Description
Literature Review Assessment Description While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project. A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a review (750-1,000 words) that includes the following sections: Title page Introduction section A comparison of research questions A comparison of sample populations A comparison of the limitations of the study A conclusion section, incorporating recommendations for further research Note: I attached the PICOT Question Paper and Literature Evaluation Table needed to complete this assignment Prepare this assignment according to the guidelines found in the APA Style Guideplagiarism report (less than 10%)
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1
PICOT Question
Yosdania Hernandez
College of Nursing and Health Care Professions, Grand Canyon University
NRS-493-0500 Professional Capstone and Practicum
Instructor: Cynthia Morton
October 1, 2023.
2
PICOT Question
PICOT: Among geriatric patients in the hospital setting (P), would the implementation of
patient-centered interventions (I) be more effective compared to the current fall prevention
interventions (C) in reducing the incidence of falls (O) one month after implementation (T)?
PICOT Problem
The PICOT problem concerns falls among hospitalized geriatric patients. Hospital falls
occur more frequently than other adverse events. According to LeLaurin & Shorr (2019),
hospital falls cause about 250,000 injuries and up to 11,000 deaths annually in the United States.
Although any patient can fall, geriatric patients are the most affected. Fall risk is high among
elderly patients because they usually have balance, mobility, and strength problems (Agency for
Healthcare Research and Quality, 2019). Other factors, such as polypharmacy and underlying
illnesses and conditions, also exacerbate the risk of falls in geriatric patients. The PICOT
question focuses on geriatric patients because it is the population most vulnerable to falls.
Injurious falls are the most prevalent, accounting for approximately one-third of all falls
recorded during hospital stays (Agency for Healthcare Research and Quality, 2019). The most
common injuries caused by falls include fractures, head trauma, dislocations, cuts, and bruises.
In some instances, falls are fatal. Non-injurious falls, previous fall experience, and the fear of
falling can also emotionally distress patients and their families (Lavedán et al., 2018). The
combined effects of falling and the psychological distress associated with falls are critical
hindrances to quality of care, hospital stay comfort, and treatment outcomes.
The impact of falls on patients is not limited to physical and psychological problems.
Falls also cause severe financial strain to patients and their families due to prolonged hospital
stays. According to Dykes et al. (2020), dangerous hospital falls may lengthen hospital stay by
3
up to 12 days. Hospitals also suffer significant financial problems occasioned by falls. The
Centers for Medicare and Medicaid does not reimburse hospitals for treating injuries caused by
falls during the hospital stay (Agency for Healthcare Research and Quality, 2019). Therefore,
hospitals urgently need to minimize falls and avoid the financial pressures associated with the
problem.
Nursing Intervention
Most hospitals implement some form of intervention to prevent falls. The most common
fall prevention interventions include fall risk assessment, bedside or chair-mounted alarms, video
surveillance, patient sitters, and patient education. However, evidence of the success of most of
these interventions is limited (LeLaurin & Shorr, 2019). Besides, most fall prevention strategies
are labor-intensive and time-consuming, straining the limited resources at hospitals’ disposal.
Patient-centered interventions may be more effective than other approaches in preventing
falls falling (Dykes et al., 2020). The PICOT question examines the effectiveness of patientcentered interventions and strategies in reducing falls among geriatric patients. The patientcentered interventions stipulated in the PICOT questions concern shared decision-making and
active collaboration between caregivers and patients and their families in designing and
implementing fall prevention strategies personalized to each patient’s needs and health outcome
desires.
Between 2019 and 2021, my organization received a favorable score on patient falls and
injuries (Leapfrog Hospital Safety Grade, 2023). However, the hospital has witnessed increased
incidences of falls this year. The prevailing practice in the hospital entails general fall prevention
strategies not tailored to each geriatric patient. The proposed timeline for implementing the
patient-centered fall prevention interventions is one month. Since these interventions are less
4
complex and do not require significant adjustments to clinical procedures and processes, one
month is sufficient to implement the proposed interventions, monitor them, and collect data
about their efficiency.
Summary of the Clinical Problem and Patient Outcome
Falls are the most prevalent adverse events experienced by hospitalized patients. Geriatric
patients, usually aged 65 and above, are the most vulnerable to falls. Patient-centered
interventions prioritize collaboration and shared decision-making. Usually, patients and their
families have valuable perspectives, which can result in effective interventions when factored by
caregivers in care planning. Active involvement of patients and their families in fall prevention
decision-making will likely make them feel recognized and appreciated, motivating them to
cooperate with caregivers. Additionally, genuine collaboration with patients may make them
more conscious and appreciative of their risks of falling (Dykes et al., 2020). Patient-centered
measures emphasize patients’ cultural needs, leading to holistic fall prevention measures.
5
References
Agency for Healthcare Research & Quality. (2019, September). Falls. Patient Safety Network.
https://psnet.ahrq.gov/primer/falls
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), e2025889e2025889. Doi:10.1001/jamanetworkopen.2020.25889.
Lavedán, A., Viladrosa, M., Jürschik, P., Botigué, T., Nuín, C., Masot, O., & Lavedán, R. (2018).
Fear of falling in community-dwelling older adults: A cause of falls, a consequence, or
both? PLoS one, 13(3), e0194967. https://doi.org/10.1371/journal.pone.0194967
Leapfrog Hospital Safety Grade. (2023). CHI St. Luke’s Health Brazosport. Retrieved from:
https://www.hospitalsafetygrade.org/table-details/chi-st-lukes-health-brazosport
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
Literature Evaluation Table.
Student Name: Yosdania Hernandez
Change Topic (2-3 sentences): The proposed change entails implementing patient-centered
interventions to address falls among hospitalized geriatric patients. Risk assessment, tailored care
planning, and intervention implementation comprise the primary practices of the patient-centered
fall prevention intervention. Additionally, engaging patients during all the intervention phases is
crucial to the effectiveness of the intervention.
Criteria
Article 1
Article 2
Article 3
Author, Journal
(Peer-Reviewed),
and
Permalink or
Working Link to
Access Article
Article 4
Morris et al.
Heng et al.
Hoffman et al.
Young et al.
Age and Ageing BMC Geriatrics
Applied Nursing
International Journal
https://doi.org/10 https://doi.org/10.
Research
of Environmental
.1093/ageing/afa 1186/s12877- https://doi.org/10.1016/j Research and Public
c077
020-01515-w
.apnr.2019.03.006
Health
https://doi.org/10.339
0/ijerph19073873
Article Title and
Interventions to Hospital falls
Caregivers’ views of The Impact of Falls: A
Year Published
reduce falls in prevention with older adult fall risk and Qualitative Study of
hospitals: a patient education:
prevention during
the Experiences of
systematic A scoping review
hospital-to-home
People Receiving
review and meta2020
transitions
Haemodialysis
analysis
2019
2022
2022
Research Questions What are the
-What was the
The authors did not
The authors did not
(Qualitative)/
effects of fall
content of the
define research
define research
Hypothesis
prevention
patient education
questions.
questions.
(Quantitative)
interventions on
program?
fall outcomes for – What mode of
adults in hospital delivery was
settings?
used?
-Was the design
informed by
educational
principles or
evidence-based
behavior change
models?
-What were the
main outcomes?
Purposes/Aim of
To assess the
The study had
The study had three
To understand the
Study
impact of single three objectives:
objectives:
factors leading to
and
-to perform a -To provide an account falls, immediate and
multifactorial current search of
of caregivers’
long-term effects, and
interventions on
hospital fall
viewpoints on the risk
patients’ coping
© 2022. Grand Canyon University. All Rights Reserved.
the risk and rate
prevention
of falls and preventive mechanisms against
of hospital falls. interventions
measures for their
falls.
The other
concerning
recently hospitalized
objective was to patient education.
elderly clients.
classify the
-To analyze the
-To understand
robustness and design of patient caregivers’ viewpoints
quality of studies
education
on the fall prevention
reviewed by the
programs.
messages provided
authors.
-To appraise
during patient
approaches for
discharge.
quantifying
-To determine
changes in falls
caregivers’
and outcomes.
understanding and
perception of the CDC
fall prevention
brochures
Design (Type of
The researchers The study used a
The investigators
A qualitative study
Quantitative, or
utilized
scoping review
utilized a qualitative
based on the
Type of Qualitative)
Cochrane
design guided by research design based
constructivist
guidelines and the Arksey and
on face-to-face
grounded theory
principles from
O’Malley
interviews.
the Preferred
framework
Reporting Items principles, the
for Systematic Joanna Briggs
Reviews and Institute, and the
Meta-Analysis
Preferred
(PRISMA).
Reporting Items
for Systematic
Reviews and
Meta-analysis
Extension for
Scoping Reviews
(PRISMA-ScR).
Setting/Sample
45 studies for AMED, PubMed,
Participants were
Three hemodialysis
meta-analysis
CENTRAL,
recruited from a
centers in East
and 16 studies
PsychINFO,
community health
Midlands, United
for systematic CINAHL, ERIC, facility in Michigan.
Kingdom.
review. The
Trove, and
The sample size
The sample size is 25
research articles
ProQuest
comprised nine
participants.
were obtained databases. The
caregivers.
from Cochrane,
researchers
Medline,
reviewed a total
CINAHL,
of 43 articles.
PsycINFO,
Embase, AMED,
and PEDro
electronic
databases.
Methods:
The search
The study began
The researchers
Data collection
Intervention/
strategy entailed with a limited collected data through
involved semi-
Instruments
Analysis
Key Findings
key terms falling search to identify face-to-face interviews structured interviews
under falls,
keywords and
guided by a semiand reviewing diaries
hospital setting, index terms. The structured interview
solicited from
and study
researchers then
directive.
patients.
design. The
broadened their
primary
search to include
outcomes
the keywords,
reviewed
index terms, and
included a
medical subject
decline in the
headings
rate of falls and a
concerning
decrease in fall
hospital fall
risks. Data
prevention and
synthesis
patient education.
focused on the
rate ratio (RaR)
and the 95%
Confidence
Interval reported
in each article.
The Grading of The researchers Data analysis involved
The researchers
Recommendatio developed a data transcription verbatim analyzed the audions, Assessment, extraction chart to of the tape-recorded
recorded interviews
Development, locate the main interviews for accuracy through transcription
and Evaluations features in each
and the Glaser and
verbatim and
(GRADE)
article and
Strauss constant
anonymization using
instrument
essential patient
comparative
the NVivo Software.
analyzed
education
techniques.
The principles of the
evidence
information. An
constructivist
robustness
independent
grounded theory
concerning risk expert assessed
guided further data
and rate of falls the quality of
analysis.
for each
each patient
article. The
education
authors also used program. The
the Consensus researchers then
on Exercise
used thematic
Reporting
analysis to
(CERT)
summarize the
checklist to
studies.
analyze articles
with physical
exercise
interventions.
Meta-analysis of Most patient
The study found six
Most patients
the articles found
education
major themes:
attributed their falls to
little evidence programs focus -Caregivers received
balance problems,
that fall risk
on fall risks and
inadequate fall
weakness, dizziness,
assessment tools, prevention. Face- prevention resources
and environmental
bed and chair to-face sessions
hazards. The sudden
Recommendations
alarms, and
were the most
during patient
impacts of falls
sensors
used education
discharge.
included fear, distress,
effectively
delivery method. -Caregivers perceived
shock, and pain.
reduce falls.
However, most
their clients’ risk of
Prolonged
However, the
programs were falling in home settings
consequences
systematic
not based on
as low.
included cuts, bruises,
review found
specific
-Caregivers prioritized dislocations, muscle
that engaging
educational
their patients’ autonomy tearing, and fractures.
patients and
design or
when addressing their Most patients avoided
clinicians
theoretical
falling risks.
reporting about falls
through
principles. Most -Caregivers engaged because their previous
education
education
their clients in
reports were treated
reduces falls programs scored
discussing fall
with little interest or
significantly.
low on
avoidance strategies. because hospital staff
Multifactorial quality. Nonethel -Caregivers perceived
rarely asked them
interventions and
ess, fall
the risks of their homeabout their fall
physiotherapyprevention
based clients falling as a history. The main
focused
education
family affair.
coping mechanism
techniques
delivered to
-Caregivers were
was to avoid
reduced falls
hospitalized
positive about the CDC perceived risky tasks
moderately. patients produced educational brochures and be more careful
positive benefits
on fall prevention.
when performing
on hospital falls.
risky but unavoidable
activities.
The authors did
Instead of
The researchers
The study
not provide any
providing
recommend that
recommends that for
recommendation recommendations clinicians assess older
health facilities to
s. They
, the authors
patients and their
prevent falls
concluded that listed the main caregivers adequately effectively, clinicians
the most
themes unearthed during discharge about should be proactive in
impactful fall
by the review:
fall prevention. This asking patients about
prevention
-Fall prevention
approach promotes
their history and
approaches were education should adopting evidence- experiences with falls.
multifactorial consider specific based fall prevention Healthcare workers
interventions and risk factors and strategies when patients should also perform
patient and
environmental
transition to homecomprehensive
caregiver
context.
based care.
evaluations and
education about
-Combining
carefully discuss fall
falls.
education
risk and mitigation
delivery modes
measures with
may be more
patients.
effective than
relying on one
method.
-The most
effective fall
prevention
education
programs
incorporate health
behavior change
theories and
educational
principles.
– Education
programs
enhanced by
active learning
designs may more
effectively
engage patients.
Explanation of How The research Patient education The study outcomes are The participants in
the Article Supports established the is one of the vital crucial to this EBP this study experienced
EBP/Capstone
significance of aspects of patientproject because
falls at home or in
Project
educating
centered
interventions employed
hospitals. Key
patients to interventions. The in the hospital can apply findings such as
reduce falls. This study’s findings
at home, too, if
patient’s coping
outcome
about patient caregivers and patients
mechanisms,
supports the education quality,
receive adequate
perception of causes
capstone change delivery, content, education about falls
of falls, and their
project because
and design
during patient
views on healthcare
patient
provide crucial discharge. Besides, falls workers’ attitudes
engagement is insights to help
post-discharge
about falls could
one of the
design patient contribute significantly
provide valuable
critical aspects education during to hospital readmission original insights to
of patientthe change
among older adults.
help design
centered
project.
interventions
interventions
informed by patients’
stipulated in the
viewpoints.
PICOT
question.
Criteria
Article 5
Article 6
Article 7
Article 8
Author,
Toye et al.
Dykes et al.
Kiyoshi-Teo et al.
Christiansen et al.
Journal
Clinical
JAMA Network
Geriatric Nursing
The Joint
(PeerInterventions in https://jamanetwork.com/jou https://doi.org/10.1016 Commission Journal
Reviewed),
Aging
rnals/jamanetworkopen/articl /j.gerinurse.2018.11.0
on Quality and
and
https://doi.org/10.
e-abstract/2773051
05
Patient Safet
Permalink 2147/CIA.S21142
https://doi.org/10.10
or Working
4
16/j.jcjq.2019.11.01
Link to
0
Access
Article
Article Title Bed Moves, Ward Evaluation of a PatientOlder hospital
Patient Activation
and Year
Environment,
Centered Fall-Prevention
inpatients’ fall risk
Related to Fall
Published Staff Perspectives Tool Kit to Reduce Falls and factors, perceptions,
Prevention: A
and Falls for
Injuries: A Nonrandomized and daily activities to Multisite Study
Older People with
Controlled Trial
prevent falling
2020
High Falls Risk in
2020
2018
an Acute
Hospital: A
Mixed Methods
Study
2019
Research
Research
Questions
questions or
(Qualitative hypotheses are
)/Hypothesis not defined.
(Quantitativ
e)
Purposes/
Aim of
Study
Research questions not
defined.
Hypothesis 1: Patients
Hypothesis:
who have fall risk Patients exposed to
factors will be more
the Fall TIPS
likely to attribute a
program will be
higher level of
more engaged in the
importance to fall
three-step fall
prevention (Level of prevention process
Importance), have and score higher on
higher Fall Efficacy
the Patient
Scale International- Activation Measure
Short (FES-I) score,
than patients not
have increased Fall exposed to the Fall
Behavioral Scale
TIPS initiative
(FaB) scale score,
report a lower level of
confidence to prevent
a fall (Level of
Confidence), and have
lower Patient
Activation Measure
(PAM) score
compared to patients
without these risk
factors.
Hypothesis 2: Each
fall prevention
perception measure
(Level of Importance,
FES-I, and PAM)—
except for the Level of
Confidence—will
positively correlate
with FaB.
The study sought
To assess if there is a
To recognize the
To establish if the
to investigate:
relationship between a
perception and daily Fall TIPS program
-The relationship,
patient-centered fall
activities of
affects patient
frequency, and prevention instrument that hospitalized adults to
activation
effects between
engages patients in care
inform effective
concerning fall
falls and bed
planning with reduced falls strategies for engaging
prevention.
moves.
and injurious fall incidents. them concerning fall
-The role of ward
prevention during their
environment,
hospital stay.
personcenteredness, and
interdisciplinary
collaboration in
preventing falls.
-The perception
of patients about
hospital transfers.
-The perception
of staff about fall
prevention
strategies and bed
moves.
Design
The researchers A nonrandomized controlled The study utilized a The researchers used
(Type of
utilized a cohort
trial
correlation research a survey research
Quantitative
design.
design.
design to study the
, or Type of
subject matter.
Qualitative)
Setting/
Sample
The study
The study occurred in 14 The research occurred The study occurred
occurred in a 600- adult medical units in 3
at three surgical- across three
bed tertiary
Boston, Bronx, and New
medical units in an healthcare systems
teaching hospital York City medical centers.
Oregon Veterans involving Boston,
in Perth,
The sample size for the Health Administration Bronx, and New
Australia.
study was 37,231 adult
hospital. The sample York City hospital
The initial patient
patients.
size was 67 patients. medical units. The
sample size
sample size was 343
included 486
patients.
admissions, while
the staff sample
size was 21
participants.
Methods:
Patient data were The study implemented a The researchers used
The research
Intervention obtained by
Fall TIPS EHR-integrated the Fall Efficacy Scale
involved
/Instrument tracking medical instrument after identifying International Short
implementing the
s
records and
patient-specific fall risk
(FESI-S) to measure Fall TIPS program
interviewing the factors using the Morse Fall the fear of falling and in select medical
patients. The Scale. Nurses could provide the Patient Activation
units. The
researchers
more patient-centered
Measure (PAM to researchers used the
performed an interventions based on how
assess patient
Patient Activation
environmental
well they knew a patient.
activation and the
Measure-13 to
audit to analyze The researchers trained and
capacity to make
evaluate patients’
the ward
educated unit nurses and independent decisions
knowledge,
environment. Last nurse leaders about the
about their health.
confidence, and
ly, data collection
toolkit.
Additionally, the study skills regarding their
among staff
used the modified
fall prevention
involved surveys,
Falls Behavioral
plans. Other data
interviews, and
Scale-Inpatient (FaB- collected included
focus groups.
I) to measure the
self-reported
patients’ daily fall
demographic
prevention activities
information.
and the AHRQ High
Fall Risk Medication
Analysis
Key
Findings
Score to assess fall
risk related to
medication.
The researchers
The researchers used
The study utilized R
Data analysis
analyzed
Poisson regression to
software for
entailed comparing
quantitative data understand the association quantitative analysis
patients’
using logistic between the independent and
and descriptive
demographic
regression models
dependent variables.
statistics for
characteristics and
and descriptive
descriptive analysis.
the primary
statistics. The
outcomes of the
analysis of
PAM-13 scale
qualitative data
before and after
entailed
implementing the
transcription and
Fall TIPS program.
thematic
The researchers used
analysis.
Fisher’s exact test
and t-test to analyze
categorical and
continuous
variables.
Bed moves
Falls after implementing the There was a strong
There was a
increased the risk intervention reduced from relationship between a
significant
of falls by 56%. 2.92 to 2.49 per 1000 bed history of severe falls improvement in the
Bathrooms,
days. The researchers found and the confidence to PAM scores after
toilets, lighting,
that injurious falls after
prevent falls. Patients implementing the
and security
implementing the tool kit
with a recent
Fall TIPS program.
installations
declined from 0.73 to 0.48 experience of falling
The mean score
emerged as the
per 1000 bed days. In the
were more likely to before implementing
most significant post-intervention period, utilize fall prevention the intervention was
environmental
older adults (65 years and
interventions. The
63.82, while the
hazards
above) achieved a reduction level of engagement mean score after the
exacerbating the in injurious falls by 48%
reported by patients
intervention was
risk of falls.
compared to younger adults between them and
80.88. All the
Communication (below 65) at 19%. Overall, healthcare staff was a
medical units
between staff,
the patient-centered
moderate 64.3.
registered
patients, and their intervention reduced falls Talking to someone
improvements in
family members
and non-injurious falls
about fall prevention patient activation
was a critical
significantly.
was the least activity post-intervention.
success
undertaken by
Overall, patients
determinant in
patients. There was a
exposed to the
preventing
strong association
intervention
falls. Staff also
between patient
achieved higher
reported that time
activation and concern PAM scores than
constraints and
about falling, fall patients not exposed
ineffective
prevention
to the program.
communication
intervention
during shift
perceptions, and the
changeovers
regularity of daily
increased the risk
activities. There was
also a strong
of falls when
moving patients.
relationship between
concern for falling and
the importance of fall
prevention.
Recommend The study
The researchers recommend Clinicians should
The study
ations
recommends that
that hospital-based fall
capture data about
recognized that
acute care
prevention interventions
patients’ fear of
health literacy, the
hospitals
actively engage patients and falling, activation,
digital divide, and
minimize bed
their families to minimize
ability, and
the participation of
moves for at-risk the risks and rates of falls willingness to make family members can
patients.
among at-risk patients.
independent decisions significantly affect
However, if bed
about their health and how patients interact
moves are
daily fall prevention with specific fall
necessary,
activities to enhance
prevention
clinicians should
existing hospital-based
programs.
prioritize moving
fall prevention
Subsequently, the
low-risk patients
interventions.
study recommends
to minimize the
hospitals implement
chances of falls
fall prevention
among high-risk
programs accessible
patients.
to all.
Explanation The research The study entailed deploying The most important
One of the
of How the
found that
a patient-centered fallaspect of this study
objectives of the
Article
communication
prevention tool kit. The
concerning the EBP capstone project is
Supports
between nurses, results indicated a significant project is the capturing to empower patients
EBP/
patients, and their decrease in falls among older of patient perspectives. to have an active
Capstone families enhanced adults (65 years and above). For example, most
voice in fall
the success of fall The intervention deployed in patients reported
prevention. This
risk assessment the study and the research
rarely talking to
article supports the
and care
findings are crucial to the
someone about fall above objective by
planning. This
capstone change project
prevention. These
establishing that
result aligns with because the initiative focuses
unique patient
patient-centered
the change
on patient-centered
perspectives will be interventions make
project because interventions and geriatric valuable in informing patients feel more
patient
patients. The research
how to implement
engaged and
engagement is
findings and
patient-centered
confident in
critical to the fall
recommendations will
interventions.
preventing falls. The
prevention
provide valuable insights on
other objective of
approaches
implementing the proposed
the capstone project
stipulated in the
intervention.
is to enhance health
PICOT question.
equity for geriatric
patients. This study
supports the health
equity objective by
recommending
hospitals implement
fall prevention
programs accessible
to all patients.
Literature Evaluation Table.
Student Name: Y
Change Topic (2-3 sentences): The proposed change entails implementing patient-centered
interventions to address falls among hospitalized geriatric patients. Risk assessment, tailored care
planning, and intervention implementation comprise the primary practices of the patient-centered
fall prevention intervention. Additionally, engaging patients during all the intervention phases is
crucial to the effectiveness of the intervention.
Criteria
Article 1
Article 2
Article 3
Author, Journal
(Peer-Reviewed),
and
Permalink or
Working Link to
Access Article
Article 4
Morris et al.
Heng et al.
Hoffman et al.
Young et al.
Age and Ageing BMC Geriatrics
Applied Nursing
International Journal
https://doi.org/10 https://doi.org/10.
Research
of Environmental
.1093/ageing/afa 1186/s12877- https://doi.org/10.1016/j Research and Public
c077
020-01515-w
.apnr.2019.03.006
Health
https://doi.org/10.339
0/ijerph19073873
Article Title and
Interventions to Hospital falls
Caregivers’ views of The Impact of Falls: A
Year Published
reduce falls in prevention with older adult fall risk and Qualitative Study of
hospitals: a patient education:
prevention during
the Experiences of
systematic A scoping review
hospital-to-home
People Receiving
review and meta2020
transitions
Haemodialysis
analysis
2019
2022
2022
Research Questions What are the
-What was the
The authors did not
The authors did not
(Qualitative)/
effects of fall
content of the
define research
define research
Hypothesis
prevention
patient education
questions.
questions.
(Quantitative)
interventions on
program?
fall outcomes for – What mode of
adults in hospital delivery was
settings?
used?
-Was the design
informed by
educational
principles or
evidence-based
behavior change
models?
-What were the
main outcomes?
Purposes/Aim of
To assess the
The study had
The study had three
To understand the
Study
impact of single three objectives:
objectives:
factors leading to
and
-to perform a -To provide an account falls, immediate and
multifactorial current search of
of caregivers’
long-term effects, and
interventions on
hospital fall
viewpoints on the risk
patients’ coping
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the risk and rate
prevention
of falls and preventive mechanisms against
of hospital falls. interventions
measures for their
falls.
The other
concerning
recently hospitalized
objective was to patient education.
elderly clients.
classify the
-To analyze the
-To understand
robustness and design of patient caregivers’ viewpoints
quality of studies
education
on the fall prevention
reviewed by the
programs.
messages provided
authors.
-To appraise
during patient
approaches for
discharge.
quantifying
-To determine
changes in falls
caregivers’
and outcomes.
understanding and
perception of the CDC
fall prevention
brochures
Design (Type of
The researchers The study used a
The investigators
A qualitative study
Quantitative, or
utilized
scoping review
utilized a qualitative
based on the
Type of Qualitative)
Cochrane
design guided by research design based
constructivist
guidelines and the Arksey and
on face-to-face
grounded theory
principles from
O’Malley
interviews.
the Preferred
framework
Reporting Items principles, the
for Systematic Joanna Briggs
Reviews and Institute, and the
Meta-Analysis
Preferred
(PRISMA).
Reporting Items
for Systematic
Reviews and
Meta-analysis
Extension for
Scoping Reviews
(PRISMA-ScR).
Setting/Sample
45 studies for AMED, PubMed,
Participants were
Three hemodialysis
meta-analysis
CENTRAL,
recruited from a
centers in East
and 16 studies
PsychINFO,
community health
Midlands, United
for systematic CINAHL, ERIC, facility in Michigan.
Kingdom.
review. The
Trove, and
The sample size
The sample size is 25
research articles
ProQuest
comprised nine
participants.
were obtained databases. The
caregivers.
from Cochrane,
researchers
Medline,
reviewed a total
CINAHL,
of 43 articles.
PsycINFO,
Embase, AMED,
and PEDro
electronic
databases.
Methods:
The search
The study began
The researchers
Data collection
Intervention/
strategy entailed with a limited collected data through
involved semi-
Instruments
Analysis
Key Findings
key terms falling search to identify face-to-face interviews structured interviews
under falls,
keywords and
guided by a semiand reviewing diaries
hospital setting, index terms. The structured interview
solicited from
and study
researchers then
directive.
patients.
design. The
broadened their
primary
search to include
outcomes
the keywords,
reviewed
index terms, and
included a
medical subject
decline in the
headings
rate of falls and a
concerning
decrease in fall
hospital fall
risks. Data
prevention and
synthesis
patient education.
focused on the
rate ratio (RaR)
and the 95%
Confidence
Interval reported
in each article.
The Grading of The researchers Data analysis involved
The researchers
Recommendatio developed a data transcription verbatim analyzed the audions, Assessment, extraction chart to of the tape-recorded
recorded interviews
Development, locate the main interviews for accuracy through transcription
and Evaluations features in each
and the Glaser and
verbatim and
(GRADE)
article and
Strauss constant
anonymization using
instrument
essential patient
comparative
the NVivo Software.
analyzed
education
techniques.
The principles of the
evidence
information. An
constructivist
robustness
independent
grounded theory
concerning risk expert assessed
guided further data
and rate of falls the quality of
analysis.
for each
each patient
article. The
education
authors also used program. The
the Consensus researchers then
on Exercise
used thematic
Reporting
analysis to
(CERT)
summarize the
checklist to
studies.
analyze articles
with physical
exercise
interventions.
Meta-analysis of Most patient
The study found six
Most patients
the articles found
education
major themes:
attributed their falls to
little eviden
