NUR 699 EBP Section C: Literature Support Example Essay
NUR 699 GC Week 3 Section C Literature Support
Evidence-Based Practice Proposal – Section C: Literature Support
Details:
To begin, work through the reference list that was created in the “Section B: Problem Description” assignment in Topic 2. Appraise each resource using the “Rapid Critical Appraisal Checklists,” available in the textbook appendix. The specific checklist you use will be determined by the type of evidence within the resource.
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Develop a research table to organize and summarize the research studies. Using a summary table allows you to be more concise in your narrative description. Only research studies used to support your intervention are summarized in this table. Refer to the “Evaluation Table Template,” available in the textbook appendix. Use the “Evaluation Table Template” as an adaptable template. NUR 699 EBP Section C: Literature Support Example Essay.
Write a narrative of 750-1,000 words (not including the title page and references) that presents the research support for the projects problem and proposed solution. Make sure to do the following:
- Include a description of the search method (e.g., databases, keywords, criteria for inclusion and exclusion, and number of studies that fit your criteria).
- Summarize all of the research studies used as evidence. The essential components of each study need to be described so that readers can evaluate its scientific merit, including study strengths and limitations.
- Incorporate a description of the validity of the internal and external research.
It is essential to make sure that the research support for the proposed solution is sufficient, compelling, relevant, and from peer-reviewed professional journal articles.
Although you will not be submitting the checklist information or the evaluation table you design in Topic 3 with the narrative, the checklist information and evaluation table should be placed in the appendices for the final paper. NUR 699 EBP Section C: Literature Support Example Essay.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
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 required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.
Upon receiving feedback from the instructor, refine “Section C: Literature Support” for your final submission. This will be a continuous process throughout the course for each section. NUR 699 EBP Section C: Literature Support Example Essay.
Evidence-Based Practice Proposal, Section C: Literature Support
Literature Support – Narrative
Prevention of inpatient falls remains a priority for medical centers across the country. While one should want to have zero falls, it is not a reality. The most commonly reported adverse event in hospitals are patient falls. In the United States, there are hundreds of thousands of patient falls in the hospitals. Of those falls, approximately 30-50% of these events result in injuries (Mitchell, 2015). Eliminating falls is ideal but even with all of the tools and equipment provided, it seems like the work of preventing falls is in vain. Rather than focusing on patients that are at risk of falling, nurses and healthcare workers need to focus on patients that are at risk of injury if they fall. This distinction protects the patients from injury, which is, after all, what every healthcare worker would like to avoid. One tool that has helped in identifying the at risk patients is the Hester-Davis Fall Risk Assessment Scale.
University of Arkansas for Medical Sciences Journal
In the article, ‘Falls and Frailty: Finding Who’s at Risk and Keeping Them Safe (2014),’ Katrina Dupins speaks with Amy Hester, R.N., clinical services manager and Dee Davis, R.N., advanced practice partner about their risk assessment tool, the Hester-Davis Scale. Hester and Davis, who work at UAMS, began looking into falls and falls with injuries in 2010. Together, they developed a tool to assess falls and the risk of falls for patients. The tool that they came up with, not only addresses the patient’s risk of falling, but also includes interventions and care plans as a comprehensive way to prevent falls. NUR 699 EBP Section C: Literature Support Example Essay. The Hester-Davis Scale decreased the falls rates at UAMS by 11 percent, decreased falls with injuries by 60 percent and continue to have decreases in both areas (Dupins, 2014). Not only were they able to save the hospital $1.27 million in costs related to falls, they were also able to save them $330,000 in sitter costs (Dupins, 2014) NUR 699 EBP Section C: Literature Support Example Essay. Through their collaboration, they have created HD Nursing, a business that Amy Hester and Dee Davis began through UAMS BioVentures.
University of Mississippi Medical Center
Cummins wrote, ‘Patient Falls: First Predict, Then Prevent,’ in 2015, which supports use of the Hester-Davis Scale in University of Mississippi Medical Center (UMMC). There are over 900 nurses at UMMC that are dedicated to preventing falls. In March, 2015, they began using the Hester-Davis Falls Risk Assessment Scale (HDS). Based on the nurses’ documentation, the HDS creates an individualized care plan for each patient. This care plan predicts the patient’s risk of falling. Furthermore, the plan includes interventions, like signage, bed or chair alarms, falls mats, etc., that are meant to be tailored to the patient’s needs based on their risk level. After the Centers for Medicare and Medicaid Services rated UMCC a 10 (the worst score) on serious patient complications (based on data that was two years old), UMMC decided to aggressively and proactively work at lowering the falls incidence using the HDS. Prior to implementing the HDS, UMMC was averaging 30 to 40 falls a month (Cummins, 2015), but since use of the HDS, they have had zero falls with injury in four months. UMMC chose the HD Scale because it is proven by research and evidence-based.
Amy Hester and Dee Davis
Amy Hester and Dee Davis wrote about their Hester-Davis Falls Risk Scale in, ‘Validation of the Hester Davis Scale (HDS) for Falls Risk Assessment in a Neurosciences Population (2013).’ Being that the fall risk assessment is an essential component in any falls prevention program, Hester and Davis decided to trial their HDS in a neurosciences population. The goal was to validate the HDS in an acute care setting for falls risk assessment. Using 1,904 patients on a neurosciences unit, the HDS was prospectively validated. The results reflected that, “Using an initial cute score of seven produced a sensitivity of 100% and specificity of 24.9%. Receiver Operating Characteristics Analysis evidenced a cut score of ten that would produce a more desirable sensitivity and specificity of 90.9% and 47.1%, respectively,” (Hester & Davis, 2013). The evaluation and validation of the HDS supported use in clinical practice.
Inpatient Falls Prevention Programs as a Patient Safety Strategy: A Systematic review
Miake-Lye, Hempel, Ganz, and Shekelle, (2013) wrote the article, ‘Inpatient fall prevention programs as a patient safety strategy: A systematic review,’ for Annals of Internal Medicine. This article was written to address the problem of falls in acute care hospitals, which reported a rate of 1.3 to 8.9 per 1000 bed days (Miake-Lye, et al., 2013). Based on their research, they found that using multicomponent interventions can reduce the risk of falls by approximately 30 percent (Miake-Lye, et al., 2013). While this study did not establish a falls bundle, it recommended risk assessments for the patients, staff and patient education, signage and wristband alerts, non-skid footwear, etc. They also found that there are other important factors that affect the success with implementation. These factors include, “leadership support, engagement of the front-line clinical staff in the design of the intervention, guidance by a multidisciplinary committee, pilot-testing the intervention, and changing nihilistic attitudes about falls,” (Miake-Lye, et al., 2013) NUR 699 EBP Section C: Literature Support Example Essay.
Searching is time consuming but it is the only way to complete the project. Terms used during the search process were Hester Davis, Falls Risk Scale, Falls Prevention, and fall interventions. Databases searched were CINAHL and GCU’s library.
In conclusion, there are several reasons that one would want to use another risk assessment tool to identify patients at risk for injury/fall. Nurses and other healthcare providers are tasked with patient safety while patients are hospitalized. However there are other factors that can affect the patient’s risk for falls and injury (i.e., medication, immobility, etc.). Through the implementation of a new falls risk assessment scale and following the care plans, nurses are able to protect their patients from falls and injuries from falls. Safety of the patients is priority. NUR 699 EBP Section C: Literature Support Example Essay.
References
Agency for Healthcare Research and Quality (AHRQ). (2015). New tools help health providers reduce patients’ risk of falls. Retrieved from http://www.ahrq.gov/patients-consumers/patient-involvement/patients-risk-of-falls.html
Agency for Healthcare Research and Quality (AHRQ). (2014). Never events. Patient Safety Network. Retrieved from https://psnet.ahrq.gov/primers/primer/3/never-events
Centers for Disease Control (CDC). (2016). Important facts about falls. Retrieved from http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html NUR 699 EBP Section C: Literature Support Example Essay
Cummins, R. (2015). Patient falls: First predict, then prevent. University of Mississippi Medical Center. Retrieved from https://www.umc.edu/News_and_Publications/Press_Release/2015-02-23-00_Patient_falls__First_predict,_then_prevent.aspx
Dupins, K. (2014). Falls and frailty: Finding who is at risk and keeping them safe. UAMS Journal. Retrieved from http://journal.uams.edu/article/falls-and-frailty-finding-whos-at-risk-and-keeping-them-safe/
Hester, A.L. & Davis, D.M. (2013). Validation of the Hester Davis Scale for fall risk assessment in a neurosciences population. Journal of Neuroscience Nursing. 45(5), pp. 298-305. doi: 10.1097/JNN.0b013e31829d8b44. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24025469
jointcommission.org. (2015). Sentinel event: Preventing falls and fall-related injuries in health care facilities. Retrieved from http://www.jointcommission.org/assets/1/18/SEA_55.pdf
Miake-Lye, I.M., Hempel, S., Ganz, D.A., Shekelle, P.G. (2013). Inpatient fall prevention programs as a patient safety strategy: A systematic review. Annals Intern Medicine, 158(5), pp. 390-396. doi:10.7326/0003-4819-158-5-201303051-00005. Retrieved from http://annals.org/article.aspx?articleID=1656443&utm_medium=referral&utm_source=pulsenews#Discussion
Mitchell, K. (2015). Is zero falls the right target? Retrieved from http://www.ihi.org/communities/blogs/_layouts/ihi/community/blog/itemview.aspx?List=7d1126ec-8f63-4a3b-9926-c44ea3036813&ID=177 NUR 699 EBP Section C: Literature Support Example Essay