Develop a 12-15 slide PowerPoint detailing your evidence-based practice project proposal. Create speaker notes of 100-250 words for each slide. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the topic Resources for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning and an additional slide for References at the end. Be sure to consider your personal demeanor and tone during the recorded presentation

Develop a 12-15 slide PowerPoint detailing your evidence-based practice project proposal. Create speaker notes of 100-250 words for each slide. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the topic Resources for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning and an additional slide for References at the end. Be sure to consider your personal demeanor and tone during the recorded presentation

Develop a 12-15 slide PowerPoint detailing your evidence-based practice project proposal. Create speaker notes of 100-250 words for each slide. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the topic Resources for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning and an additional slide for References at the end. Be sure to consider your personal demeanor and tone during the recorded presentation.

            Falls among hospitalized patients are a crucial health concern for hospitals globally. Falls have negative effects on the health of the patients. Patients are predisposed to health outcomes such as unintended injuries, loss of mobility and productivity, a decline in the quality of life, increased hospitalization costs, and hospital stay. Due to their health effects, falls are considered safety and quality issues in healthcare. Nurses and other healthcare providers are responsible for adopting measures that reduce the risk and prevent falls. Evidence-based strategies such as patient assessment for risk of falls are effective in reducing the risk of falls among hospitalized patients. Despite this, the practice site has not implemented evidence-based interventions to address the problem. As a result, the purpose of this paper is to explore the literature on the effective strategies for fall prevention that can be considered in nursing practice. The PICOT statement for the proposed project is; among elderly patients admitted to the hospital; does the use of accurate fall assessment tools upon triage for fall risk compared to usual care reduce the incidence of falls within eight weeks?

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Search Methods

            The articles for the project were obtained from databases that included CINAHL, EMBASE, MEDLINE, and PubMed. A search of the literature was performed on the databases using keywords that included ‘falls,’ ‘fall prevention,’ ‘fall risk assessment,’ ‘fall risk reduction in elderly,’ and ‘fall prevention in elderly.’ The inclusion criteria for the selected articles was that the articles must have been published over the last seven years to ensure relevance, and focused on falls and fall prevention. The articles must also have been published in the English language.

Synthesis of the Literature

            The literature search yielded seven articles. The first one is the research by McEwan et al., (2018). McEwan et al., (2018) conducted a qualitative study that investigated the determinants of adherence to guidelines by NICE in managing older fallers attending the emergency department. The study involved two emergency departments where 27 episodes of observing healthcare providers interacting with patients aged 65 years and above were done. The patients were identified to have a risk of or presenting with a fall. Interviews were conducted with 30 healthcare professionals with the framework approach being used for qualitative analysis. The results of the study showed that barriers and enablers that included support from senior staff, cross-boundary care, staff education, the definition of falls, organizational factors, staffing, and communication affected adherence to the guidelines. This article supports the proposed project by showing that guidelines for fall prevention in the emergency department are effective. However, barriers to adherence to the guidelines should be addressed for optimum outcomes.

            The other study is that by McCarty et al., (2018), which entailed the identification and implementation of an evidence-based fall-risk assessment tool for use in the emergency departments at Essentia Health. The researchers adopted the Iowa Model of Evidence-Based Practice to Promote Quality Care to guide the process. The adopted tool for use was the Memorial Emergency Department Fall-Risk Assessment Tool (MEDFRAT). The educational session was delivered to nurses in 11 out of 12 emergency departments. The results of the study showed that nurses appreciated their involvement in the project implementation. Resources for tool identification were identified and its implementation was done. The article was included in the review since it provides insights into the effectiveness of fall-prevention tools and the use of the Iowa model in the process to enhance change.

            The other study is the one by LeLaurin and Shorr (2019), which was a review of studies on the prevention of falls in hospitalized patients. The authors explored different studies that have focused on fall prevention in hospitalized patients. The researchers identified that strategies such as the use of tools for fall risk identification, alarms, sitters, intentional rounds, environmental modification, and multicomponent interventions are effective for fall prevention. The article informs the effectiveness of different fall prevention strategies such as risk assessment, hence, its inclusion in this project. Huded et al., (2015) conducted a study that focused on the adoption of a novel nursing program to prevent falls. The program entailed the adoption of a screening tool for identifying elderly patients at high risk of falls and implementing interventions through the geriatric nurse liaison model. The participants included patients aged 65 years and above who were assessed for fall risks by emergency department nurses. The results showed that the risk assessment tool for falls was effective in identifying and facilitating intervention implementation for high-risk falls. This article was included in the review as it demonstrates the effectiveness of risk assessment tools when use in fall prevention among elderly patients.

            The study by Guse et al., (2015) was also included in this review. The study was a randomized controlled trial that aimed at translating a fall prevention program into practice. The program was implemented among adults aged 65 years and above. Those in the intervention group received special resources and guidance on fall prevention and those in the control group did not receive any intervention. The study results showed that those in the intervention group had lower fall injuries than those in the control group. The article was included since it demonstrates the effectiveness of fall prevention programs for elderly populations.

            The study by GZ (2020) investigated the effectiveness of Agency for Healthcare Research and Quality patient falls reduction guidelines in addressing falls. The study was translational research where the guidelines were used to reduce the fall rate. The results showed a significant reduction in the fall rate of emergency department falls. This article shows the effectiveness of the intervention, hence, its inclusion. van Wijck et al., (2019) conducted a mixed-methods study to investigate the unexpected challenges of fall prevention. The study was conducted among patients aged 65 years and above who visited the emergency department. The results showed that unexpected challenges included competing health issues, perception of fall risk, and practical considerations. This article was included because it informs about the issues of focus in fall prevention in healthcare.

Comparison of Articles

            Most of the included articles focus on fall prevention among elderly patients. However, the studies by McEwan et al., (2018) and van Wijck et al., (2019) investigated the factors that affect the effectiveness of the adopted strategies to prevent falls in elderly patients. The studies differ significantly based on their designs. Three of the studies are translational studies (Guse et al., 2015; GZ, 2020; Huded et al., 2015), one qualitative (McEwan et al., 2018), one mixed-methods (van Wijck et al., 2019), literature review (LeLaurin & Shorr, 2019), and a quality improvement project (McCarty et al., 2018). The articles share common themes that fall are preventable and risk assessment is effective in minimizing falls among elderly patients. The studies also differ based on their strengths. For example, the study by Guse et al., (2015) presents highly reliable data compared to other studies due to the randomization of participants and controlled interventions. The articles also differ based on the interventions used to prevent falls among elderly patients. For example, McCarty et al., (2018) focused on MEDFRAT, McEwan et al., (2018) on NICE guidelines and resource support in the study by Guse et al., (2015).

Suggestions for Future Research

            The analysis of the articles demonstrates that most hospitals are yet to conduct studies determining the effectiveness of risk assessment tools in falls prevention. Scarce evidence exists on the effectiveness of risk assessment strategies in the emergency department in preventing falls among elderly patients. The evidence also shows that large studies have not been conducted to determine the effectiveness of risk assessment in fall prevention. The implications include a lack of generalizability of the findings reported in studies to a larger population. Therefore, future studies should utilize a large sample and randomization to determine the effectiveness of risk assessment of elderly patients at the emergency department in reducing falls.

Conclusion

            The literature review shows that programs that aim at reducing patient fall in hospital settings are effective. Interventions such as the use of fall risk assessment tools can be implemented for clinical use in fall prevention. Barriers and facilitators to effective implementation of change initiatives to address falls should be considered. Large, multi-center, randomized studies determining the effectiveness of fall assessment tools will enhance the validity and reliability of their use in patient care.

References

Guse, C. E., Peterson, D. J., Christiansen, A. L., Mahoney, J., Laud, P., & Layde, P. M. (2015). Translating a Fall Prevention Intervention Into Practice: A Randomized Community Trial. American Journal of Public Health, 105(7), 1475–1481. https://doi.org/10.2105/AJPH.2014.302315

GZ, W. (2020). Translational Nursing Science: Implementation of a Patient Fall Reduction Strategy in the Emergency Department at a Community-Based Medical Center. Open Access Journal of Biomedical Science, 1. https://doi.org/10.38125/OAJBS.000148

Huded, J. M., Dresden, S. M., Gravenor, S. J., Rowe, T., & Lindquist, L. A. (2015). Screening for Fall Risks in the Emergency Department: A Novel Nursing-Driven Program. The Western Journal of Emergency Medicine, 16(7), 1043–1046. https://doi.org/10.5811/westjem.2015.10.26097

LeLaurin, J. H., & Shorr, R. I. (2019). Preventing Falls in Hospitalized Patients: State of the Science. Clinics in Geriatric Medicine, 35(2), 273–283. https://doi.org/10.1016/j.cger.2019.01.007

McCarty, C. A., Woehrle, T. A., Waring, S. C., Taran, A. M., & Kitch, L. A. (2018). Implementation of the MEDFRAT to Promote Quality Care and Decrease Falls in Community Hospital Emergency Rooms. Journal of Emergency Nursing, 44(3), 280–284. https://doi.org/10.1016/j.jen.2017.10.007

McEwan, H., Baker, R., Armstrong, N., & Banerjee, J. (2018). A qualitative study of the determinants of adherence to NICE falls guideline in managing older fallers attending an emergency department. International Journal of Emergency Medicine, 11(1), 33. https://doi.org/10.1186/s12245-018-0192-9

van Wijck, S., Rizzo, C., S. Tsegai, N., Raybould, T., & W. Liu, S. (2019). Unexpected challenges to preventing falls in older adults: A mixed methods study of an emergency department-based falls prevention referral pilot project. Health Education and Care, 4(2). https://doi.org/10.15761/HEC.1000158

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The dissemination of an evidence-based practice project proposal is an important part of the final project. Dissemination of your project to a local association or clinical site/practice informs important stakeholders of evidence-based interventions that can improve clinical practice and ultimately patient outcomes.

For this assignment, develop a professional presentation that could be disseminated to a professional group of your peers.

Develop a 12-15 slide PowerPoint detailing your evidence-based practice project proposal. Create speaker notes of 100-250 words for each slide. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the topic Resources for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning and an additional slide for References at the end. Be sure to consider your personal demeanor and tone during the recorded presentation.

Include the following in your presentation:

Introduction (include PICOT statement)
Organizational Culture and Readiness
Problem Statement and Literature Review
Change Model, or Framework
Implementation Plan
Evaluation Plan
Conclusion
You are required to cite a minimum of six peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.