to evaluate the efficacy of the TIPS program in lowering patient falls. However, the qualitative study looked at the facilitators and barriers to fall prevention.
Data Collection	The researchers used two tools to collect data. These included data assessment tool and the Morse Risk Assessment Scale for fall. The researchers used the second toll to evaluate the implementation of TIPS and routine interventions to prevent falls among the selected health population or patients.	The researchers in this article used semi-structured interviews with 50 patients and focus groups. The study also interviewed 71 staff. The analysis of data entailed conventional content analysis.	The two studies used different methods to collect data. The translational research article used patient health records and assessment scales to collect data from the participants. However, the qualitative research applied semi-structured approach in collecting data. All the articles collected data to evaluate the efficacy TIPS adoption in healthcare settings.

 

 

Comparison 2: Translational Research vs. Quantitative Research

Criteria	Peer-Reviewed Translational Article and Permalink/Working Link: Dykes, P. C., Duckworth, M., Cunningham, S., Dubois, S., Driscoll, M., Feliciano, Z., … & Scanlan, M. (2017). Pilot testing fall TIPS (tailoring interventions for patient safety): a patient-centered fall prevention toolkit. The Joint Commission Journal on Quality and Patient Safety, 43(8), 403-413. https://doi.org/10.1016/j.jcjq.2017.05.002   Translational Research Type: T3	Peer-Reviewed Traditional Article and Permalink/Working Link: Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., … & Bates, D. W. (2020). Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial. JAMA network open, 3(11), e2025889-e2025889. doi:10.1001/jamanetworkopen.2020.25889   Traditional Quantitative Research Type: Non-randomized controlled trial	Observations (Similarities/Differences)
Methodology	The researchers used a conceptual model for implementing fall TIPS at Brigham and Women’s Hospital (BWH: Boston); the Institute for Healthcare Improvement’s Framework for Spread. According to the article, translation of evidence into practice requires engaging stakeholders through using shared governance structure, knowing unit champions and training staff as well as auditing to evaluate and offer feedback on adherence to protocols and patient outcomes.	The researchers in this study deployed a nonrandomized control trial approach through the stepped-wedge design. The researchers also carried out an interruptive time series assessment of patient-centered fall TIPS tool kit where over 37,000 patients participated to determine the efficacy of the intervention.	The two studies employed two different research methodologies based on their goals or focus areas. The translational research used a conceptual model by the Institute for Healthcare Improvement while the quantitative study used a nonrandomized controlled trial with a step-wedged design.
Goals	The primary goal of this study was to conduct a pilot test of fall TIPS in two medical centers through the use of the conceptual model.	The main goal of the study entailed exploring if a fall-prevention tool kit which engages patients and their families can reduce fall prevalence and the associated injuries and other adverse events.	The two articles’ main goal was to evaluate the efficacy of TIPS framework in preventing falls among patients.
Data Collection	The researchers collected data using patient surveys and observation of the adherence to the set protocols to reduce falls and associated injury rates.	The researchers used an event reporting approach to collect data and analyze the outcomes.	The two studies employed different data collection tools with the translational research using patient surveys and observation while the quantitative article applied event reporting model. A similarity between the two articles is the leveraging of data as effective in evaluating the efficacy and effectiveness of the interventions.

Conclusion

The comparison of the four articles demonstrates the differences and similarities in the use of translational and traditional research studies concerning the identified patient health issue. Falls are a major concern for healthcare organizations and implementing different measures is essential to addressing the issue in practical situations. The comparison of the articles shows that through the use of translational research approaches, providers can translate scientific discoveries in real practice settings or environments.

 

 References

Carter, E. J., Khasnabish, S., Adelman, J. S., Bogaisky, M., Lindros, M. E., Alfieri, L., & Dykes, P. C. (2020). Adoption of a patient-

tailored fall prevention program in academic health systems: a qualitative study of barriers and facilitators. OBM Geriatrics, 4(2), 15. http://dx.doi.org/10.21926/obm.geriatr.2002119

Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., … & Bates, D. W. (2020). Evaluation of a patient-

centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial. JAMA network open, 3(11), e2025889-e2025889. doi:10.1001/jamanetworkopen.2020.25889.

Dykes, P. C., Duckworth, M., Cunningham, S., Dubois, S., Driscoll, M., Feliciano, Z., … & Scanlan, M. (2017). Pilot testing fall TIPS

(tailoring interventions for patient safety): a patient-centered fall prevention toolkit. The Joint Commission Journal on Quality and Patient Safety, 43(8), 403-413. https://doi.org/10.1016/j.jcjq.2017.05.002

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

Mayhob, M. M., & Amin, M. A. (2022). Fall Prevention Interventions: Tailored Approach versus Routine Interventions among

Elderly Hospitalized Patients. American Journal of Nursing Research, 10(1), 26-33. DOI:10.12691/ajnr-10-1-4