Provide a Summary of the Clinical Issue
Provide a Summary of the Clinical Issue
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: TProvide a Summary of the Clinical Issue
The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.
For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-reviewed research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.
Use the “Literature Evaluation Table” to complete this assignment.
Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
The PICOT question will provide a framework for your capstone project.
Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.
Click here to ORDER an A++ paper from our Verified MASTERS and DOCTORATE WRITERS: TProvide a Summary of the Clinical Issue
Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
Attachments
NRS-433V -RS1-LiteratureEvaluationTable.do
Falls among patients, especially older patients in nursing homes, are a critical healthcare concern because of their adverse effects on outcomes. Falls lead to increased cost of care due to lengthened stay in hospital, adverse events like head injuries and even death. Older patients, 65 years and above, are susceptible to falls due to different reasons that include loss of muscle mass, a condition known as sarcopenia, cognitive impairment or due to certain types of dementia and failing eye sight. Medications can also increase one’s susceptibility to due to their side effects like confusion and dizziness. According to the Centers of Disease Control and Prevention (CDC) (2023), fall pose a threat to the health of older adults and reduces their ability to remain independent. The CDC says that over 36,000 deaths occurred in 2020 associated with falls among the elderly with another 3 million emergency department visits due to falls. The Centers for Medicare and Medicaid Services (CMS) consider falls as a never event because they are preventable when hospitals implement evidence-based practice (EBP) interventions. Evidence-based practice interventions like tailoring interventions for patient safety (TIPS) can help providers reduce and prevent falls and their adverse effects in diverse healthcare settings. The purpose of this paper is to review articles on TIPS based on the formulated PICOT question. The paper reviews both qualitative and quantitative research articles on TIPS as an effective intervention to reduce falls among the elderly in nursing homes.
PICOT Question: Among older adults aged 65 years and above in nursing homes and residences (P), does the implementation of TIPS framework (I) compared to normal safety measures (C), reduce and prevent fall by 60% and associated effects (O) within six months (T)?
| Criteria | Article 1 | Article 2 | Article 3 |
| APA-formatted article citation with permalink | Vincenzo, J. L., Patton, S. K., Lefler, L. L., McElfish, P. A., Wei, J., & Curran, G. M. (2022). A qualitative study of older adults’ facilitators, barriers, and cues to action to engage in falls prevention using health belief model constructs. Archives of gerontology and geriatrics, 99, 104610. https://doi.org/10.1016/j.archger.2021.104610 | Carter, E. J., Khasnabish, S., Adelman, J., Bogaisky, M., Lindros, M. E., Alfieri, L., … & Dykes, P. (2020). Adoption of a patient-tailored fall prevention program in academic health systems: a qualitative study of barriers and facilitators. OBM Geriatrics, 4(2), 1-21. doi:10.21926/obm.geriatr.2002119 | Rogers, C., Shamley, D., & Amosun, S. (2021). Older adults’ experience of an exergaming intervention to improve balance and prevent falls: a nested explanatory qualitative study. Applied Sciences, 11(24), 11678. https://doi.org/10.3390/app112411678 |
| How does the article relate to the PICOT question? | The article supports the PICOT as it demonstrates the efficacy of using different interventions that focus on improving patient safety among patients | The article relates to the PICOT question as it demonstrates that fall TIPS can have significant impact on patients and staff when implemented in any setting. | The article relates to the PICOT as it shows that using better tailored interventions can reduce falls among patients in different settings. |
| Is the article qualitative, quantitative, or mixed methods?
Justify your selection. |
Qualitative
The article is qualitative based on the method that the researchers apply informed grounded theory and focus groups based on semi-structured interviews |
Qualitative
The researchers use qualitative approaches like observation and interviews to gather perceptions and opinions about the implemented Fall TIPS aspects. |
Qualitative
The researchers uses focus groups and analyze the results using content analysis. |
| Purpose statement | The purpose of the study was to gather views and perceptions from older patients about ways to prevent falls | The purpose of the article was to identify the barriers and facilitators to Fall TIPS adoption. | The purpose of the article was to explore the efficacy of a large-scale randomized control trial that compared an exergaming intervention and gold-standard one as well as no intervention. |
| Research question(s) | Does engagement in fall prevention activities reduce and prevent falls? | What are the barriers and facilitators to Fall TIPS adoption in healthcare organizations? | What is the effects of using tailored interventions to improve patient safety through reduction and prevention of falls? |
| Outcome(s) | The outcomes demonstrate that using fall prevention activities focused on patient safety reduce falls among elderly patients in diverse settings | The researchers identified both facilitators and barriers to Fall TIPS implementation. The outcome also show that Fall TIPS enhanced collaboration between staff and patients since they were tailored to each patient needs and preferences | The outcomes show an improvement in different aspects related to fall prevention. The study also explored attitudes toward fall and fall prevention. |
| Setting
(Where did the study take place?) |
The setting was a community dwelling of older adults with average age of 78 years. | The setting entailed 11 hospitals representing three academic health systems. | The setting comprised of different areas based on the origin of participants. |
| Sample | The sample comprised of 27 older adults living in a community dwelling. | The sample comprised of 50 patients and focus groups with 71 staff | The sample comprised of 14 participants in the OEP framework and 16 on the WBB model |
| Method | Informed grounded theory and focus groups | The researchers used interviews and focus groups | The researchers used focus groups and interviews. |
| Key findings of the study and implications for nursing practice | The findings from the study show that individuals do not engage in fall prevention activities due to different reasons like severity and susceptibility. The findings also demonstrate diverse facilitators in engaging in fall prevention.
The implications for nursing practice from this study is that providers should engage in tailored interventions based on the unique setting of the patients. |
The use of Fall TIPS led to increased motivation among nurses, improved patients’ understanding of their roles and integration of the intervention into the workflow processes. The researchers also identified barriers like poor engagement practices, use of residual fall prevention strategies; especially one-size-fits-all approach.
The implication of the study is that nurses should adopt Fall TIPS to improve safety in their settings. |
The findings from the study show that those engaged through exergaming model enjoyed the applied intervention but did not comply with the provisions. The focus groups showed barriers and facilitators to implementation of TIPS in their areas or facilities. |
| Recommendations of the researcher | The researchers recommend the need for people to engage in fall prevention behaviors by addressing the barriers like limited knowledge and perceived self-severity and susceptibility to falls. | The researchers recommend the use of Fall TIPS adoption and enhancement of staff engagement of patients to develop trusting partnerships to improve safety among them. | The article recommends increased engagement of patients and implementation of strategies that are tailored to meet patient needs. |
| Criteria | Article 4 | Article 5 | Article 6 |
| APA-formatted article citation with permalink | Guo, X., Wang, Y., Wang, L., Yang, X., Yang, W., Lu, Z., & He, M. (2023). Effect of a fall prevention strategy for the older patients: A quasi‐experimental study. Nursing open, 10(2), 1116-1124. https://doi.org/10.1002/nop2.1379 | Duckworth, M., Adelman, J., Belategui, K., Feliciano, Z., Jackson, E., Khasnabish, S., … & Dykes, P. C. (2019). 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. Journal of medical internet research, 21(1), e10008. DOI: 10.2196/10008 | Dykes, P. C., Khasnabish, S., Burns, Z., Adkison, L. E., Alfieri, L., Bogaisky, M., … & Adelman, J. S. (2022). Development and validation of a fall prevention efficiency scale. Journal of patient safety, 18(2), 94. DOI: 10.1097/PTS.0000000000000811 |
| How does the article relate to the PICOT question? | The article relates to the PICOT as it illustrates the effectiveness of using a fall prevention approach tailored to patient needs. | The article relates to the PICOT question as it shows that Fall TIPS framework is effective in reducing and preventing the occurrence of falls among diverse patients even in their homes. | Using a mixed method approach, the article related to the PICOT question as it shows that Fall TIPS model is effective in reducing falls |
| Is the article qualitative, quantitative, or mixed methods?
Justify your selection. |
Quantitative
The article is quantitative since it employs a quasi-experimental design |
Quantitative
The article analyzes the outcomes through quantitative approaches like conducting risk assessments. |
Mixed Methods
The article incorporates both qualitative and quantitative approaches. |
| Purpose statement | The purpose of the article was to explore the impact of a fall prevention strategy among older patients founded on the patient engagement design. | The purpose of the article was to assess the effects of Fall TIPS modality on patient engagement in a three-step fall prevention process and gauge efficacy. | The purpose of the study was to learn the benefits and burdens associated with Fall TIPS program. |
| Research question(s) | Does engagement of patients reduce and prevent the occurrence of falls among elderly patients or individuals? | Does the Fall TIPS modality affect patient engagement using a 3-step fall prevention process and efficacy? | Does the implementation of Fall TIPS improve nurses’ ability to reduce and prevent falls? |
| Outcome(s) | The outcomes show that the intervention reduces falls among the targeted population. | The outcomes show that patient engagement is essential for implementing Fall TIPS interventions. | The outcomes show that learning about providers’ beliefs in the use of time related to Fall TIPS implementation is essential to enhance results that include a reduction in falls. |
| Setting
(Where did the study take place?) |
The study occurred in a hospital with two groups or cohorts to demonstrate the efficacy of the intervention. | The researchers conducted the study in healthcare settings in Boston and New York, Bronx and Manhattan | Three hospitals in Massachusetts and 3 in New York |
| Sample | The sample comprised of 116 subject with the intervention group having 58 and control with 58. | The sample comprised of nurses at the selected facilities. | The sample comprise of 72 nurses who participated in two phases of group interviews. |
| Method | The researchers used a longitudinal quasi-experimental quantitative design | Three modalities that included laminated Fall TIPS poster, electronic Fall TIPS poster and paperless patient safety displays at the bed side. | The methods included initial qualitative, second qualitative and psychometric evaluation. |
| Key findings of the study and implications for nursing practice | The key findings include effectiveness of the intervention, and need to engage patients when implementing the strategy. The implications of the study for nursing practice is that nurses should implement strategies that are patient-centered to improve their overall safety.
The implication for nursing practice is each intervention works differently based on patient’s overall condition. |
The findings show that these interventions are Fall TIPS that lead to improved safety and management of falls among patients.
The implication of the article to nursing practice is that nurses should embrace these interventions to improve safety by preventing and reducing falls in their settings. |
The key findings for the article include learning about the facilitators and burdens that nurses encounter when implementing falls in their settings, especially through Fall TIPS.
The implications for nursing practice is that nurses should understand organizational barriers that can hinder the implementation of Fall TIPS. |
| Recommendations of the researcher | The researchers recommend more studies to understand the efficacy and effectiveness of engaging patients to develop a patient safety tool to reduce and prevent falls. | The researchers recommend implementation of the Fall TIPS to enhance patient safety and quality care for the affected patients. | Learning of these barriers allows organizations to improve areas of weakness and correct problems that waste time. |
Conclusion
Falls are a concern for nurses and other providers in diverse settings. Falls lead to adverse events and a rise in the cost of care. The use of evidence-based practice approaches is essential in preventing and reducing these events. As such, nurses, patients and other providers should develop Fall TIPS to reduce their occurrence and improve overall safety. The evaluation table shows that researchers can use diverse methodologies to demonstrate the effects of implementing Fall TIPS in their facilities for better management of these events.
References
Albasha, N., Ahern, L., O’Mahony, L., McCullagh, R., Cornally, N., McHugh, S., & Timmons, S. (2023). Implementation strategies
to support fall prevention interventions in long-term care facilities for older persons: a systematic review. BMC geriatrics, 23(1), 47. DOI: https://doi.org/10.1186/s12877-023-03738-z
Centers for Disease Control and Prevention (CDC) (2023). Older Adult Fall Prevention. https://www.cdc.gov/falls/index.html
Ziegl, A., Hayn, D., Kastner, P., Löffler, K., Weidinger, L., Brix, B., … & Schreier, G. (2020). Quantitative falls risk assessment in
elderly people: results from a clinical study with distance based timed up-and-go test recordings. Physiological measurement, 41(11), 115006. DOI 10.1088/1361-6579/abc352
PICOT Question and Literature Search – Rubric
Criteria Description
Summary of Clinical Issue
5. 5: Excellent
6 points
A clinical issue is thoroughly described. The issue relates to nursing practice.
4. 4: Good
5.64 points
A clinical issue is presented. The issue relates to nursing practice. Minor detail is needed for clarity.
3. 3: Satisfactory
4.98 points
A clinical issue is summarized. The issue generally relates to nursing practice.
2. 2: Less Than Satisfactory
4.5 points
A clinical issue is partially presented. It is unclear how the clinical issue relates to nursing practice. Significant aspects are missing, or there are inaccuracies.
1. 1: Unsatisfactory
0 points
A clinical issue is omitted or is not relevant to nursing practice.
Criteria Description
PICOT Question
5. 5: Excellent
12 points
A PICOT question is clearly presented. The PICOT question format is applied accurately and presents an answerable and researchable question.
4. 4: Good
11.28 points
A PICOT question is provided. The PICOT question format is applied accurately. Some detail is need for support or clarity.
3. 3: Satisfactory
9.96 points
A PICOT question is provided. The PICOT question format is generally applied. Some information or revision is needed.
2. 2: Less Than Satisfactory
9 points
A PICOT question is provided but is incomplete. The PICOT question format is used incorrectly.
1. 1: Unsatisfactory
0 points
A PICOT question is not included.
Criteria Description
APA-Formatted Article Citations With Permalinks
5. 5: Excellent
6 points
Article citations and permalinks are presented. Article citations are accurately presented in APA format.
4. 4: Good
5.64 points
Article citations and permalinks are presented. Article citations are presented in APA format. There are minor errors.
3. 3: Satisfactory
4.98 points
Article citations and permalinks are presented. Article citations are presented in APA format, but there are errors.
2. 2: Less Than Satisfactory
4.5 points
Article citations and permalinks are presented. There are significant errors in the APA format. One or more links do not lead to the intended article.
1. 1: Unsatisfactory
0 points
Article citations and permalinks are omitted.
Criteria Description
Relationship of Articles to the PICOT Question
5. 5: Excellent
12 points
Each article clearly relates to the PICOT question. The articles provide strong support for the PICOT question.
4. 4: Good
11.28 points
Each article relates to the PICOT question. The articles provide support for the PICOT question.
3. 3: Satisfactory
9.96 points
At least one articles does not relate to the PICOT question. The remaining articles provide general support for the PICOT question. One or two different articles are needed to provide better support for the PICOT question.
2. 2: Less Than Satisfactory
9 points
At least two articles do not relate to the PICOT question. The remaining articles provide a small degree of support for the PICOT question. Different articles are needed to provide better support for the PICOT question.
1. 1: Unsatisfactory
0 points
Three or more articles do not relate to the PICOT question.
Criteria Description
Quantitative and Qualitative Articles
5. 5: Excellent
12 points
Six research articles are presented. Each article meets the assignment criteria for a quantitative, qualitative, or mixed study. An ability to identify the different types of research design used in a study is consistently demonstrated.
4. 4: Good
11.28 points
Six research articles are presented. One article does not meet the assignment criteria for a quantitative, qualitative, or mixed study. A general ability to identify the type of research design used in a study is demonstrated.
3. 3: Satisfactory
9.96 points
Six research articles are presented. Two articles do not meet the assignment criteria for a quantitative, qualitative, or mixed study. Some ability to identify the type of research design used in a study is demonstrated.
2. 2: Less Than Satisfactory
9 points
Six research articles are presented. Three articles do not meet the assignment criteria for a quantitative, qualitative
1. 1: Unsatisfactory
0 points
Fewer than six research articles are presented. Four or more articles do not meet the assignment criteria for a quantitative, qualitative,
Criteria Description
Purpose Statements
5. 5: Excellent
6 points
Purpose statements are accurate and clearly summarized.
4. 4: Good
5.64 points
Purpose statements summarized. There are some minor inaccuracies in some.
3. 3: Satisfactory
4.98 points
Purpose statements are presented. There are minor omissions in some areas, or major inaccuracies.
2. 2: Less Than Satisfactory
4.5 points
Purpose statements are referenced but are incomplete in some areas.
1. 1: Unsatisfactory
0 points
Purpose statements are omitted or are incomplete overall.
Criteria Description
Research Questions
5. 5: Excellent
6 points
Research questions are accurate and capture the fundamental question posed by the researchers in each study.
4. 4: Good
5.64 points
Research questions are presented. Minor detail is needed for clarity in some areas.
3. 3: Satisfactory
4.98 points
Research questions are presented. The research question has been misidentified or misinterpreted for one of the articles. Some detail is needed to fully illustrate the research question for one or two articles.
2. 2: Less Than Satisfactory
4.5 points
Research question is presented for each article. The research question has been misidentified or misinterpreted for at least two of the articles. Additional information is needed to fully illustrate the research question for several of the articles.
1. 1: Unsatisfactory
0 points
Research questions are omitted or are incomplete overall.
Criteria Description
Outcome
5. 5: Excellent
6 points
Research outcomes are accurate and described in detail for each article.
4. 4: Good
5.64 points
Research outcomes are presented. Minor detail is needed for clarity in some areas.
3. 3: Satisfactory
4.98 points
Research outcomes are presented. The research outcome has been misidentified or misinterpreted for one of the articles. Some detail is needed to fully illustrate the research outcomes for one or two articles.
2. 2: Less Than Satisfactory
4.5 points
Research outcome is presented for each article. The research outcome has been misidentified or misinterpreted for at least two of the articles. Additional information is needed to fully illustrate the research outcomes for several of the articles.
1. 1: Unsatisfactory
0 points
Research outcomes are omitted or are incomplete overall.
Criteria Description
Setting
5. 5: Excellent
6 points
The setting in which the researcher conducted the study is detailed and accurate for each article.
4. 4: Good
5.64 points
The setting is indicated for each article. Some detail is needed to fully illustrate the physical, social, or cultural site in which the researcher conducted the study.
3. 3: Satisfactory
4.98 points
The setting is indicated for each article. The setting described for one article is inaccurate or incomplete.
2. 2: Less Than Satisfactory
4.5 points
The setting is indicated for each article. The setting described for two of the articles is inaccurate or incomplete.
1. 1: Unsatisfactory
0 points
The setting is omitted for one or more of the articles. The setting described for three or more articles is inaccurate or incomplete.
Criteria Description
Sample
5. 5: Excellent
6 points
The sample is indicated and accurate for each article.
4. 4: Good
5.64 points
The sample is indicated for each article. Minor detail is needed for accuracy.
3. 3: Satisfactory
4.98 points
The sample is indicated for each article. The sample described for one article is inaccurate or incomplete.
2. 2: Less Than Satisfactory
4.5 points
The sample is indicated for each article. The sample described for at least two of the articles is inaccurate or incomplete.
1. 1: Unsatisfactory
0 points
The sample is omitted for one or more of the articles. The sample described for three or more articles is inaccurate or incomplete.
Criteria Description
Method
5. 5: Excellent
6 points
A thorough discussion on the method of study for each article is presented.
4. 4: Good
5.64 points
A discussion on the method of study for each article is presented.
3. 3: Satisfactory
4.98 points
The method of study for each article is presented. Some key aspects are missing for one or two articles, or there are some inaccuracies for the methods reported.
2. 2: Less Than Satisfactory
4.5 points
The method of study is partially presented for each article. Key information is consistently omitted. Overall, the methods reported contain inaccuracies.
1. 1: Unsatisfactory
0 points
Method of study for one or more articles is omitted. Overall, the methods of study are incomplete.
Criteria Description
Key Findings of the Study
5. 5: Excellent
6 points
Discussion of study results, including findings and implications for nursing practice, is thorough with relevant details and extensive explanation.
4. 4: Good
5.64 points
Discussion of study results, including findings and implications for nursing practice, is complete and includes relevant details and explanation.
3. 3: Satisfactory
4.98 points
Discussion of study results, including findings and implications for nursing practice, is generally presented for each article. Overall, the discussion includes some relevant details and explanation.
2. 2: Less Than Satisfactory
4.5 points
A summary of the study results includes findings and implications for nursing practice but lacks relevant details and explanation. There are some omissions or inaccuracies.
1. 1: Unsatisfactory
0 points
Discussion of study results, including findings and implications for nursing practice, is incomplete.
Criteria Description
Recommendations of the Researcher
5. 5: Excellent
6 points
Researcher recommendations accurate are thoroughly described for each article.
4. 4: Good
5.64 points
Researcher recommendations for each article are accurately presented. Minor detail is needed for accuracy.
3. 3: Satisfactory
4.98 points
Researcher recommendations for each article are presented. Researcher recommendations described for one article are inaccurate or incomplete.
2. 2: Less Than Satisfactory
4.5 points
Researcher recommendations are indicated for each article. The researcher recommendations described for two of the articles are inaccurate or incomplete.
1. 1: Unsatisfactory
0 points
Researcher recommendations are omitted for one or more of the articles. The recommendations described for three or more articles are inaccurate or incomplete.
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
5. 5: Excellent
12 points
Writer is clearly in command of standard, written, academic English.
4. 4: Good
11.28 points
Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.
3. 3: Satisfactory
9.96 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.
2. 2: Less Than Satisfactory
9 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present.
1. 1: Unsatisfactory
0 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used.
Criteria Description
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
5. 5: Excellent
12 points
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
4. 4: Good
11.28 points
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
3. 3: Satisfactory
9.96 points
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
2. 2: Less Than Satisfactory
9 points
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
1. 1: Unsatisfactory
0 points
Sources are not documented.
Total 120 points