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Evidence Based Practice Project Laura Chestman Walden University Nursing 4100: Quality and Safety Through Evidence-Based Practice August 11, 2018 Week 5: EBP Practice Introduction Research question: What preventative evidenced-based practice nursin $9.49   Add to cart

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Evidence Based Practice Project Laura Chestman Walden University Nursing 4100: Quality and Safety Through Evidence-Based Practice August 11, 2018 Week 5: EBP Practice Introduction Research question: What preventative evidenced-based practice nursin

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Evidence Based Practice Project Laura Chestman Walden University Nursing 4100: Quality and Safety Through Evidence-Based Practice August 11, 2018 Week 5: EBP Practice Introduction Research question: What preventative evidenced-based practice nursing interventions can decrease falls...

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Evidence-Based Practice Paper Week 5 1


Evidence Based Practice Project

Laura Chestman

Walden University

Nursing 4100: Quality and Safety Through Evidence-Based Practice

August 11, 2018

Week 5: EBP Practice

Introduction

Research question: What preventative evidenced-based practice nursing

interventions can decrease falls, resulting in an increase in patient safety in inpatient adult

medical-surgical units?

Falls are a common and serious health problem with devastating consequences. Several

risk factors have been identified in the literature. Falls can be prevented through several

evidence-based interventions, which can be either single or multicomponent interventions.

Identifying at-risk patients is the most important part of management, as applying preventive

measures in this vulnerable population can have a profound effect on public health.

Falls are a major concern for older adults in all settings, causing significant morbidity

and mortality and affecting the quality of life. In the hospital, falls occur at an estimated rate of

8.9 per 1,000 patient days. About 30% to 50% of these falls cause injury. Falls increase hospital

stays and may necessitate a long-term stay (Wexler, S. and D'Amico, C., 2015).

A fall-risk assessment is required for all patients on admission, transfer to a new unit,

after a change in the level of care or the patient’s condition, and after a fall. Because falls have




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, Evidence-Based Practice Paper Week 5 2


multifactorial causes, the healthcare team should collaborate in the comprehensive

assessment. Risk factors for falling include previous falls, balance impairment, decreased

muscle strength, visual impairment, polypharmacy and/or psychoactive drugs, gait impairment,

depression, dizziness, age older than 80 years, female sex, incontinence, cognitive impairment,

arthritis, diabetes, and pain (Al-Aama, T., 2011).

Analysis

Screening patients for a fall risk are the first step to prevention of falls. When screening

patients for fall risk, check for a history of a fall within the past year, orthostatic hypotension.

impaired gait or mobility, altered mental status, incontinence, and sedative-hypnotic

medications. Various interventions have been shown to decrease the risk and the rate of

falls.

Interventions that are proven to prevent falls include home assessment and modification for

highrisk individuals, exercise programs that include strength, gait, and balance exercises, such

as physiotherapy or Tai Chi. Vitamin D supplementation in doses greater than 700 IU/day for

longterm residents (Al-Aama, T. (2011).

It has been shown that age, functional status, fatigue, radiation, surgery, chemotherapy,

endocrine therapy, anemia, nutritional status, and depression were factors associated with

falls. It was found that gender, cognitive status, and medication use were not found to be

predictive of falls (Melin, C. M., 2018).

Other interventions that are likely to be beneficial for prevention of falls include

reviewing the patient's medications; check to see if they are on any psychoactive medications

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