Evidence-based Project Critical Appraisal Part 3

Evidence-based Project Critical Appraisal Part 3

Patient falls are adverse events that pose significant safety concerns by leading to prolonged hospitalization, increased care costs, deaths, and preventable patient harm. According to Jähne-Raden et al. (2019), individual factors like gait and balance disorders, vigilance disorders, neurodegenerative conditions, such as dementia and Parkinson’s disease, and disorientation are primary risk factors for in-patient falls, especially in geriatric care settings. Equally, organizational issues, including the presence of slip hazards, a poorly-organized hospital environment, ineffective and deficient risk assessment practices, and a lack of patient monitoring activities can exacerbate incidences of patient falls. Since healthcare professionals have an ethical and professional obligation to ensure patient safety and avert harm, they should embrace evidence-based strategies for preventing patient falls. The current scholarly research identifies various organizational-level and nurse-led strategies for preventing in-patient and out-patient falls. As a result, this paper is a critical appraisal of four articles that provide justifiable and proven interventions for fall prevention in different clinical contexts.

A Critical Appraisal of the Selected Scholarly Articles

Critically appraising evidence is a profound step of evidence-based practice (EPB). The primary objective of appraising evidence is to ascertain its relevance, consistency, and validity consistent with foreground (PICOT) questions. The clinical question selected in the previous assessment entails exploring the duty of each geriatric nurse in implementing fall prevention techniques to reduce the number of patients falls. As a result, the identification of ideal evidence sources revolved around advanced and proven interventions for preventing falls. Upon leveraging keywords and subtitles to select scholarly articles, this search technique yielded four scientific studies; King et al. (2018), Radecki et al. (2018), Thomas et al. (2018), and Jähne-Raden et al. (2018). Each article provides insights into evidence-based strategies for preventing patient falls. They are current, peer-reviewed, and relevant to the foreground question. Finally, their findings are generalizable and transferable to different clinical contexts.

Best Practice that Emerges from the Reviewed Research

The reviewed research provides insights into different approaches for preventing patient falls. In a qualitative study, Radecki et al. (2018) describe the patient’s perspective on fall prevention in an acute care setting. According to the researchers, patient fall assessments are vital in identifying risk factors for falls. Nurses should develop meaningful relationships with patients during assessments and understand their priorities. Further, this study recommends the creation of patient-centered programs for assessing falls to reduce over-reliance on bed alarms. Other strategies identified in the study include maintaining safety precautions and alarms that notify clinicians about patients’ movement.

Thomas et al. (2019) conducted a literature review to identify physical activity programs effective in increasing balance in the elderly. According to the researchers, resistance and anaerobic exercise, balance training, T-bow and wobble board training, and stability ball are ideal physical therapies for enhancing stability and mobility for the elderly. Other physical approaches for improving physical fitness are a Wii Fit training program encompassing yoga, downhill skiing, heading soccer, and game balls.

In a qualitative study, King et al. (2018) explore nurses’ experiences with fall prevention in a hospital setting. According to the researchers, patient falls have multifactorial etiology, including gait instability, fall history, environmental hazards, and staffing ratios. After reviewing responses from 27 RNs and CNAs, King et al. (2018) identified intense messaging from hospital administration, restricting patients’ movement, and maintaining patients’ physical strength and mobility as profound interventions for preventing patient falls. The study recommends a contingency plan that incorporates all these interventions.

Finally, Jähne-Raden et al. (2019) focus on a highly specialized solution for fall prevention and detection. This article explores the application of technology in preventing and detecting falls. The INBED system is a modular prototype consisting of wearable devices for detecting rising events, restlessness, fall, and high-risk areas. This system sends signals to nursing staff and seeks to eliminate the over-reliance on belt systems or bed rails that limit the patient’s freedom of movement. This study recommends more research on the applicability of the INBED system to confirm its applicability in different clinical contexts.

Conclusion

Critical appraisal of evidence sources is a fundamental step for evidence-based practice because it allows researchers to understand the evidence’s relevance, consistency, validity, and usability. In this paper, the selected articles provide information regarding the best practices for preventing patient falls. These interventions include alarm systems, risk assessments, improving patients’ physical fitness and strength, and incorporating technological systems, such as the INBED system to alert clinicians of the imminent falls or restlessness events.

 

References

Jähne-Raden, N., Kulau, U., Marschollek, M., & Wolf, K. H. (2019). INBED: A highly specialized system for bed-exit detection and fall prevention on a geriatric ward. Sensors, 19(5), 1017. https://doi.org/10.3390/s19051017

King, B., Pecanac, K., Krupp, A., Liebzeit, D., & Mahoney, J. (2018). Impact of fall prevention on nurses and care of fall risk patients. The Gerontologist, 58(2), 331–340. https://doi.org/10.1093/geront/gnw156

Radecki, B., Reynolds, S., & Kara, A. (2018). Inpatient fall prevention from the patient’s perspective: A qualitative study. Applied nursing research: ANR, 43, 114–119. https://doi.org/10.1016/j.apnr.2018.08.001

Thomas, E., Battaglia, G., Patti, A., Brusa, J., Leonardi, V., Palma, A., & Bellafiore, M. (2019). Physical activity programs for balance and fall prevention in elderly: A systematic review. Medicine, 98(27), e16218. https://doi.org/10.1097/MD.0000000000016218

 

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NURS-6052N-12 (11/28/2022-02/12/2023)-PT27
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Module 4: Assignment
Winter 2022(11/28/2022-02/12/2023)-PT27.202330.27

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Module 4: Assignment
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Due Sunday by 10:59pm Points 100 Submitting a text entry box or a file upload Attempts 0 Allowed Attempts 2
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EVIDENCE-BASED PROJECT, PART 3: CRITICAL APPRAISAL OF RESEARCH
Realtors rely on detailed property appraisals—conducted using appraisal tools—to assign market values to houses and other properties. These values are then presented to buyers and sellers to set prices and initiate offers.

Research appraisal is not that different. The critical appraisal process utilizes formal appraisal tools to assess the results of research to determine value to the context at hand. Evidence-based practitioners often present these findings to make the case for specific courses of action.

In this Assignment, you will use an appraisal tool to conduct a critical appraisal of published research. You will then present the results of your efforts.

RESOURCES

 

Be sure to review the Learning Resources before completing this activity.

Click the weekly resources link to access the resources.

WEEKLY RESOURCES

To Prepare:

Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
The Assignment (Evidence-Based Project)

Part 3A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 3B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

BY DAY 7 OF WEEK 7
Submit Part 3A and 3B of your Evidence-Based Project.

SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.

To submit your completed assignment, save your Assignment as MD4Assgn+last name+first initial.
Then, click on Start Assignment near the top of the page.
Next, click on Upload File and select Submit Assignment for review.

 

Rubric

 

NURS_6052_Module04_Week07_Assignment_Rubric

NURS_6052_Module04_Week07_Assignment_Rubric

CriteriaRatingsPtsThis criterion is linked to a Learning Outcome

Part 3A: Critical Appraisal of ResearchCritical Appraisal of Research Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tool Worksheet Template. Be sure to include: · An Evaluation Table45 to >40.0 pts

Excellent

The critical appraisal accurately and clearly provides a detailed evaluation table. …The responses provide a detailed, specific, and accurate evaluation of each of the peer-reviewed articles selected.

40 to >35.0 pts

Good

The critical appraisal accurately provides an evaluation table. …The responses provide an accurate evaluation of each of the peer-reviewed articles selected with some specificity.

35 to >31.0 pts

Fair

The critical appraisal provides an evaluation table that is inaccurate or vague. …The responses provide an inaccurate or vague evaluation of each of the peer-reviewed articles selected.

31 to >0 pts

Poor

The critical appraisal provides an evaluation table that is inaccurate and vague or is missing.

45 pts

This criterion is linked to a Learning Outcome

Part 3B: Evidence-Based Best PracticesEvidence-Based Best Practices Based on your appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with the selected resources.35 to >31.0 pts

Excellent

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The responses accurately and clearly suggest a detailed best practice that is fully aligned to the research reviewed. …The responses accurately and clearly explain in detail the best practice, with sufficient justification of why this represents a best practice in the field. …The responses provide a complete, detailed, and specific synthesis of the four peer reviewed articles.

31 to >27.0 pts

Good

The responses accurately suggest a best practice that is adequately aligned to the research reviewed. …The responses accurately explain the best practice, with adequately justification of why this represents a best practice in the field. …The responses provide an accurate synthesis of at least one outside resource reviewed on the best practice explained.

27 to >24.0 pts

Fair

The responses inaccurately or vaguely suggest a best practice that may be aligned to the research reviewed. …The responses inaccurately or vaguely explain the best practice, with inaccurate or vague justification for why this represents a best practice in the field. …The responses provide a vague or inaccurate synthesis of outside resources reviewed on the best practice explained.

24 to >0 pts

Poor

The responses inaccurately and vaguely suggest a best practice that may be aligned to the research reviewed or are missing. …The responses inaccurately and vaguely explain the best practice, with inaccurate and vague justification for why this represents a best practice in the field or are missing. …A vague and inaccurate synthesis of no outside resources reviewed on the best practice explained is provided or is missing.

35 pts

This criterion is linked to a Learning Outcome

Resource Synthesis5 to >4.0 pts

Excellent

The response fully integrates at least two outside resources and two or three course-specific resources that fully support the responses provided.

4 to >3.0 pts

Good

The response integrates at least one outside resource and two or three course-specific resources that may support the responses provided.

3 to >2.0 pts

Fair

The response minimally integrates resources that may support the responses provided.

2 to >0 pts

Poor

The response fails to integrate any resources to support the responses provided.

5 pts

This criterion is linked to a Learning Outcome

Written Expression and Formatting—Paragraph Development and Organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided, which delineates all required criteria.5 to >4.0 pts

Excellent

Paragraphs and sentences follow writing standards for flow, continuity, and clarity. …A clear and comprehensive purpose statement, introduction, and conclusion are provided, which delineates all required criteria.

4 to >3.0 pts

Good

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. …Purpose, introduction, and conclusion of the assignment are stated but are brief and not descriptive.

3 to >2.0 pts

Fair

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. …Purpose, introduction, and conclusion of the assignment is vague or off topic.

2 to >0 pts

Poor

Paragraphs and sentences follow writing standards for flow, continuity, and clarity less than 60% of the time. …No purpose statement, introduction, or conclusion is provided.

5 pts

This criterion is linked to a Learning Outcome

Written Expression and Formatting—English Writing Standards: Correct grammar, mechanics, and proper punctuation.5 to >4.0 pts

Excellent

Uses correct grammar, spelling, and punctuation with no errors.

4 to >3.0 pts

Good

Contains a few (one or two) grammar, spelling, and punctuation errors.

3 to >2.0 pts

Fair

Contains several (three or four) grammar, spelling, and punctuation errors.

2 to >0 pts

Poor

Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

5 pts

This criterion is linked to a Learning Outcome

Written Expression and Formatting:The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running head, parenthetical/in-text citations, and reference list.5 to >4.0 pts

Excellent

Uses correct APA format with no errors.

4 to >3.0 pts

Good

Contains a few (one or two) APA format errors.

3 to >2.0 pts

Fair

Contains several (three or four) APA format errors.

2 to >0 pts

Poor

Contains many (five or more) APA format errors.

5 pts

Total Points: 100

 

 

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Attached below are the sources used for modules 3

•Wong, C. (2011). The Cost of Serious Fall-Related Injuries at Three Midwestern Hospitals. The Joint Commission Journal on Quality and Patient Safety, 37(2); 32-34

 

 

•Hempel, S. Newberry, P., & Wang, Z. (2013). Hospital Fall Prevention: A Systematic Review of Implementation, Components, Adherence, and Effectiveness. Journal of American Geriatric Society. 61(4): 483–494.

 

 

•Headily, F. (2008). Falls in English and Welsh hospitals: a national observational study based on retrospective analysis of 12 months of patient safety incident reports. Quality & Safety In Health Care, 17(6):424-430

 

 

•Jähne-Raden, N., Kulau, U., Marschollek, M., & Wolf, K. H. (2019). INBED: a highly specialized system for bed-exit-detection and fall prevention on a geriatric ward. Sensors, 19(5), 1017. https://doi.org/10.3390/s19051017

 

 

 

Module 2 Articles

King, B., Pecanac, K., Krupp, A., Liebzeit, D., & Mahoney, J. (2018). Impact of Fall Prevention on Nurses and Care of Fall Risk Patients. The Gerontologist, 58(2), 331–340. https://doi.org/10.1093/geront/gnw156

 

 

Radecki, B., Reynolds, S., & Kara, A. (2018). Inpatient fall prevention from the patient’s perspective: A qualitative study. Applied nursing research: ANR, 43, 114–119. https://doi.org/10.1016/j.apnr.2018.08.001

 

Dykes, P. C., Carroll, D. L., Hurley, A., Lipsitz, S., Benoit, A., Chang, F., Meltzer, S., Tsurikova, R., Zuyov, L., & Middleton, B. (2010). Fall prevention in acute care hospitals: a randomized trial. JAMA, 304(17), 1912–1918. https://doi.org/10.1001/jama.2010.1567

 

Thomas, E., Battaglia, G., Patti, A., Brusa, J., Leonardi, V., Palma, A., & Bellafiore, M. (2019). Physical activity programs for balance and fall prevention in elderly: A systematic review. Medicine, 98(27), e16218. https://doi.org/10.1097/MD.0000000000016218

Rubric Detail

 

Select Grid View or List View to change the rubric’s layout.

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Name: NURS_4220_Week5_Assignment_Rubric

Grid View

List View

Excellent              Proficient            Basic      Needs Improvement

Required Content

Provided a detailed explanation of the evidence-based practice quality improvement plan used to address the practice problem.

50 (33.33%) – 60 (40%)

Provided a fully developed evidence-based practice performance improvement plan with insightful analysis of concepts and related issues.

40 (26.67%) – 49 (32.67%)

Provided a developed evidence-based practice performance improvement plan with reasonable analysis of concepts and related issues.

30 (20%) – 39 (26%)

Provided a minimally developed evidence-based practice performance improvement plan with limited analysis of concepts and related issues.

0 (0%) – 29 (19.33%)

Provided an under-developed evidence-based practice performance improvement plan with little or no analysis of concepts and related issues.

Required Content

Described resources that will be needed to support the change in practice and explained why each resource is necessary.

36 (24%) – 40 (26.67%)

Provided a fully developed explanation of resources used to support the plan and why each resource is needed with insightful analysis of concepts and related issues.

32 (21.33%) – 35 (23.33%)

Provided a developed explanation of resources used to support the plan and why each resource is needed with reasonable analysis of concepts and related issues.

28 (18.67%) – 31 (20.67%)

Provided a minimally developed explanation of resources used to support the plan and why each resource is needed with limited analysis of concepts and related issues.

0 (0%) – 27 (18%)

Provided an under-developed explanation of resources used to support the plan and why each resource is needed with little or no analysis of concepts and related issues.

Required Content

Provided a comprehensive concluding summary with no new additional information included.

15 (10%) – 20 (13.33%)

Provided a fully developed summary with insightful analysis of concepts and related issues.

11 (7.33%) – 14 (9.33%)

Provided a developed summary with reasonable analysis of concepts and related issues.

6 (4%) – 10 (6.67%)

Provided a minimally developed summary with limited analysis of concepts and related issues.

0 (0%) – 5 (3.33%)

Provided an under-developed summary with little or no analysis of concepts and related issues.

Professional Writing: Clarity, Flow, and Organization

9 (6%) – 10 (6.67%)

Content is free from spelling, punctuation, and grammar/syntax errors. Writing demonstrates very well-formed sentence and paragraph structure. Content presented is completely clear, logical, and well-organized.

8 (5.33%) – 8 (5.33%)

Content contains minor spelling, punctuation, and/or grammar/syntax errors. Writing demonstrates appropriate sentence and paragraph structure. Content presented is mostly clear, logical, and well-organized.

7 (4.67%) – 7 (4.67%)

Content contains moderate spelling, punctuation, and/or grammar/syntax errors. Writing demonstrates adequate sentence and paragraph structure and may require some editing. Content presented is adequately clear, logical, and/or organized, but could benefit from additional editing/revision.

0 (0%) – 6 (4%)

Content contains significant spelling, punctuation, and/or grammar/syntax errors. Writing does not demonstrate adequate sentence and paragraph structure and requires additional editing/proofreading. Key sections of presented content lack clarity, logical flow, and/or organization.

Professional Writing: Context, Audience, Purpose, and Tone

9 (6%) – 10 (6.67%)

Content clearly demonstrates awareness of context, audience, and purpose. Tone is highly professional, scholarly, and free from bias, and style is appropriate for the professional setting/workplace context.

8 (5.33%) – 8 (5.33%)

Content demonstrates satisfactory awareness of context, audience, and purpose. Tone is adequately professional, scholarly, and/or free from bias, and style is consistent with the professional setting/workplace context.

7 (4.67%) – 7 (4.67%)

Content demonstrates basic awareness of context, audience, and purpose. Tone is somewhat professional, scholarly, and/or free from bias, and style is mostly consistent with the professional setting/workplace context.

0 (0%) – 6 (4%)

Content minimally or does not demonstrate awareness of context, audience, and/or purpose. Writing is not reflective of professional/scholarly tone and/or is not free of bias. Style is inconsistent with the professional setting/workplace context and reflects the need for additional editing.

Professional Writing: Originality, Source Credibility, and Attribution of Ideas

9 (6%) – 10 (6.67%)

Content reflects original thought and writing and proper paraphrasing. Writing demonstrates full adherence to reference requirements, including the use of credible evidence to support a claim, with appropriate source attribution (when applicable) and references.

8 (5.33%) – 8 (5.33%)

Content adequately reflects original writing and paraphrasing. Writing demonstrates adequate adherence to reference requirements, including the use of credible evidence to support a claim, with appropriate source attribution (when applicable) and references.

7 (4.67%) – 7 (4.67%)

Content somewhat reflects original writing and paraphrasing. Writing somewhat demonstrates adherence to reference requirements, including the use of credible evidence to support a claim, with appropriate source attribution (when applicable) and references.

0 (0%) – 6 (4%)

Content does not adequately reflect original writing and/or paraphrasing. Writing demonstrates inconsistent adherence to reference requirements, including the use of credible evidence to support a claim, with appropriate source attribution (when applicable) and reference.

Total Points: 150

Name: NURS_4220_Week5_Assignment_Rubric